You can change the file size if you wish, but for best results use a size that's square and not less than 50 pixels in height and width.
Then, add your graphics or icons in a slightly different color. To do so, first place the color you wish to use for your icons in the foreground color swatch by either clicking the swatch to display the Color Picker or selecting a color from your Swatches or Color palettes. I like to choose colors that are similar in value for the background and graphics, because if I were to use colors with a high amount of contrast, I would risk making any text placed on top unreadable.
After selecting a color, draw, paint, paste, or otherwise put your graphics on the page. For the diaper pin, I use a special type of font called a dingbat that is really a set of pictures instead of letters. For instance, when you type the letter b using the font called Baby's Blocks from fraternet.com, you get this diaper pin:
OB' UiBUed-1 @i1HKi(... |E3E
You can also draw your own graphics, or paint with one of the many new brushes in Photoshop.
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