Cloth vs. Disposables, Once and for All

Dear Mamas,

I am so tired of this topic I could SCREAM! The women in my playgroup spend endless hours arguing the virtues of cloth vs. disposable diapers and I need info from an authoritative source to put an end to it. It seems like the debate is about more than how we deal with pee and poo — it has taken on a moral tone. PLEASE weigh in and help me end the discussion!

What I need to know is: 1) Are there any health risks/benefits of either option? 2) Is there a definitive environmental advantage of one over the other? I’ve heard so many conflicting opinions and frankly I’m sick to death of it! Please save me from the torment.


Dear Jessie,

Thanks so much for this probing question. Fact is, it’s not as easy to answer as you might think. If you ask 10 parenting gurus (or 10 moms, for that matter) about this hot-button issue you’ll get 11 different answers. I agree there’s an undercurrent of judgement surrounding the debate that doesn’t make it any easier.

The challenge of the diaper years is keeping baby’s skin as dry, healthy and free from diaper rash as possible, and there’s more than one way to accomplish this. Rashes are usually caused by one or more of the following: prolonged wetness, lack of air circulation, soap, chemical and dye allergies, ammonia formed by bacteria that sits against the skin and the growth of microbes in the diaper area.

There have been concerns expressed about the chemicals used to make the super absorbent gel (sodium polyacrylate) and dyes and bleaches used to process the paper products in disposables. Some believe they increase the risk of severe rashes and may be absorbed by infant skin causing consequences we won’t know for years.

Others worry about cloth diapers, which don’t wick wetness away from the skin like disposables and can cause more irritation and a friendly culture medium for microbes.

The best way to prevent diaper rash is to change diapers, cloth or disposable, frequently to keep skin dry. And it goes without saying that you should never leave a poopy diaper on any longer than absolutely necessary.

There has been much debate over the impact of disposable diapers and cloth diapers on the environment.  The pro-disposable diaper advocates say that the extra water and detergents used to wash cloth diapers is just as damaging as the production and waste of disposable diapers. Here are the numbers:

It takes around 80,000 pounds of plastic and over 200,000 trees a year to manufacture disposable diapers for American babies alone. They account for at least 5 million tons of untreated biological waste, paper and plastic added to landfills each year, or about 2.5% of the total.

But cloth diapers have problems, too. The Natural Resources Defense Council considers the issue a wash when it comes to disposables in a landfill versus reusables in the laundry. Environmental scientists claim there is no compelling green argument for getting rid of disposables in favor of reusables.

Last, but not least, is the issue of convenience. Disposables have long been considered the easier choice, but as cloth has become more popular there are newer and better ways to package it. Velcro has replaced the pin ordeal, and cute covers that are easy to clean come complete with a pre-sewn pocket to hold the nappy.

Bottom line: this is a matter of personal preference — yours and baby’s. If your kiddo has sensitive skin and does better with one than the other, there’s your answer. Otherwise think about how the variables rank in importance for you and rest easy with your choice. It’s not about world peace or a cure for cancer, and in a couple of years you’ll be so focused on getting him toilet trained you won’t give a hoot, and the women at playgroup will have moved on to the virtues of standing vs. sitting to pee.

The choice is yours.


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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?

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