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Summary Introduction and objective During the last decades, the development of the modern disposable diaper (DD) has changed the way we diaper our children, as they are safe, easy to use, comfortable and easy to dispose, compared to cloth diapers used earlier. Concurrently, the age of initiating toilet training (TT) is rising. We aimed to investigate the connection between DD usage and the tendencies seen in TT and childhood urinary incontinence, with specific interest on studies evaluating the effect of diapering on enuresis. Study design A literature search was conducted in PubMed and Embase. A systematic literature search was conducted, revealing 309 studies in Embase and 269 studies in Pubmed. After removing duplicates, 400 studies were eligible for screening. All abstracts were screened, and 12 relevant abstracts where identified, but only eight studies were eligible. No prospective intervention studies specifically evaluating the effect of diaper on enuresis were identified. Literature on TT and diapers in general was identified using the respective search terms on both databases. Results The eight studies identified showed a tendency towards diaper use being related to a delay on obtaining continence in children, but no secure conclusions can be made, as the literature is inadequate. Discussion and conclusion Based on the available literature no secure conclusions can be drawn although an association is suggested. In order to evaluate the effect of diapers on incontinence, prospective randomized studies are needed. Download : Download high-res image (516KB) Download : Download full-size image Summary figure . Does diapers affect bladder control?.

Disposable diapers have become a prominent feature of solid waste dumped in landfills. It is estimated that disposable diapers take anywhere between 300 to 500 years to decompose. Despite the associated environmental challenges, a plethora of studies show that disposable diapers have become a popular choice for parents when compared with cloth diapers. Disposable diapers are argued to be more convenient for parents because of their once-off use and super-absorbent ability, of which they are able to absorb 200-300 times the weight as compared to the cloth diapers. This study investigates thermal devolatilisation profiles of disposable diapers as well as their iso-conventional kinetic parameters, elemental and fractional composition. In this study, the two most dominant disposable diaper brands were sampled and analysed qualitatively and quantitatively. It was observed that the exterior fraction of both diapers showed a single peak devolatilisation at a temperature of around 500°C, while the interior fraction showed two distinctive devolatilisation peaks observed below 400°C and above 500°C. However, the pyrolysis heating rate produced no effect on the pyro-char fraction. Furthermore, the devolatilisation pathways of different types of disposable diaper fractions showed that there is a potential for conducting stepwise pyrolysis to promote fractional recovery of valuable products. Disposable diapers waste conversion can be better handled by separating the outer fraction (mainly fossil-based plastics and rubbery materials) from the inner fraction (mainly bio-based fibers and absorbents). It is further illustrated that the kinetic parameters, Ea and k0 are different for each disposable diaper fraction.

Toilet training is the challenging stages of development that all children are required to successfully complete it to achieve independence and self-esteem. In the last few decades, there has been a trend of late success on toilet training accompanied by a change in diapering habit, which today tends to be more disposable diaper than cloth diaper. In addition, toilet training method (parent oriented, child oriented and combination of the two) is a training provided by parents also have an important aspect in the success of toilet training. The research aim to know the effect of history of the diaper usage and toilet training method to the success of toilet training in children aged 18-48 months in five Posyandu Malang 2017. The research used analytic observational with case-control approach by using chi square and logistic regression test. The number of selected samples is 70 based on cluster random sampling technique. The result is a history of diaper usage on the success of toilet training (p = 0,003), as well as toilet training method (p = 0,003). In logistic regression, the results of cloth diaper users have a tendency to reach toilet training success of 4.6 times than disposable diaper users and who use parent oriented methods tend to achieve successful toilet training of 5.6 times than those using child oriented methods. The research conclude that there is a significant effect of the history of diaper usage and toilet training method on the success of toilet training. Key words: toilet training, disposable diaper, cloth diaper, toilet training method ABSTRAK Toilet training adalah salah satu tahap perkembangan yang menantang pada awal kehidupan anak, yang semua anak diharuskan dapat berhasil menyelesaikannya untuk mencapai kemandirian dan penghargaan diri. Beberapa dekade terakhir, terjadi tren keterlambatan keberhasilan toilet training yang disertai dengan perubahan kebiasaan pemakaian popok yang saat ini cenderung lebih banyak pemakaian popok sekali pakai daripada popok kain. Oleh karena itu, pemakaian popok diduga menjadi salah satu faktor yang berpengaruh terhadap keberhasilan toilet training . Selain itu, metode toilet training merupakan pelatihan yang diberikan oleh orang tua juga berperan penting dalam keberhasilan toilet training . Metode toilet training yang paling sering digunakan saat ini yaitu parent oriented, child oriented dan kombinasi antara keduanya. Tujuan penelitian adalah untuk mengetahui pengaruh riwayat pemakaian popok dan metode toilet training terhadap keberhasilan toilet training pada anak balita usia 18-48 bulan di lima Posyandu Kota Malang Tahun 2017. Desain penelitian ini adalah observasional analitik dengan pendekatan case-control dengan menggunakan uji chi square dan regresi logistik. Jumlah sampel terpilih adalah 70 berdasarkan teknik cluster random sampling. Hasilnya adalah riwayat pemakaian popok berpengaruh terhadap keberhasilan toilet training (p = 0,003), begitu pula dengan metode toilet training (p = 0,003). Pada regresi logistik, didapatkan hasil pemakai popok kain memiliki kecenderungan mencapai keberhasilan toilet training sebesar 4,6 kali daripada pemakai popok sekali pakai dan yang menggunakan metode parent oriented cenderung mencapai keberhasilan toilet training sebesar 5,6 kali daripada yang menggunakan metode child oriented. Kesimpulan penelitian ini adalah terdapat pengaruh yang bermakna dari riwayat pemakaian popok dan metode toilet training terhadap keberhasilan toilet training. Kata Kunci: toilet training, popok sekali pakai, popok kain, metode toilet training

