Reusable Cloth Diapers vs. Single use Disposable Diapers
The battle between reusable cloth diapers and single-use diapers is heating up once again. In the 1955 virtually every baby in the United States was diapered using cloth diapers. In 1961, Proctor & Gamble introduced Pampers, a single-use diaper. In 1991, approximately 90% of babies in the United States were diapered using single-use diapers3. Coincidentally, the occurrence of diaper rash has increased from 7% in 1955 to 78% in 19913.
Many parents are taking a hard look at the many health and developmental, environmental, and economic advantages cloth diapering has over single-use diapers. This section provides information which supports the position that cloth diapering is clearly superior to single-use diapering in each of these areas. Additionally, this section discusses other considerations such as convenience and practicality.
Health and Developmental Issues
"Dry" does not mean "clean"
The multinational corporations who manufacture single-use diapers have misled the American consumer to believe that as long as a baby is dry, that they are clean. The urine in a wet diaper breaks down into ammonia and is a breeding ground for harmful bacteria regardless of how dry it feels.
Whatever kind of diaper you use, cotton or disposable, babies should be changed often… about every two hours! Bacteria begin to form as soon as a child wets or soils, and leaving a diaper on a baby for prolonged periods can not only produce irritation and rash but may compromise the skin to the point of serious infection. The chemical dryness of single-use has produced a great lowering of standards in baby care because parents are led to believe that as long as the diaper feels dry, it's all right to leave on. It isn't. Dry does not mean clean, and the urine absorbed by the chemicals used in single-use diapers stays right next to a baby's skin. (As do feces, which are a tremendous breeding ground for noxious bacteria.) Chemicals are not a substitute for the attention babies need, and "set-and-forget" diapering is not healthy.
Another area of concern are the toxic chemicals present in most single-use diapers. Nearly all single-use diapers use sodium polyacrylate to absorb moisture. Sodium polyacrylate is the same sort of substance that was used in Rely tampons in the mid-1980s4. Many consumers notice clear beads of gel on their baby's genitals after a diaper change. This material is sodium polyacrylate.
An additional serious concern is the risk that dioxin, a by-product of the paper-bleaching process, may exist in single-use diapers. Dioxin in various forms has been shown to cause cancer, birth defects, liver damage, and skin diseases.5
Disposable diapers linked to asthma6
Harsh perfumes and chemical emissions have long been known to induce asthma-like symptoms in children and adults. Now, researchers have found that disposable diapers might be a trigger for asthma.
A study published in the October, 1999 issue of the Archives of Environmental Health found that laboratory mice exposed to various brands of disposable diapers suffered increased eye, nose, and throat irritation, including bronchoconstriction similar to that of an asthma attack. Six leading cotton and disposable diaper brands were tested; cloth diapers were not found to cause respiratory problems among the lab mice.7
Dr. Rosalind C. Anderson, lead author of the report, "Acute Respiratory Effects of Diaper Emissions," explains that the diapers were tested right out of the package, and one at a time. Even in a mid-sized room, the emissions from one diaper were high enough to produce asthma-like symptoms. Solvents and other substances are typically added to products during the manufacturing process in order to affect malleability and other properties, Dr. Anderson explains. "Even if you don't want these chemicals in the final product, it's hard to take them out. We are finding chemical off-gasses in all sorts of baby products besides diapers, including baby mattresses and mattress covers," she says.
What chemicals were released from the diapers- Tolune, xylene, ethylbenzene, styrene, and isopropylbenzene, among others. Dr. Anderson says these, like certain scents, are bronchial irritants. "It's similar to when asthmatics smell perfume and all of a sudden their chests get tight." Although mice are much smaller than humans, they were chosen for the study because their physiology and biochemistry are similar to that of humans. Of the brands tested, three diaper brands were found not to affect the breathing of the lab mice: American Fiber and Finishing Co., Gladrags organic cotton diapers, and Tender Care disposable diapers.
Further study is needed to determine what level of diaper chemical emission triggers infant respiratory distress. In the meantime, Dr. Anderson advises asthmatic mothers to avoid exposure to these chemicals, and to be mindful of the fact that their children may be sensitive to these and other asthma antagonists such as dust mites, roaches, and smoking. Asthma rates are on a sharp incline in the US and worldwide, particularly among poor and inner-city children.
