Twice every 24 hours. A nighttime diaper change in the morning, and a day time diaper change right before bed. Because I'm in college, and money is pretty tight, I use the cheapest tape-ons I can find at Walmart, and make them last the full day/night. Wet, messy, or otherwise. I developed bed wetting again in the past month, something I think might be a bi-product of wearing pretty much 24/7.