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Nappy Dilemma: cloth or disposable?
Q: Are there any valid reasons for choosing cloth nappies over disposables? I know that disposables are much easier to use, but do they cause more nappy rash and pose any other health problems? I also worry about clogging up the landfills with all this plastic!
Jodi Los Angeles
A: Jodi, both cloth and disposable nappys have advantages and disadvantages.

Why do some parents choose cloth nappys? Many feel that they are more traditional and natural. Some parents are concerned about the synthetic materials and chemicals in disposable nappys, which can contribute to nappy rash. If you worry about the environmental effects of disposable nappys—they add 1 to 2 percent to solid waste disposal, which is becoming increasingly scarce—you can feel reassured that cloth nappys and nappy covers are entirely reusable. If you live in an area that offers a nappy service, your dirty nappys will be taken away and clean nappys delivered, for about the same cost as disposable nappys. If you want to save money, you can launder cloth nappys at home, although it is a lot of work. Also, many parents use extra cloth nappys to drape over their shoulder when they hold and burp their baby, since they are convenient to clean up spit-up milk.

Why do some parents choose disposable nappys? Many find them convenient. Disposable nappys are more absorbent than cloth nappys, so you don’t need to change them quite as frequently. This also means that your baby is less likely to develop a nappy rash that is caused by urine and stool sitting on the skin for prolonged periods of time. Also, due to their absorbency and snug fit, disposable nappys typically have less leakage of urine and stool and soiling of the baby’s clothes. (For this reason, most childcare centres prefer children to wear disposable nappys.) Even though disposable nappys have an adverse impact on the environment, the nappy manufacturers also argue that laundering cloth nappys uses more energy and water and can lead to air and water pollution.

Some parents choose to use only cloth nappys; some use only disposable nappys. Other parents use both. For example, you may decide to use cloth nappys during the daytime at home and disposable nappys at night and on outings when it’s less convenient to change the nappy. Or, you may decide to use cloth nappys in your baby’s first few months, when there are very frequent nappy changes, so you spare the impact on the environment. Then, when your baby’s older and using fewer nappys, you’ll change to disposables.

In the end, it’s a choice that has trade-offs on both sides, and you need to find what works best for you and your baby.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician