The great diaper debate continues
Monday, March 01, 2004
Parents still ponder: cloth vs. disposable By Laura BayardPhotos by Josh Hawkins Gabriella Jackson-Olson, 23 months, of Oak Forest, makes her own study of cloth vs. disposable diapers.
Kristine Greiber never even considered what kind of diapers to use for her son, Soren, now 2½. No question, cloth was the way to go.
"I feel awfully strongly about the fibers he has in contact with his body," says Grieber of Chicago. "I've had a very good experience. I feel very pleased to be putting that type of cloth against his skin."
The days of sloppy cloth diapers and poking babies with pins in the bottom are long gone. Covers with velcro tabs to hold the diapers have been around for more than 15 years.
"It's so easy," Grieber says.
Web sites, such as www.barefootbaby.com, offer advice on washing and buying the right type of cloth. "We're at a point in our society where we have never had it more convenient," she says.
Still, the vast majority of American families today use disposable diapers and most pediatricians recommend them. A spokesperson for Procter & Gamble, the manufacturer of Pampers, says more than 95 percent of parents use disposables. With busy schedules and homes where both parents work, most parents choose the convenience of disposables.
There is no doubt, cloth takes extra effort and time. To keep away diaper rash, you need to change the baby more often. And then, there is the washing. It used to be easy to get someone to do that for you-a diaper service. But diaper services are few and far between since many did not survive the rise of disposables.
Tonya Conde, whose Bottoms Up Diaper Service has about 400 customers in northern Illinois and southern Wisconsin, says a hectic lifestyle is one reason parents cancel their diaper service. More mothers working outside the home than ever before means more kids in daycare, where cloth is usually not acceptable, for both health and convenience purposes. 18 billion diapers While most people use disposables, there is still a committed minority of parents who believe the benefits of cloth far outweigh any alternative.
"Anything disposable is horrible and we should be outlawing disposable diapers," jokes Dr. Toni Bark, a pediatrician and owner of Plan it Green, a center for health and the environment in Evanston. Actually, Bark tells her patients, "To use cloth as much as they possibly can."
"It doesn't just happen that you can put things out in nature and they won't have an effect," says Ken Dunn, Greiber's husband and the director of the Resource Center, a non-profit Chicago environmental organization. The pro-cloth side argues 18 billion diapers are dumped every year and each of those diapers can take anywhere from 200 to 500 years to biodegrade, depending on the type of landfill.
But Paul Reusch, an environmental engineer with the U.S. Environmental Protection Agency says diapers do not come close to stacking up against all the other garbage Americans produce. A 2000 EPA study reports we throw away 3.3 million tons of infant diapers and adult incontinence products annually, but that accounts for only 1.4 percent of total waste generated. Diaper waste is dwarfed by the 86.7 million tons of paper products tossed into landfills each year. And, Reusch adds, since disposables have only been around for about 30 years, no one knows for sure how long they'll take to biodegrade.
"I don't go along with any of those long-term degradation studies," he says. "It is difficult to get real world experience." There is also a concern that untreated yucky stuff in diapers could contaminate the air and ground water. Dunn says diaper waste is getting into the environment, but even he is not as worried about that as he is about more dangerous chemicals we throw out. "The long-term effects of these [diaper] pathogens are minimal compared to hazardous organic compounds that are common in solid waste," he says.
Proponents of disposables have jumped into the environmental argument, saying washing cloth diapers causes just as much harm to the environment as disposables because of energy and water usage.
"I don't believe that argument at all," says Greiber. "I think that is some myth that has been perpetuated by Pampers."
Best for baby's bottom The impact diapers have on the environment is not sending most parents running to the store to stock up on cloth. "I think it would take something big," says Greiber. "It's not going to be enough that it is harmful to the environment."
That something big could be the baby's health. The pro-cloth side argues cloth is much better for a baby's skin. According to Conde of Bottoms Up Diaper Service, cloth keeps a baby's bottom cooler and more comfortable. Some pro-cloth people even refer to a German study that says disposables lead to fertility problems in males, a claim the American Academy of Pediatrics dismisses.
At the center of the healthy diaper debate is a dry, bead-like substance that turns into a gel when it gets wet. The gel, which is also found in many feminine hygiene products, pulls water away from the skin, keeping the baby's bottom dry.
The cloth advocates say studies have shown the gel contains untested chemicals that are potentially harmful to infants. Bark says studies show the chemicals can cause maladies including headaches, asthma or even DNA damage. And the fact that these chemicals are so close to an infant's skin only exacerbates the problem. "Skin is a much better transport medium than the digestive tract," she says. w
Both the American Academy of Pediatrics and the EPA, however, say the gel is completely safe for both adults and children.
"That [absorbent gel material] made a major advance in decreasing the instances of diaper rash," says Dr. Alfred Lane, professor of dermatology and pediatrics at Stanford University Medical Center. Lane, who has completed many studies on diapers, says cloth is much more likely to cause rashes because a baby's skin does not stay dry.
"Most of the kids we see now are in [disposable] diapers," he says. "The thing that has been amazing to me is that I used to see one or two diaper rashes a week. Now I see one or two a year."
Still, he does not discourage using cloth diapers.
"That's fine if that's what they want to do," Lane says. "But if they use cloth diapers, they really have to change them frequently."
Other pediatricians do recommend against cloth. Dr. Anthony J. Mancini, an associate professor of pediatrics and dermatology at Northwestern Medical School and Children's Memorial Hospital, says most pediatric dermatologists agree that cloth is more likely to cause diaper rash.
"I always tell parents to stick with disposables," Mancini says. "No question, the [absorbent gel] technology is far superior to cloth diapers."
