Thinking of cloth diapers

The last few weeks I have been obsessing reading everything I can about cloth diapers. It gets addictive. There is a lot written on the subject. There are videos, tutorials, user reviews and contradicting recommendations all over the place. Making a decision is not easy, given that I have next to no experience on babies and there is just so much choice and confusing terms involved.

I started looking into cloth diapers because I was shocked to hear of the environmental impact of disposable diapers. A disposable diaper can take around 500 years to decompose in the landfills and a single baby contributes around 1 ton of waste in disposable diapers to the landfills (1). That's not even taking into consideration that: "disposable nappies use 3.5 times as much energy, 8 times as much non-regenerable raw materials and 90 times as much renewable material as reusable nappies. They produce 2.3 times as much waste water and 60 times as much solid waste, and require between 4 and 30 times as much land for growing natural materials as reusable nappies." (2)

There are also public health concerns. Taking into account that more than 100 different enteric viruses, including polio and hepatitis (from vaccines) are known to be excreted in human feces and that these viruses can live for months after the stool has passed from the body; and knowing that even when the World Health's Organization advocates for adequate disposal of human excreta (via the sewage system)  and product labels instructing consumers to empty the feces into the toilet before disposing of the diaper are not commonly followed: human excreta entering the waste stream via disposable diapers pose potential health risks to sanitation workers and threaten to contaminate groundwater if landfills are not properly constructed. (3)

Then there are health concerns as well. Here, the opinions and research seem inconclusive, but there appears to be unanimity among cloth-diaper users saying that babies who are cloth-diapered are less prone to diaper rash, or (anecdotal) experience of parents associating diaper-rash with disposable diapers when they have temporarily switched from one type to the other. This seems intuitive to me as the super-absorbent chemicals present in disposable diapers would tend to excessively dry the baby's skin, making it more prone to irritation. And because disposable diapers are so good at gelifying, the baby would tend to stay longer periods of time in a soiled diaper.  The increased incidence in diaper rash in the last 50 years (from 7% to 78% ) seems to coincide with the massive use of disposable diapers (4). A study published in The British Journal of General Practice (5) found the type of diaper worn as a highly significant possible causal factor for nappy rash in a regression model. The same study found that disposable diapers give little protection against nappy rash and encouraged parents to use cotton diapers, natural fibers being gentler on the skin. Yet another study (6) found that in baby boys, scrotal temperature (a reflection of testicular temperature) is increased in disposable plastic lined nappies. The mean scrotal temperature was significantly higher in all age groups during the periods of plastic nappy use than with cotton nappies (p < 0.001). Because scrotal hypothermia is an important factor for normal spermatogenesis, this increased testicular temperature in early childhood could be an important factor contributing to the decline of male reproductive health observed in recent decades. Further research is needed, though, to establish the impact of increased testicular temperature in infancy on later spermatogenesis. My (humble) knowledge of microbiology leds me to hypothesize that higher temperatures can also have an impact on bacterial growth while the diaper is on (but that's just me speculating). Then there is also the possibility of dioxin exposure. A study (7) (that was however performed in mice) reported that some types of disposable diapers emit mixtures of chemicals that are toxic to the respiratory tract and concludes that disposable diapers should be considered as one of the factors that might cause or exacerbate asthmatic conditions. As a side note, people also report less "blowouts" and explosions when using cloth-diapers, because they are supposedly able to contain the mess inside better.

And finally, there is the economic factor. Over 2 years, the cost of disposable diapers will range from  €1200 to €2000 depending on the brand, whereas with cloth diapers, taking into account the initial investment (€350 to €500) for 25 diapers and the costs of water, energy and detergent over 2 years, the total spending would amount to approx. €850, only for 1 kid. If the cloth diapers live up to a second child, the savings would be even greater. If anyone is interested, we made an Excel sheet to calculate all this, so let me know and I'll email it to you. You should be able to introduce your own values and make a comparison according to your specific situation (water / energy / diaper costs). We considered washing the diapers every 1.5 days and line/sun drying them.

Environmentally speaking you could argue that washing the diapers involves a lot of energy (394 kWh) and water (circa 19,142 L) for 2 years, with our machine that uses 0.88 kWh and 43 L per cycle, and that producing the cloth-diapers uses raw materials as well (most worryingly the waterproof polyurethane laminate of which most diaper covers are made). However, we are still comparing 25 cloth-diapers against roughly 5,700 disposable diapers over the whole diapering period.  It's difficult to reach a sensible conclusion considering all the factors, and of course every family's situation is particular. We are probably going to try to cloth diaper, but I don't want to seem judgemental of other people's choices. I am not above using other disposable items for convenience, like baby wipes, and, ahem, other products targeted to girls; or using disposable diapers for specific situations (like travel or the first few months), but I guess every bit counts. And we will have to learn through trial and error and (hopefully) make it work. Other family's experiences have been helpful and informative in making our decision, I particularly liked the posts by : "Young House Love", "Becoming Peculiar", "My cheap version of therapy" and more recently "Random Giggles"

Anyhow, as for the next question... which cloth-diapers to choose. There are so many terms involved in cloth-diapering that it gets confusing, but roughly you can choose from:

- prefolds/flats: this is probably what comes to your mind when you think of cloth diapers. It's the diapers that our grandmas' and moms' used. These are squares of cloth (cotton, hemp, bamboo, terry) that you can fold in several ways and attach with safety pins or the more-modern 3-headed artifacts called Snappis. They are used together with a plastic / PUL (polyurethane) cover. They are the most basic in design and one of the cheaper options available, but also involve more work and learning, and you will typically need several sizes of diapers as the baby grows. As the covers can be reused for a full day, provided they don't get soiled, you would potentially save money by investing in less covers.

-fitteds: these are basically a simplified version of the above, that is, they are formed and sewn to look like a diaper (no folding needed), and they come with snaps or velcro, but they are fully made of cloth and they are also to be worn with a waterproof cover. With this type you'd also need to invest in several sizes.

-all-in-ones: as the name says, in this case all you need is the cloth-diaper, as the inner liner is attached to the waterproof cover. This means that the whole diaper gets washed every time (unlike with prefolds or fitteds, where a cover is usually reused during a same day). This system seems the easiest and most convenient, as they basically work like a disposable-diaper (where you would put the diaper on, change it, and then send it right off to the laundry). There are a few variations in this category, like so-called pocket diapers, which as the name says, have an inside-pocket where you can stuff the diaper with liners of different absorbancy depending on the situation.

Then, there are one-size diapers which have several rows of snap-buttons, meaning they "grow" with your baby and can be used from nearly-the beginning to potty training. There are also all kinds of materials to choose from: some synthetic (fleece, microfiber) and others natural (cotton, hemp, bamboo). At some point you'll need to use flushable, biodegradable liners (used between the diaper and the baby's skin, letting moisture pass through to the diaper while preventing solids to soak into the diaper, which are then thrown in the toilet) or "spray" your diapers (that is use a shower-head like device that attaches to the toilet to take the mess away from the diaper and into the toilet after the diaper has been used). There are also intermediate systems (like the one called Flip) which consists of foldable diaper liners of different absorbancy and one-sized covers that grow with your baby.

As for us, preferably we want all-in-one diapers that grow with the baby, as we don't want to have to invest in different sizes of diapers, and we want to basically just throw the dirty diaper in the laundry. We prefer snap closures because they seem to last longer than velcro, and we want a natural material (cotton, bamboo or hemp). I am not convinced with microfiber or other synthetic fabrics, some people love them because they dry faster, some people say they get  stinky, others say they can irritate the skin (depending on how sensitive the baby is). We do not want to try pocket diapers because I am lazy and the thought of pre-stuffing the diapers, and then, getting the inlayer full of yuck out for washing was too much... though I read that apparently it all comes out by shaking them, or it happens by itself in the washing machine. I already let the dry laundry hang out for way too long instead of folding our clothes right away (oops), so I don't think I need the extra labor of stuffing the diapers.  We are probably going to try with Bumgenius cloth diapers, as they consistently get really high reviews and more importantly (most) people say they do not leak. We also considered 2-in-ones (foldable cloth in-layers with a cover, these names are all so confusing) like the Flip system, but I worry that the inserts would move around or to the sides and that if the cover got dirty it would translate in more work by either having to clean the reusable covers at every diaper change, or in a higher cost, by needing to stock up more covers if we need to wash more than 2 per day. I am also personally not fully comfortable with the thought of reusing waterproof covers without washing them in between. (But maybe these things do not happen, some people really like these systems and they are happy with how they work. Mark really liked this idea because the diapers would dry a lot faster, for sure). Anyhow, all things considered this means we will probably choose the Bumgenius Elementals, as they are one-size, all-in-ones that come with snaps and are made of organic cotton. We will probably also invest in some extra cotton or hemp in-layers to add absorbancy when needed. We saw them in person, and even if a few reviews say the in-layers sometimes bunch up, we hope that by folding them tightly we will make the system work.

Does anyone have any thoughts or experience on any of this?

(2) Disposable Nappies: A Case Study in Waste Prevention, Women's Environmental Network, 2003.

(3) American Public Health Association. Policy 8910. 1/1/1989

(5)  Getting to the Bottom of Nappy Rash, Philipp R., Hughes A, Golding J. The British Journal of General Practice, 1997.Br J Gen Pract. 1997 August; 47(421): 493–497. 

(6) Scrotal Temperature is Increased in Disposable Plastic Lined Nappies, Partsch C-J, Aukamp M, Sipell W.G. Royal College of Pediatrics and Child Health, 2000. Archives of Disease in Childhood 2000;83:364-368 doi:10.1136/adc.83.4.364

 (7)  Acute respiratory effects of diaper emissions. Anderson RC, Anderson JH. Archives of Environmental  Health. 1999 Sep-Oct;54(5):353-8.

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  *This is NOT a sponsored post. I have mentioned certain brands, as after reading extensive reviews online they have seemed the ones that best-fitted our particular criteria, however I am not getting compensated in any way and these are not affiliate links.

* Photo credit: Kim Ronson at Green Mom.