Increased scrotal temperature in single-use diaper may lead to male infertility8
The increased use of single-use diapers may explain the increase in male infertility over the past 25 years, suggests a study in the Archives of Disease in Childhood. The research shows that single-use diapers lined with plastic significantly increase the temperature of the scrotum when compared to the scrotal temperature of boys using cloth diapers. Temperature is critical to normal testicular development and sperm health.
The researchers monitored the scrotal temperature of 48 healthy boys, including five premature babies, from birth up to the age of 55 months, using a tiny, non-invasive thermal probe. The study ranged over two 24-hour periods. During one of the periods the boys wore reusable cotton diapers; during the other, they wore plastic-lined single-use diapers. Temperature was measured during waking and sleeping hours; and rectal temperature was also measured for comparison.
The study shows that scrotal temperature, which closely reflects testicular temperature, is increased in boys wearing single-use plastic-lined diapers. The mean difference in scrotal temperature between the two ranged between .6°C and 1.1°C (1.1°F and 2.0°F). The authors of the study conclude that the insulation properties of the single-use diapers impaired normal testicular cooling mechanisms and in 13 of the boys studied, the cooling mechanism failed altogether.
In adults, it has been shown that exposure to high temperatures can reduce sperm count in adult males. The subsequent risk of adult infertility in boys whose testicles fail to descend at the normal age is thought to be attributable to increased testicular temperature. The authors of the study conclude that a prolonged increase in scrotal temperature in early childhood may therefore have an important role in subsequent testicular health and function, with implications for male fertility.
Manufacturing and Disposal
An estimated 18 billion single-use diapers are thrown in landfills each year, taking as many as 500 years to decompose, and commonly contain raw, untreated sewage. Disposable diapers make up the third largest source of solid waste in landfills, after newspapers and food and beverage containers9. It takes upwards of 82,000 tons of plastic and 1.3 million tons of wood pulp, or a quarter-million trees, to manufacture the disposable diapers that cover the bottoms of 90 percent of the babies born in the US10.
The negative impact of single-use diapers on the environment goes far beyond the disposal problem. A study prepared by The Landbank Consultancy for The Women's Environmental Network shows that single-use diapers use 3.5 times as much energy, 8 times as much non-regenerable raw materials, and 90 times as much renewable material as cloth diapers11. In a world with an expanding population and increasingly limited available resources, the need for conservation in day-to-day activities becomes much more evident.
A report written by Carl Lehrburger, Jocelyn Mullen, and C.V. Jones concluded in part "Single-use diapers are shown to generate significantly more solid waste, to consume greater quantities of energy and raw materials, and to generate more potentially toxic pollutants on a per-diaper-change basis."12 The report continues "Considering the overall environmental burdens, and most notably the higher volumes of solid waste produced and energy and raw materials consumed by single-use diapers, reusable diapers are determined to be superior from an environmental perspective."12
Lehrburger concludes in another report "The conclusions of this study are that in light of dwindling landfill capacity, growing waste disposal costs and potential public health concerns, the use of reusable cotton diapers should be encouraged over single-use diapers, and the elimination of single-use diapers going to landfills is a desirable and reasonable public policy objective."13
Single-use diapers are, as their name implies, used once, then discarded. They are almost always sent to landfills or incinerators, never reused and almost never recycled. In contrast, the average cloth diaper is used between 100 and 150 times as a diaper, and then retired. Retired cloth diapers are in high demand and have a second lifecycle as rags for detailing shops, window washing services, janitorial services, piano retailers, and assorted other businesses where soft, lint-free rags are needed.
Whether using cloth or single-use diapers, a baby should be immediately changed after it wets or soils a diaper. Based on this fact, the average infant should be changed approximately 70-80 times per week. Below is a comparison of the costs of single-use and a cloth diaper service:
Figure 1: Comparison of Weekly Cost
Cloth Diaper Service15
30 diapers per week
40 diapers per week
50 diapers per week
60 diapers per week
70 diapers per week*
80 diapers per week
90 diapers per week
100 diapers per week
* Average number of diapers per week for newborns
Some may argue that single-use diapers don't need to be changed as often as cloth, which justifies their higher cost per diaper. We strongly disagree. Leaving a baby in a soiled diaper, whether it is cloth or single-use, is an open invitation for diaper rash and other problems. A baby's diaper is not meant to be used as a septic tank.
