Which diaper practice is appropriate for a newborn with a repaired myelomeningocele?

• A. Securely fastening the diaper
• B. Wrapping the diaper tightly around the legs
• C. Omitting the diaper
• D. Placing a diaper under the infant but not fastened

Answer: (D)

After a newborn’s myelomeningocele repair, protecting the surgical site from pressure, friction, and irritation is essential to promote healing and prevent infection. Placing a diaper under the infant but not fastening it keeps moisture away from the incision and sac without squeezing or pulling on the repair. This approach reduces the risk of constriction or rubbing that could disrupt the incision, while still allowing the diaper to collect urine and stool and be examined if needed.

Securing the diaper tightly or wrapping it around the legs would apply pressure and friction to the repaired area, increasing the chance of irritation or injury. Omitting the diaper altogether would leave skin exposed to moisture and contaminants, raising the risk of skin breakdown and infection. Placing a diaper under the infant but not fastened strikes the right balance between cleanliness and protection of the repair site.