I've never had it be an issue, dirty diapers need to be changed - doesn't matter where. As for the kids they learn pretty quick to stay still until I say it's ok to go play again. I'm not lifting 25-30lbs kids to get changed....my back wont take it! and it's my luck that all the kids I have are "chunky-monkeys".....even the 10ms old is already 24lbs!
I always use a change pad...to protect from 'spills' and wipe it down afterwards.



































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