Diapers: Disposable or Cloth?

​​​By: Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP

As a new parent, you may not have heard of the ongoing cloth versus disposable diaper debate. Use of disposable diapers has become so accepted as a modern-day convenience that many parents wouldn't dream of using a substitute. In contrast to 1955, when essentially all American babies wore cloth diapers, an estimated 90% (or even 95%) of 21st century American babies are sporting the latest in disposable fashions.

While a simple internet search on the subject quickly makes it clear how strongly some people feel about the cloth versus disposable debate, we have no intention of taking sides. Instead, we figure we'd offer you some facts and practical advice related to the use of each type, with the rest of our information weighted toward disposable use only because it is applicable to a majority of parents these days.

Disposable diapers these days are so effective at absorbing whatever pee may come their way, they can actually pose a challenge to parents who are trying to keep close tabs on just how much their newborns are peeing . Fortunately, some diaper brands now come with a colorfully effective solution: a strip on the diaper that changes color when wet, allowing you to more clearly see when your baby pees.

Some cloth diaper advocates argue that babies in disposable diapers have a much higher incidence of diaper rash (presumably due to longer contact with diaper contents resulting from less frequent changing). Interestingly, however, one of the commonly recommended approaches to treating Diaper rashes is for cloth diaper users to switch to disposable. Also garnishing a lot of attention is the fact that “disposable" diapers are not biodegradable, and billions (with estimates around 20 billion diapers, or 3.5 million tons) make their way into landfills each year.

We have been happy to learn that some communities have begun recycling or responsibly composting used disposable diapers, while some of the country's leading diaper makers seem to be making an effort to be more eco-friendly, improving everything from the materials they use to the amount, transport, and packaging of diapers. We certainly hope that this sustainability-minded approach continues across the entire disposable diaper industry.

One of the most significant concerns parents have when it comes to the use of diapers these days is the effect they have on the environment—a concern that is well worth paying attention to. What may come as a surprise, however, is that it's in no way clear that disposable diapers have any greater effect than their cloth counterparts. Both disposable and cloth diapers have an effect on the environment that is determined by taking into account the full “life cycle" of the diaper, from start to final use. This includes how much energy, water, and raw materials are used, as well as how much atmospheric emissions and waterborne and solid wastes are created.

While studies suggest that disposable diapers use more raw materials and produce more solid wastes, cloth diaper use potentially consumes significantly more water and produces more waterborne wastes. The conclusion: we wish we had a definitive one for you. When it comes to declaring environmental superiority of cloth versus disposable diapers, it still seems to be a wash.

As for the materials used to make them, cloth diapers have long been made of cotton—a material that is notorious for requiring a lot of water to produce. Those focused on reducing the environmental impact of diapering point to bamboo-based cloth diapers as more eco-friendly, as well as a more readily available alternative to cotton.

And because cloth diapers (and their covers) require a lot of washing by either the parents or a diaper service and therefore use a great deal of water and detergent, people in the disposable diaper camp point out that cloth diapers also have a negative effect on the environment—especially when they are washed in small, half-full loads of laundry, put into a dryer instead of line dried, or both washed and dried.

Diapers and Clothing (HealthyChildren.org)

Laura A. Jana, MD, FAAP, is a pediatrician and mother of 3 with a faculty appointment at the Penn State University Edna Bennett Pierce Prevention Research Center. She is the author of more than 30 parenting and children's books and serves as an early childhood expert/contributor for organizations including the Maternal and Child Health Bureau, Primrose Schools, and US News & World Report. She lives in Omaha, NE.

Jennifer Shu, MD, FAAP serves as the medical editor of HealthyChildren.org and provides oversight and direction for the site in conjunction with the staff editor. Dr. Shu is a practicing pediatrician at Children's Medical Group in Atlanta, Georgia, and she is also a mom. She earned her medical degree at the Medical College of Virginia in Richmond and specialized in pediatrics at the University of California, San Francisco. Her experience includes working in private practice, as well as working in an academic medical center. She served as director of the normal newborn nursery at Dartmouth-Hitchcock Medical Center in New Hampshire. Dr. Shu is also co-author of

              Food Fights and 
            
              Heading Home with Your Newborn published by the American Academy of Pediatrics (AAP).