This study was to determine the reduction in the degree of diaper rash with olive oil spread. Problems that are often found onthe baby's skin are diaper rash and are associated with external irritants such as dirt, material from diapers, urine, microorganisms, and friction caused by diapers and recur. The incidence of diaper rash in Indonesia reaches 7-35% which afflicts boys and girls under three years old. Non-pharmacological therapy in diaper rash, which is to eliminate or reduce skin moisture and friction by replacing diapers according to capacity, applying olive oil that contains antioxidants in high amounts of vitamin E (α-tocopherol) and phenolic compounds.The design of this study was quasi-experimental, with a sample of 22 infants divided into 2 groups, each with 11 diapers rashes smeared with olive oil and 11 other infants using only cloth diapers that were changed every time they were wet, finished chapter and tub. The population in this study were children aged 0-24 months who experienced diaper rash. The sampling technique in this study uses a non-probability sampling method with a purposive sampling technique. Analysis with Wilcoxon statistical tests.The results of the study showed a significant difference between the spread of olive oil and the use of cloth diapers on the degree of diaper rash with a significant number of 0.007 at p 0.05.

Em um programa de promoção em saúde da criança observou-se que as mães adotam diferentes posições posturais para higiene bucal em bebês. Objetivo:Realizar um levantamento acerca das posições mais utilizadas por mães durante a limpeza bucal de bebês com até 08 meses de idade. Metodologia: A amostra foi constituída de 38 mães e seus bebês, participantes do programa de atenção Básica de Saúde, na cidade de Gurupi, Estado do Tocantins, Brasil.Em uma visita domiciliar, solicitou-se que a mãe realizasse a limpeza da cavidade bucal do bebê, em que se fez uma tomada fotográfica neste momento. Posteriormente, as mães preencheram um questionário com perguntas envolvendo o conhecimento sobre saúde bucal da criança. Esta pesquisa teve aprovação do comitê de ética/CAAE: 32671414.4.0000.5518. Resultados: Observou-se que todas as mães receberam as devidas informações sobre a saúde bucal do bebê, mas não foram orientadas quanto a uma posição ideal para limpeza bucal do bebê. O estudo demonstrou que a higienização ocorria mais frequentemente no período da manhã (60,5%), sendo que 75% das mães utilizavam a posição sentada com o bebê apoiado no colo para realizar a higienização bucal, e a fralda (79%) era o instrumento mais utilizado para a limpeza bucal do bebê. O teste qui-quadrado apresentou resultados significativos quanto à posição de limpeza em relação a dificuldade de se realizar a higiene bucal (p=0,008). Conclusão:A posição mais utilizada pela mãe para higienização da boca foi com a criança no colo, notando-se a necessidade de estudos que busquem orientar as mães quanto a uma posição adequada, que promova conforto e segurança na hora deste procedimento.

Irritant diaper dermatitis occurs at a higher frequency with cloth diaper use than disposable diapers. We present four cases of vesiculobullous, erosive diaper dermatitis occurring in older infants and toddlers with cloth diaper use that resolved completely after transitioning to disposable diapers. This is the first report of vesicles and bullae as a type of irritant diaper dermatitis.

Background To identify the prevalence and risk factors associated with diaper dermatitis in Thai children aged 1–24 months. Methods This was a cross-sectional study of 1153 participants using structural questionnaires, which was conducted at Khon Kaen University Faculty of Medicine Pediatric department in Thailand. Univariate and multivariate logistic regression analyses were used to test the association between diaper dermatitis and its possible risk factors. Results The prevalence of diaper dermatitis among the study population was 36.1%, a rate which significantly decreased with age. The highest prevalence was found in subjects who were one to six months old. Risk factors that had a statistically significant association with diaper dermatitis in both univariate and multivariate analysis were i) diaper changing fewer than three times/night, ii) previous episodes of diaper rash, iii) using cloth diapers, and iv) topical application of baby talcum powder to the diaper area. Conclusions Frequent diaper changings during the daytime do not compensate for fewer changings during the night. Moreover, the use of baby talcum powder on the diaper area significantly increased the risk of diaper dermatitis among the study population. These findings should be applied in future preventive strategies for diaper dermatitis in this age group. Electronic supplementary material The online version of this article (10.1186/s12895-019-0089-1) contains supplementary material, which is available to authorized users.

Diapering practices vary among different countries from the use of cloth diapers to the modern disposable diaper. In the last few decades, diaper technology has advanced significantly thus decreasing the prevalence of diaper dermatitis. Recent innovative techniques used in the manufacturing of diapers include incorporation of superabsorbent polymer gel that can absorb 30 times its weight in liquid. Recently, smart diapers have been developed which not only prevents diaper dermatitis but significantly has reduced the burden on parents. This article reviews how changes in disposable diaper technology have improved diapering practices.

Diaper Rash is one of the problems that arise in the baby skin due to the incorrect treatment of the perineal area. The worst impact of incorrect treatment perineal care can disrupt the growth process, so it is necessary to give an intens good treatment, especially the perineal area of the baby in order to avoid problems such as Diaper Rash. The purpose of this study was to determined the description of perineal care in infants with diaper rash at PMB Santi Rahayu Jabung Malang Regency. This study using Qualitative descriptive research method with a case study approach. The method of geting respondens with a purposive sample of 4 mothers who have babies with diaper rash, 3 baby grandmothers, and 1 baby aunt who lives together as familly and involved in daily care of the baby. The validity of the data uses source triangulate method. The instrument that used in this study is the guideline for in depth interviews and the results from mobile voice recordings as documentation in the study. The result of this study showed that mothers treated their perineal babies before Diaper Rash by using pampers diapers longer than cloth diapers, changing brands of pampers, using fragrance softeners when washing diapers and baby clothes, changing pampers more than four hours, does not dry the perineal area after cleaning, use powder to the perineal area, change the brand of bath soap

Brazil, an emerging economy with more than 208 million inhabitants, is currently one of the biggest consumers of disposable diapers worldwide, generating huge waste streams to sanitary landfills or dumps. This take-make-dispose system causes high material and fuel consumption and serious environmental impacts. The concept of the Circular Economy, promoting that material flows should be circular, material and energy efficiency should be maximized and residues, as far as possible, designed out, has continuously gained attention over the last decade. For a Circular Economy, technological innovation, new business models and changes in consumer behavior are needed. The present study compares the use of modern cloth diapers and disposable diapers via a screening Life Cycle Assessment, checking conventional and innovative circular business models for the application of modern cloth diapers, such as the leasing or pay-per-service models, while focusing on the regional context of Brazil. Results indicate that cloth diapers show generally a better environmental performance than disposable diapers, whose poor performance is mainly due to their end-of-life treatment in sanitary or unsanitary landfill, provoking high greenhouse gas emissions. For cloth diapers, the most advantageous product system consists in a diaper-as-service model at large scale, using efficient continuous batch washers for sanitizing the diapers. Diaper-as-service models at smaller scale in so-called on-premise laundries show poorer environmental performance, due to higher water and energy needs. Domestic laundering of diapers is a good alternative regarding its environmental performance, because of its low energy consumption. However, consumers accustomed with disposable diapers might be reluctant to engage with this additional domestic labor.

The emergence of consolidated nighttime sleep and the formation and maintenance of parent-infant relationships are 2 primary developmental achievements of the infancy period. Despite the development of a transactional model that links parenting behaviors to infant sleep, limited attention has been devoted to examining experimental manipulations of infant sleep that may impact the discrete parent-infant interactions that may form the foundation for emerging attachment relationships. In the present study, infants were randomly assigned to wear high-absorbency disposable diapers or to continue using traditional low-absorbency cloth diapers that necessitate frequent changes and associated disruptions of nighttime sleep. Parents reported on infant sleep before and during the 6-week experimental manipulation; a subset of infants also wore actigraphs. Parents and infants also participated in a parent-infant interaction task both before and near the end of the experimental manipulation. Infants who wore cloth diapers experienced more frequent sleep disruptions overall as well as a greater number of disruptions that did and did not wake the infant from sleep. Infants who wore disposable diapers were rated as experiencing more engagement and positive affect near the end of the intervention relative to infants who wore cloth diapers; mothers of infants who wore disposable diapers were rated as more engaged and sensitive near the end of the intervention relative to mothers of infants who wore cloth diapers. These findings suggest that the disposable diaper manipulation was causally related to characteristics of mother-infant interactions that may form the foundation for emerging attachment relationships.

Objective To study whether disposable diapers decrease the incidence of neonatal infections compared with cloth diapers in a level II neonatal intensive care unit (NICU). Method and material All neonates admitted to the NICU and having duration of stay >48 h were enrolled. Those babies with signs and symptoms of infection were screened with septic screen and/or blood culture. Results The primary outcome of the study was incidence of probable sepsis. Of 253 babies enrolled in the study period, probable sepsis was present in 101 (39.9%) infants in the total study group and was higher in cloth diaper group as compared with disposable diaper group (p = 0.01). For an average NICU stay of 6 days, cloth diapers would cost Rs. 241 vs. Rs. 162 for disposable diaper for any infant. Conclusion Usage of disposable diapers decrease the incidence of probable sepsis in babies admitted to NICU. It is also cost effective to use disposable diapers in the NICU.

* Abbreviations: EC — : elimination communication MRSA — : methicillin-resistant Staphylococcus aureus When we were planning to have our third child, we made a conscious decision to not use disposable diapers. We felt sheepish that we had already contributed 2 children’s worth of diapers to our nation’s landfills. Unfortunately, washing and drying cloth diapers could triple the amount of work for us. Further, exchanging disposable diapers for energy- and water-consuming laundering was not an environmentally guilt-free option. How did we as humans take care of children before disposable diapers? Researching this question, we soon learned about elimination communication (EC). EC, also known as natural infant hygiene, is the practice of using the infant’s natural timing and cues to recognize when they need to defecate or urinate. By identifying these cues, caregivers can coordinate elimination in the toilet rather than in a diaper. Contrary to the notion that infants relieve themselves randomly and constantly throughout the day, infants naturally eliminate at predictable times, such as on waking or after feeding. Caregivers can incorporate audio cues (soft whistle or hum) to associate with the act of eliminating. With practice, many children learn to eliminate when they are in proper position and hear the cue. EC is not a new concept. Humans have been doing this for millennia and still do in most resource-limited regions. As little as 3 to 4 generations ago, most Americans did as well. So, why has the pendulum in mainstream American culture swung so far away from EC? The disposable diaper was first patented in 1955.1 In 1962, pediatric developmental specialist Dr T. Berry Brazelton published … Address correspondence to Jeffrey M. Bender, MD, Department of Pediatrics, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 51, Los Angeles, CA 90027. E-mail: jbender{at}chla.usc.edu

Over the past several years, a number of articles and online posts have circulated on the Internet associating use of disposable and cloth diapers with chemical burns on babies’ skin. Because both mild chemical burns and diaper dermatitis (diaper rash) can cause skin redness and peeling, it is not surprising that some confusion has arisen regarding the association between these two conditions. However, diapers cannot cause chemical burns because they are made of inert materials. Diaper rash and chemical burns are distinct conditions that require different evaluation and treatment, which is why it is important for pediatricians to help parents understand the difference.

Granuloma gluteale infantum is a rare nodular complication of irritant diaper dermatitis. The association of this condition with the widespread use of nondisposable cloth diapers has been increasingly recognized. We present the case of an 18-month-old girl with granuloma gluteale infantum. Our aims are to emphasize the importance of clinical recognition of this re-emerging complication of diaper dermatitis and to point out the potential role of topical calcineurin inhibitors as a treatment option. info:eu-repo/semantics/publishedVersion

