How to Use an Underpad: Complete Step-by-Step Guide for Caregivers

Incontinence is one of the most common yet least talked-about health conditions in India. Whether it affects a parent, a spouse, or even yourself, the silence around it can make an already difficult situation feel isolating. Having the right product only helps if you know how to use it correctly. This guide walks you through everything you need to know about using underpads effectively.

What Exactly Is an Underpad?

An underpad is not a diaper. This is an important distinction that confuses many first-time users.

An underpad (also called a bed pad or chux) is an absorbent sheet designed to protect surfaces like beds, chairs, wheelchairs, and furniture from fluid leakage. Think of it as a protective barrier that sits between a person and the surface they are resting on.

Understanding Underpad Construction

Quality underpads feature three essential layers:

• Top Layer (Absorbent Side): The soft, non-plastic side that contacts skin or clothing. It pulls moisture away quickly, keeping the area dry and comfortable.
• Absorbent Core: The middle layer containing fluff pulp and superabsorbent polymers that lock liquid away and prevent leakage.
• Waterproof Backing: The bottom layer made from CPE film that protects the mattress or furniture underneath.

Stay Sure underpads are made with antibacterial virgin wood pulp and CPE film, designed for both postpartum patients and adults managing incontinence.

Who Needs to Use Underpads?

• Adults Managing Incontinence: Underpads provide protection and peace of mind for those facing bladder or bowel leakage due to ageing, medical conditions, or medication side effects.
• Bedridden or Immobile Individuals: For people recovering from surgery or with limited mobility, underpads provide protection without requiring frequent movement.
• New Mothers in Postpartum Recovery: After childbirth, women experience lochia (uterine discharge). Underpads offer excellent protection during the first few weeks of recovery.
• People with Cognitive Conditions: Individuals with dementia or Alzheimer's may not recognise when they need the bathroom. Underpads help manage accidents with dignity.
• Those with Severe Gastrointestinal Issues: During illness or medical treatments causing diarrhoea, underpads protect while the person conserves energy for healing.

Step-by-Step: How to Use an Underpad Correctly

Step 1: Choose the Right Location

Decide where you need protection — beds, chairs, wheelchairs, changing tables, or car seats. Make sure the surface is clean and dry before placing your underpad.

Step 2: Remove and Unfold the Underpad

Take the underpad out of its package. One side feels soft and absorbent; the other has a plastic, waterproof feel. Hold it at the edges and gently unfold it to full size, smoothing out any creases.

Step 3: Position the Underpad Correctly

The soft absorbent side must face UP. The waterproof plastic side faces DOWN against the surface.

• For bed use: Centre the underpad under the hips and lower back. Ensure it covers enough area on both sides to catch potential leakage.
• For chair use: Place the underpad so it covers the seat and extends slightly up the back.

Step 4: Secure the Underpad in Place

• Tucking Method (beds): Tuck the edges under the mattress like a fitted sheet to prevent bunching or sliding.
• Tape Method: For chairs or wheelchairs, use medical tape on the corners of the waterproof side.
• Under or On Top of Sheet: Place under the regular bed sheet for extra comfort, or on top for maximum protection.

Step 5: Help Position the Person

• Gently turn or lift them to one side
• Slide the underpad underneath, positioning it under hips and lower back
• Smooth out any wrinkles to prevent discomfort
• Help them settle back comfortably, centred on the pad

How to Change a Soiled Underpad

When to Change

Change the underpad immediately when it becomes soiled or wet, when you notice odour, when the person reports discomfort, or after any incontinence incident. For regular incontinence, change 3 to 5 times per day. For nighttime use, change first thing in the morning.

The Changing Process

Gather supplies first: fresh underpad, disposable gloves, cleansing wipes, barrier cream, plastic bag for disposal.

Remove the soiled underpad: Gently turn the person to one side. Pull the underpad away, folding it with the soiled side inward. Place in a plastic bag or bin.

Clean and dry the skin: Use gentle wipes or a damp cloth. Pat completely dry — never rub. Apply barrier cream if needed and allow a moment for air drying.

Place the new underpad following the same steps as above. Make sure it is smooth and properly positioned before helping the person settle back.

Dispose properly: Seal the used underpad in a plastic bag to contain odour. Place in regular trash — never flush underpads. Wash hands thoroughly.

Underpads vs. Adult Diapers: Understanding the Difference

Underpads work better when the person spends most of their time in one location, is bedridden or has limited mobility, finds diapers uncomfortable, or is at home where changing is convenient.

Adult diapers work better for active individuals who move around, people who leave home regularly, situations with limited bathroom access, or times when immediate changing is not possible.

Best approach: use both together. The diaper catches most accidents while the underpad provides backup protection for your mattress. This two-layer approach gives complete peace of mind — especially at night.

How to Choose the Right Underpad

Size Guide

• Small (17" x 24"): Best for sitting users, chair protection, and travel
• Medium (23" x 36"): Best for standard bed use and most adults
• Large (30" x 36" or bigger): Best for people who move during sleep or need maximum coverage

Absorbency Guide

• Light: Minor occasional leakage, frequent daytime changes
• Moderate: Regular incontinence, most daytime situations
• Heavy: Severe incontinence, overnight use
• Maximum/Overnight: Very heavy nighttime incontinence, 8+ hours of wear

Preventing Skin Problems When Using Underpads

• Change promptly — never leave someone on a soiled underpad longer than necessary
• Clean gently — use pH-balanced cleansers or warm water, avoid harsh soaps
• Dry thoroughly — pat (do not rub) the skin completely dry, paying attention to skin folds
• Use barrier cream — apply a thin layer to protect skin from moisture
• Allow air circulation — give skin a few minutes to breathe when changing
• Check skin regularly — look for redness, warmth, or texture changes early

Common Mistakes to Avoid

• Wrong side up — the soft absorbent side must always face UP
• Choosing only on price — poor quality underpads leak more and cause skin irritation
• Using the same underpad too long — change promptly when soiled to protect skin
• Wrong size — too small leaves gaps; too large bunches up and causes discomfort
• Not smoothing wrinkles — creases become pressure points that reduce effectiveness

Frequently Asked Questions About Underpads

What is the correct way to place an underpad on a bed?

Place the underpad with the soft absorbent side facing up, centred under the hips and lower back. Tuck the edges under the mattress to prevent sliding. Make sure there are no wrinkles before the person lies down.

Can underpads be used with adult diapers together?

Yes — and this is the recommended approach for heavy incontinence. The adult diaper catches most leakage while the underpad protects the mattress or chair. Together they provide the most complete protection, especially overnight.

How often should underpads be changed?

Change underpads immediately when soiled. For regular incontinence, this typically means 3 to 5 times per day. Always change first thing in the morning after nighttime use.

Are underpads safe for sensitive skin?

Yes, when made from quality materials. Stay Sure underpads use antibacterial virgin wood pulp which is gentle on sensitive skin. Always change promptly when soiled and apply barrier cream to prevent moisture-related skin irritation.

What size underpad do I need for a standard bed?

A medium underpad (approximately 23" x 36") is suitable for most adults using a standard single or double bed. Choose large (30" x 36" or bigger) if the person moves a lot during sleep or requires maximum coverage.