This is my quick rebuttal of the current disposable diaper danger hoax.
There are many good reasons for choosing to use cloth diapers, such as the cost of disposables, tradition, personal preference, and especially ecological reasons (although the energy and chemicals involved in making diapers sterile can also present a challenge to the environment), but concern for your baby's health is NOT a legitimate reason.
While cloth diapers, if they are washed, sterilized, and properly rinsed, can be a healthy choice, disposable diapers are always healthier.
A survey of advertising propaganda warning of the "dangers" of disposable diapers show that they generally bring up these arguments:
1) Disposable diapers contain dioxins, which are known to be harmful, and are a byproduct of bleaching disposable diaper components during manufacture.
Response: Cloth diapers, which are bleached to disinfect and to remove stains, contain the same amounts of dioxins, and new unwashed diapers have more. Many brands of disposable diapers have been tested, and none contain the dangerously potent dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin). Exposure to dioxins from disposable diapers is up to 2.2 million times lower than the amounts infants and toddlers get from food or breast milk. (2002)
(DO NOT bleach old diapers from a pail that smells like ammonia. Ammonia and bleach are a poisonous combination. Wash the diapers first, to get the ammonia out, then soak them no longer than 30 minutes in a full load with one tablespoon of bleach, then rinse the diapers three times, to ensure all bleach is removed. "Fresh" dirty diapers do not require bleach to sanitize them (unless they have been rinsed in a toilet, in which case they MUST be bleached), but bleach will remove stains. When using bleach with dirty diapers, it is not necessary to rinse them multiple times. The interaction of the bleach with the normal dirt in a load of laundry is adequate to neutralize the bleach, so that one rinse should be adequate. However, if a load of diapers smells like bleach after rinsing, rinse them again.)
2) Sodium Polyacrylate is the super-absorbent gel that makes disposable diapers so absorbant, but it has been shown to cause skin irritation, and is believed to be the cause of toxic shock syndrome due to use of the chemical in tampons. These crystals were once used in tampons until they were later removed due to their association with Toxic Shock Syndrome.
Response: One of my Facebook friends is the wife of a friend of mine who worked for the USDA laboratory in Peoria, Illinois that originally invented this chemical (in 1976?). He demonstrated the chemical to a Bible study group I attended shortly after I graduated from high school. He took a glass of water, stirred a teaspoon of powder into the water, and talked about the discovery of what he called "super slurper" for a minute or so. Then he turned the glass up-side-down show that although the water appeared the same in the glass, it was actually a gel that remained in the glass.
Sodium Polyacrylate ("super-slurper" was the official name eventually given it at the Peoria Illinois USDA laboratory that created it) is a polymer made from cornstarch. The long chains of corn starch molecules prevent the self-limiting effect on absorption that regular corn starch has, due to outer layers of clumps of corn starch creating a barrier that prevents inner layers from absorbing water. In a polymer form, every molecule of corn starch is able to absorb water, resulting in a substance that can absorb up to 300 times its own volume in water. Skin irritation claims are based on warnings to employees in facilities that manufacture the chemical. Immediately after manufacture, its drying power can cause burns by pulling water from skin, but the hydrated crystals used in diapers cannot cause these burns. In fact, Hydrogel® bandages, (1986) made from this same corn starch derivative, and originally for used in hospitals for wound dressings, are now used as bandage adhesive in hospitals providing neonatal care, to prevent damage to infant skin that can be caused by traditional bandage adhesives. (2008) Most of us use products containing Sodium Polyacrylate every day. Super absorbent two-ply paper towels have a layer of Sodium Polyacrylate between the layers of paper. Many foods, such as instant puddings, contain Sodium Polyacrylate. The chemical is used in nursing homes to enable patients who have difficulty drinking without inhaling liquids, to enable their patients to eat an instant flavored gelatin instead. (The loose bonds between molecules of corn starch in Sodium Polyacrylate are quickly broken down by stomach acid, leaving normal corn starch, which is easily digested.)
The reason for removing Sodium Polyacrylate from tampons was that the super absorbency made possible by Sodium Polyacrylate resulted in women leaving the tampons in for days at a time, which enabled dangerous bacteria to grow, which was eventually identified as the cause for the toxic shock that killed women in the '80's who used the super-absorbent tampons.
