It's advisable to change him especially in the case of nappy rash. After changing, try rocking him or singing to him so that he can sleep. For some babies, swaddling helps too. If u r breastfeeding, latching him helps.
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It is better to change him if he has pooped. Try rocking, patting, swaddling or cuddling him to help him get back to sleep.
it best to change if not it can cause infection or rashes.. after change try pat him to sleep again