The most common approach is to gently grasp both ankles with one hand and lift the baby’s bottom just high enough to slide the diaper in or out. But there’s a better technique that’s easier on your baby’s hips and easier on your wrists: rolling your baby to the side instead of lifting straight up. Both methods work, and the right choice depends on your baby’s age, size, and how much they’re squirming.
The Traditional Ankle-Lift Method
For newborns and young infants who aren’t yet rolling (typically under four months), lifting the legs with one hand is the most straightforward approach. Place your index finger between the baby’s ankles to prevent the bones from pressing together, then wrap your remaining fingers around the outside of each ankle. This gives you a secure but gentle grip. Lift just enough to raise the bottom an inch or two off the surface, not high enough to curl the spine upward.
Keep the baby’s knees slightly bent and let the legs fall naturally apart rather than pressing them together. The International Hip Dysplasia Institute recommends that infant hips stay in slight flexion and abduction, meaning the knees are softly bent and the legs are angled outward, like a frog position. Pulling the legs straight up toward the ceiling or pressing them tightly together puts unnecessary stress on developing hip joints. A gentle lift with relaxed, slightly spread legs is the goal.
The Side-Rolling Technique
Rolling your baby gently to one side instead of lifting both legs is increasingly recommended by pediatric chiropractors and physical therapists. It puts less pressure on your baby’s lower back and hips, supports more natural movement patterns, and can even ease tummy tension in gassy babies. It also saves your own wrists, shoulders, and back from strain, which matters when you’re doing this eight to twelve times a day.
Here’s how it works: unfasten the dirty diaper but leave it in place. Place one hand on your baby’s hip and gently roll them onto their side, toward you. Use your free hand to wipe and then pull the dirty diaper away. Slide the clean diaper underneath, then roll the baby back to center and fasten it. You never need to lift the legs at all. This technique works well at any age, though it takes a bit of practice to feel smooth with it.
Why Hip Position Matters
A baby’s hip joints are still largely made of soft cartilage in the first several months of life. The ball of the thighbone sits in a shallow socket that’s still forming, which makes the joint vulnerable to positioning that forces the legs straight or presses them together. The International Hip Dysplasia Institute is clear that avoiding forced or sustained hip extension in the first few months is essential for proper development. Tightly straightening the legs or yanking them upward can, over time, contribute to instability in that joint.
During diaper changes, this translates to a simple rule: let the legs stay relaxed. Whether you’re lifting or rolling, the baby’s knees should be slightly bent and the legs should be free to splay outward. You don’t need to actively position them in a frog pose. Just avoid pulling them straight or squeezing them together, and the natural resting position of a baby’s legs will do the rest.
Handling a Squirming Older Baby
Once babies learn to roll (around four to six months), diaper changes become a wrestling match. The instinct is to pin the legs down or grip harder, but forcefully restraining a baby tends to make them fight more, not less. A few strategies help.
Give them something to hold. A clean diaper, a small toy, or even the tube of diaper cream keeps hands and attention busy. For babies over six months, handing them a wipe to “help” can turn resistance into cooperation. Singing or making faces works for some babies, though this only buys you a few seconds.
If your baby is constantly flipping onto their stomach mid-change, try placing one hand gently but firmly on their chest or belly while you work with the other hand. You can also try changing them on the floor instead of an elevated surface, which feels less precarious for both of you and gives you the option to use your own body as a gentle barrier on one side.
Standing Changes for Toddlers
By the time your child is a confident stander, you don’t have to hold their legs at all. Standing diaper changes work well for wet-only diapers, especially with pull-up style diapers. Let your toddler stand at a table, look out a window, or flip through a book while you swap the diaper from below. For messier changes, you may still need to lay them down, but asking them to “help” by lifting their own legs gives them a sense of participation. Toddlers who feel like participants rather than patients cooperate significantly more.
Quick Reference for Each Age
- Newborn to 4 months: Ankle lift with finger between ankles, or side roll. Keep knees soft and legs relaxed apart.
- 4 to 8 months: Side rolling becomes easier as the baby gets heavier. Use a toy or object for distraction when rolling starts.
- 8 to 12 months: Floor changes with a hand on the chest for stability. Give them something to hold. Move quickly.
- 12 months and up: Standing changes for wet diapers. Involve them in the process for messy ones.
Whatever method you use, the core principles stay the same: keep a secure but gentle grip, let the hips and knees stay naturally bent, avoid pulling the legs straight up or pressing them together, and work as quickly as you reasonably can. The side-rolling technique is worth learning early, since it scales well from newborn through toddlerhood and is gentler on everyone involved.