3) (Quotation) "A study published in 1999 by Anderson Laboratories, Inc. found that lab mice that were exposed to various brands of disposable diapers experienced asthma-like symptoms, as well as eye, nose and throat irritation. The results demonstrated that some types of disposable diapers emit chemicals that are toxic to the respiratory tract and that disposable diapers should be considered as one of the factors that might cause or exacerbate asthmatic conditions. Exposure to cloth diapers did not cause these symptoms." (Boerum)
Response: This pointless and inhumane study (1999), which involved the dissection of hundreds of mice, had nothing to do with the known ability for freshly manufactured Sodium Polyacrylate powder to cause skin and lung damage by burning tissues by absorbing water from them too quickly. (This powder is an intermediate step of the manufacturing process. Water is added to the powder to produce the hydrolyzed crystals found in products manufactured from the pure powder.) The lung and throat irritation that was studied, has to do with trace amounts of gasses that are emitted from all plastics, and many other products such as soaps, deodorants, and shampoos, that are used daily by everyone, and also happen to be found in disposable diapers and to a lessor extent, in cloth diapers that are washed in fragrant detergents.
The study involved placing mice in a small sealed container for 100 minutes with a diaper. Three brands of diapers were tested with many mice. A new cloth diaper was also tested, with a control that had nothing in the tank but the mouse, and a sham control with activated charcoal in the tank. The mice with diapers in the tank exhibited breathing distress, but the mouse with the cloth diaper exhibited less distress, with no distress noted for the control or the sham. The mice that had exhibited distress had signs of inflammation in their lungs. The cloth diaper, the control, and the sham also had some inflammation in their lungs, but not nearly as severe as the mice with the disposable diapers. Clearly plastic diapers emit limited levels of irritating fumes. I noted that if a human infant were placed in an equivalent volume of air for an equivalent amount of time, with an equivalent volume of diapers, that he or she might experience similar levels of lung irritation, but one would not expect to store that many diapers in the open air in an air tight room.
The study mentioned that diapers that had been washed in commercial laundry detergent with fabric softener could potentially emit higher levels of irritating fumes.(1999) Many other products intended for use with babies also contain potentially irritating fragrances, but the fragrances most likely to cause irritation to infants, are those from cleaning products used to disinfect cribs and mattresses, and the scents added to antiperspirants, deodorants, soaps, and hair care products used by the adults that care for infants. To my knowledge, there are no documented cases other than those involving an allergy to a specific commonly used fragrance, in which babies have been adversely effected by the scents of disposable diapers, but there have been cases documented of infants having adverse reactions to fragrances in the hygienic products their caregivers use.
4) One article mentioned that studies show that babies with cloth diapers have fewer incidents with diaper rash than babies with disposable diapers. I had to do some serious searching to find any peer-reviewed medical journal articles that suggested cloth diapers are superior to disposable diapers for diaper rash, but I did record several pages of citations of articles that demonstrated conclusively, that disposable diapers are superior to cloth diapers for preventing and curing diaper rash, all of which were done in controlled hospital neonatal care units. Hundreds of such studies, demonstrated that disposable diapers, changed on a regular schedule, were vastly superior in preventing diaper rash, over cloth diapers changed on the same regular schedule. No hospital studies showed that cloth diapers were more effective than disposable diapers in preventing diaper rash.
In studies of babies that already had diaper rash, the use of zinc oxide ointment (Desitin) with a regular changing schedule using disposable diapers, cleared up the diaper rash quickly, while babies in cloth diapers did not recover. In other studies, babies that did not have diaper rash, who were changed on a regular hospital schedule using cloth diapers developed diaper rash, but no babies who were changed on the same schedule with disposable diapers developed a rash. Other studies included bacteria cultures developed from swabs taken from the skin of babies in cloth diapers versus babies in disposable diapers. The cultures taken from cloth diaper babies had vastly greater numbers and varieties of bacteria living on their skin in comparison with babies wearing disposable diapers.
Of the two studies I found that showed opposite results, one was a review of the original study, and the original study was done in China, by interviewing parents using a questionnaire. The parents in the study were aware that the Chinese Government prefers the use of cloth diapers, because they cost less than disposable diapers. These people also did not have a variety of brands to choose from, but used inexpensive diapers manufactured by the Chinese State. No information was provided about the composition of those diapers.