Making a choice The list of concerns goes on and on and neither side is budging. All said, the diaper debate boils down to a parent's preference. But, for new parents trying to decide which way to go, be careful when examining the information and keep a look-out for distorted facts.
For example, numerous pro-cloth articles and Web sites cite a 1997 Procter & Gamble study, claiming it shows the incidence of diaper rash increases from 7.1 percent to 61 percent with the use of disposables. In reality, the study, which examined the occurrence of diaper rash for 10 years in babies wearing cloth and various disposables, found just the opposite-the percentage of infants without diaper rash decreased by about 55 percent.
And you have to bring a skeptical eye to any study commissioned and paid for by diaper manufacturers since you can't be sure if the research is independent.
If all else fails, some suggest parents use a combination of both cloth and disposable. When disposable is more convenient, go ahead and use it. Experiment with the two; if one gives the baby diaper rash, switch to the other. Find out what works best for your baby.
"I think households should not feel they have to be purists," says Dunn. "There are occasions where we are willing to take the extra burden of putting diapers in landfills."
Bare it all: No diapers At 25 days old, Deborah FioRito's daughter Isabella began to experience terrible diaper rashes. After trying with no luck, several over-the-counter ointments and even mixtures of products, FioRito of Addison, tried holding her infant daughter over the toilet.
"Out of necessity to protect her [daughter's] skin, she picked up on cues when her daughter goes to the bathroom," says Dr. Thomas DeStefani, the FioRitos' pediatrician and the chairman of pediatrics at Loyola University.
At only 3 months, Isabella, now 6, only had bowel movements over the toilet. "If introduced at such an early age, they only know to eliminate in the toilet," says FioRito. "You get to know the difference between the cries, and if they need to eliminate, you take them to the toilet."
This method not only takes time and patience but is also controversial. Many developmental experts believe this is too difficult to be tried by most parents because you need to be with a child constantly and pay very close attention to the child. If not, both the parent and child can become easily frustrated.
Last April, FioRito and her husband, Dan, released their video, "Toilet Training Begins at Birth," based on their experiences toilet training their children, Isabella, Sophia, 3, and Danny, 2. (Their youngest daughter, Helena, was born in October.)
The video, which sells for $19.95 at www.completechildinc.com and at www.littleredrobin.com, teaches parents how to recognize nonverbal cues that their baby needs to go to the bathroom, including grunts and groans. "It becomes part of your daily routine," says FioRito. "After 5 months there is no need to put a diaper on the child." She says that by 15 months, most children will not even have to wear a diaper at night.
The "Toilet Training Begins at Birth" method advocates using only cloth diapers, which help a child toilet train much earlier. "It [a disposable diaper] pulls the wetness away from the children's skin," says FioRito. "You are training your child to be diaper trained."
According to DeStefani, the average age at which toilet training begins increased with the growth of disposables.
"As a result of the convenience of disposable diapers, there was less motivation to bother to not soil diapers," he says.
Since its release, the FioRitos have sold about 200 copies. DeStefani, who endorses the video, is trying to coordinate a research study to convince the medical community the method works. Although he says the method "may only be for some people" because it requires much attention and patience from parents, he adds, "I have yet to see a downside. The majority of folks get a response."
Surprising diaper facts
Fish carcasses in diapers Srinivasan Damodaran, food science professor at the University of Wisconsin-Madison, found a way to use proteins taken from fish parts to create an absorbent hydrogel for disposable diapers, instead of the synthetic material now used to pull all that stuff away from your baby's bottom. Although original research involved soy proteins, Damodaran switched to studying fish in response to an overpopulation of carp in Wisconsin's lakes.
The hydrogel can absorb 15 to 20 times its weight in body fluids. But best of all, "it is totally biodegradable," Damodaran says. "Within three weeks, it will be completely chewed up by microorganisms in the soil."
But don't expect fish in your baby's diapers anytime soon. Damodaran says the technology still needs to be developed before it is ready.
Can't make up your mind? Tushies Diapers (www.tushies.com) offers an alternative-gel-free disposable diapers. According to Tushies chief executive officer, Edward Reiss, the natural cotton-blend diapers have no chemicals, which means not only do chemicals stay away from baby's skin, they also stay out of the environment. Before owning the company, Reiss' daughter suffered from severe diaper rash, which he says was a reaction to the synthetic absorbent gel in regular disposables. "I bought the diapers and the rash went away in three days," Reiss says.
Diapers fighting fires In 1993, Florida firefighter John Bartlett helped put out a common trash fire. "In mopping up after the fire and making sure everything was out, we noticed what looked like white tissue paper," he says. "Everything else was charred and blackened."
That white tissue paper was actually a wet disposable diaper. Because the absorbent gel inside the diaper can soak up a large amount of water, it was the only piece of garbage saved from a fiery fate. Bartlett developed a liquid gel, similar to the absorbent material in diapers. The gel, known as Barricade, is sprayed on houses to prevent them from being burned in wild fires. Most recently, Barricade was used in the California fires this past fall, says Bartlett.
Reusing diapers If you are worried about diapers piling up in landfills, Knowaste thinks it has the solution. Using a process to wash, sanitize and extract wood pulp and plastic from used disposables, Knowaste can recycle them. The original factory opened in 1999 in the Netherlands and has been popular in the European market, says a spokesperson for the company. Plans call for expansion to the United States, and Knowaste recently completed a nine-month test run in California. The materials they extract from diapers go into air filters, shoe insoles, wall paper, plastic decking and plastic roofing.
Laura Bayard is a student at the Medill School of Journalism at Northwestern University and a former Chicago Parent intern who is currently studying in Paris.