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

Why do some parents choose cloth diapers? Many feel that they are more traditional and natural. Some parents are concerned about the synthetic materials and chemicals in disposable diapers, which can contribute to diaper rash. If you worry about the environmental effects of disposable diapers—they add 1 to 2 percent to solid waste disposal, which is becoming increasingly scarce—you can feel reassured that cloth diapers and diaper covers are entirely reusable. If you live in an area that offers a diaper service, your dirty diapers will be taken away and clean diapers delivered, for about the same cost as disposable diapers. If you want to save money, you can launder cloth diapers at home, although it is a lot of work. Also, many parents use extra cloth diapers 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 diapers? Many find them convenient. Disposable diapers are more absorbent than cloth diapers, so you don't need to change them quite as frequently. This also means that your baby is less likely to develop a diaper 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 diapers typically have less leakage of urine and stool and soiling of the baby's clothes. (For this reason, most childcare centers prefer children to wear disposable diapers.) Even though disposable diapers have an adverse impact on the environment, the diaper manufacturers also argue that laundering cloth diapers uses more energy and water and can lead to air and water pollution.

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