Babies that wore only cloth diapers were reported to have the fewest cases of diaper rash. Babies whose parents mostly used cloth diapers, but occasionally used disposable diapers for travelling, had nearly the same reported levels of diaper rash, but babies whose parents used exclusively disposable diapers had nearly double the reported cases of diaper rash. The Chinese study did not have controls, depended on the reports of parents who were intimidated by the State's unexplained investigation of their parenting, in an environment in which the parents were aware that the Chinese Government had already decided that cloth diapers were preferred. The chinese study mentioned that there have not been many studies of chinese babies and diaper rash, and suggested that chinese babies may be more susceptible to diaper rash than babies of other races.
The original cloth diaper propaganda included the same statement about the rarity of studies, but left out the qualifying word, "Chinese" babies, making the blatantly false statement that there have not been many studies of diaper rash in the context of cloth versus disposable diapers. There have, in fact, been hundreds, if not thousands of such studies comparing cloth diapers with disposable diapers, and the overwhelming majority (I was only able to find one Chinese study that said otherwise) concluded that disposable diapers reduce diaper rash, and associated skin bacteria levels.
References:
Anderson, R. C., & Anderson, J. H. (1999). Acute respiratory effects of diaper emissions. Archives of Environmental Health, 54(5), 353–8. doi:10.1080/00039899909602500
Retrieved from http://web.b.ebscohost.com/ehost
Boerum, L. The harmful chemicals in disposable diapers [Web log message]. Retrieved from http://awesomebeginnings4children.com/the-harmful-chemicals-in-disposable-diapers/
Counts, J., Helmes, C., Kenneally, D., & Otts, D. (2014). Modern Disposable Diaper Construction Innovations in Performance Help Maintain Healthy Diapered Skin. Clinical Pediatrics. Retrieved fromhttp://cpj.sagepub.com/content/53/9_suppl/10S.short
DeVito, M. J., & Schecter, A. (2002). Exposure assessment to dioxins from the use of tampons and diapers. Environmental Health Perspectives, 110(1), 23–8. Retrieved fromhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1240689&tool=pmcentrez&rendertype=abstract
Heimall, L. M., Storey, B., Stellar, J. J., & Davis, K. F. (2012). Beginning at the bottom: evidence-based care of diaper dermatitis. MCN: American Journal of Maternal Child Nursing, 37(1), 10–16. doi:10.1097/NMC.0b013e31823850ea
Retrieved fromhttp://journals.lww.com/mcnjournal/Abstract/2012/01000/Beginning_at_the_Bottom__Evidence_Based_Care_of.3.aspx
Kickhöfen, B., Wokalek, H., Scheel, D., & Ruh, H. (1986). Chemical and physical properties of a hydrogel wound dressing. Biomaterials, 7(1), 67–72. doi:10.1016/0142-9612(86)90092-X
Li, C., Zhu, Z., & Dai, Y. (2012). Diaper Dermatitis: A Survey of Risk Factors for Children Aged 1 - 24 Months in China. Journal of International Medical Research, 40(5), 1752–1760. doi:10.1177/030006051204000514
Rai, P., Marsman, D., & Felter, S. (2010). Dermal Safety Evaluation: Use of Disposable Diaper Products in the Elderly. Textbook of Aging Skin. Retrieved from http://link.springer.com/10.1007/978-3-540-89656-2_82
Shanmugasundaram, O. L., & Gowda, R. V. M. (2010). Development and characterization of bamboo and organic cotton fibre blended [disposable] baby diapers. Indian Journal of Fibre & …. Retrieved fromhttp://nopr.niscair.res.in/handle/123456789/10217
Sharpe, Elizabeth L. (2008) Tiny Patients, Tiny Dressings. Advances in Neonatal Care 8(3).
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David Lloyd The best disposable diapers, which also contain Sodium Polyacrylate, are the ones made from a combination of bamboo pulp (instead of paper, which is made from wood pulp) and cotton (2010, Shanmugasundaram & Gowda). Cloth diaper inserts made from bamboo, cotton, and Sodium Polyacrylate, can be used to make cloth diapers more absorbent, but these diapers must still be changed as frequently as any other diapers to avoid potentially deadly infections, which was the reason for removing Sodium Polyacrylate from tampons. The super absorbency resulted in women leaving the tampons in for days, which enabled dangerous bacteria to grow, which was eventually identified as the cause for the toxic shock that killed women in the '80's who used the super-absorbent tampons, and not the tampons or the Sodium Polyacrylate.
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