Many parents who use single-use diapers think nothing of spending $15 or $20 on diapers when they shop for groceries, which quickly gets hidden in the total grocery bill. When this hidden cost is revealed, and the cost of additional diapering because of delayed potty training, it becomes immediately apparent that cloth diapering is far less costly than the total cost of single-use diapers.
Figure 2: Comparison of Total Cost
Cloth Diaper Service15
24 Months (104 weeks)
36 Months (156 weeks)
48 Months (208 weeks)
The chart above assumes an average of 70 diapers per week throughout the diapering period, with stable pricing for both single-use diapers and cloth diaper service ($39.90 per week for single-use diapers, $17.50 per week for cloth diaper service as shown in the previous chart). Clearly, when compared diaper for diaper, cloth has an indisputable economic advantage over single-use diapers. When you consider the fact that most babies diapered using cloth diapers are toilet trained up to a year earlier, the economic advantage of cloth is even more dramatic.
Convenience and Practicality
Things have changed since 1955
The large multinational manufacturers of disposable diapers have been successful at convincing uninformed consumers about how easy using single-use diapers is. However, they neglect to mention how cloth diapering has progressed since the folding and pinning of the 1950s. Modern cloth diapering now gives you the option of using diaper wraps which secure the diaper in place with Velcro fasteners, and make pinning and extensive folding unnecessary.
As mentioned earlier, the average babies wearing cloth diapers are toilet trained at 24-30 months, while the average age for babies wearing single-use diapers is 36-42 months. This not only has obvious economic implications, but it is highly significant for your baby's development. Toilet training is an important step on the way to increased competence, confidence, and sense of self. Having an estimated one year less of diapering is a real convenience that the single-use diaper manufacturers can't match.
To Sum it All Up
There is a noticeable increased awareness and interest in cloth diapering as a viable alternative to the short-sighted and wasteful practice of using single-use diapers. This article and its references demonstrate that cloth diapering holds clear and significant health and developmental, environmental, and economic advantages over single-use diapering. Additionally, the convenience of modern cloth diapering rivals the convenience of single-use diapers, particularly when a diaper laundering service is used.
For further information, contact the National Association of Diaper Services on the Internet at firstname.lastname@example.org.
1 The New York Times, January 12, 1999
2 The Wall Street Journal, May 4, 1993
3 Journal of Pediatrics, 1959, Vol 54 pp. 793-800 "Relationship of Peri-Anal Dermititis to Fecel pH" by Drs. Tamio, Steiner, Benjamin
Clinical Pediatrics, May 1991, Vol 30 Department of Internal Medicine & Pediatrics, Loyola University Medical Ctr.
Newborn Chemical Exposure from over-the-counter Skin-Care Products by Drs. Cetta, Lambert, & Ross
4 Judy Braiman-Lipson, Empire State Consumer Association, Rochester, NY.
5 EPA, "Integrated Risk Assessment for Dioxins and Furans from Chlorine Bleaching in Pulp and Paper Mills."
6 Reprinted by permission of Mothering, Issue 98, www.mothering.com
7Anderson, Rosalind, and Julius Anderson. "Acute Respiratory Effects of Diaper Emissions," Archives of Environmental Health, 54, October 1999.
8 Partsch, Aukamp, and Sippell. "Scrotal temperature is increased in disposable plastic lined nappies." Division of Pediatric Endocrinology, Department of Pediatrics, Christian-Albrechts-University of Kiel. May 2000.
9 EPA, "Positive Steps towards Waste Reduction," June 1989
10 Rhode Island Solid Waste Management Corporation.
11 The Landbank Consultancy Limited, "A Review of Proctor & Gamble's Environmental Balances for Disposable and Re-usable Nappies" July 1991
12 Leherburger/Mullen/Jones, "Diapers: Environmental Impacts and Lifecycle Analysis," January 1991
13 Carl Leherburger, "Diapers in the Waste Stream: A Review of Waste Management and Public Policy Issues"
14 Kmart.com, April 3, 2004, Huggies® Ultratrim, size M, 14-pack, $7.98 plus tax
15 TideeDidee.com published rate schedule as of September 1, 2004, infants to regular size