A rapid and relatively clean method for determining six organotin compounds (OtC) in textile goods with a gas chromatograph equipped with a conventional flame photometric detector (GC-FPD) has been developed. After the reflux-extraction to use methanol containing 1% (v/v) of hydrochloric acid, five hydrophobic OtC (e.g. tributyltin: TBT) and slightly less hydrophobic dibutyltin (DBT) could be drawn out through partitioning between the methanolic buffer solution and tert-butyl ethyl ether instead of hazardous dichloromethane, of which usage is provided by the official-methods notified in Japan, and following the ethylation procedure to use sodium tetraethylborate, the OtC were determined with the GC-FPD. The recoveries of DBT, TBT, tetrabutyltin, triphenyltin, dioctyltin, and trioctyltin from textile products (cloth diaper, socks, and undershirt) were 60–77, 89–98, 86–94, 71–78, 85–109, and 70–79% respectively, and their coefficients of variation were 2.5–16.5%. Calibration curves for OtC were linear (0.01–0.20 μg as Sn mL−1), and the correlation coefficients were 0.9922–1.0000. Their detection limits were estimated to be 2.7–9.7 ng as Sn g−1. These data suggested that this method would be applicable to their simultaneous determination. Five retailed textile goods were analyzed by this proposed method, and 0.013–0.65 µg as Sn g−1 of OtC (e.g. DBT) were determined in three. Moreover, a possibility that various OtC including non-targeted species in textile would be specifically detected by applying the studying speciation-technique of controlling signal intensity-flame fuel gas pressures of the GC-FPD was found.

Aims: We evaluated risks associated with diaper changing in Finnish kindergartens where children were using either modern disposable paper or reusable cloth diapers. Methods and Results: We determined enteric micro-organisms and ammonia in diaper-changing rooms in four kindergartens in autumn and winter in the ambient air. No coliphages were detected in the air. The numbers of faecal coliforms and enterococci in air were typically low regardless of whether the children used either paper or cloth diapers. Ammonia concentrations increased over the background level because of diaper changing. Conclusions: The numbers of bacteria or coliphages are not expected to pose any high air hygiene risks, and increased ammonia air concentrations are unlikely to impair the health of staff or children when diapers are changed in modern kindergartens. However, increased ammonia gas concentrations indicate that some other diaper-related gas-phase emissions should be studied to understand better diaper-related health risks. Significance and Impact of the Study: Modern reusable cloth baby diapers and the modern paper baby diapers used in this study are equally safe with respect to risks from airborne virus, bacteria or ammonia.

Aim: To test the hypothesis that olfactory stimulation in growing healthy preterm infants leads to an increase in resting energy expenditure (REE). Design: A prospective, randomized clinical trial with crossover was conducted in 20 healthy, appropriate weights for gestational age, gavage-fed preterm infants. Infants were studied while asleep and cared for in a skin servo-controlled convective incubator. Using a pipette, 15 drops of saturated solution of vanillin (Aldrich, Fallavier, France) were dripped to a cloth diaper that was placed on the opposite side of the incubator. REE was measured by indirect calorimetry (DeltaTrac II, Helsinki, Finland) exactly 1 h after feeding. Each infant was studied twice by randomization: after a period of 20 min of vanillin odour or after 20 min without vanillin odour. Results: We found no statistically significant difference in REE of preterm infants when exposed to vanillin odour (74.5 ± 10.1 kcal ⁄kg ⁄day) in comparison with their REE when not exposed to vanillin odour (79.0 ± 11.3 kcal ⁄kg ⁄day). Conclusions: Vanillin odour does not significantly influence REE in metabolically and thermally stable preterm infants.

Chinese cloth diapers differ from disposable diapers in several respects that are central to our understanding of the etiology of diaper dermatitis (DD), yet there are no published reports on the dermatological correlates of this manner of infant care, which is prevalent among the world's second-largest pediatric population. The objective was to determine the prevalence and severity of DD in exclusive users of Chinese cloth diapers. This observational study was conducted during a single home visit to 694 Chinese children who were exclusive users of cloth diapers in five inland cities of China. During each home visit, study nurses documented the presence and severity of DD using a visual dermatological scale and conducted transepidermal water loss (TEWL) and pH measurements. Diaper dermatitis was rare in the buttocks and genital area of the children (

Adults of monkey and ape species often examine and fondle the penis and scrotum of youngsters. In the past, tribal societies in hot climates routinely wore little clothing so that the genitalia of boys were commonly exposed and unremarked. Diapers were unknown. By contrast, in Western societies genitalia must always be covered, and unethical adults can traumatize boys to the point of their suicide by in secret manipulating these genitalia. The cause of this negative reaction seems to be related to the tension involved in toilet-training toddlers. Parents are usually anxious to hurry the process, in the past to reduce the laundry of cloth diapers and presently to enrol the child in day care programs that refuse to admit children in diapers. Coercive toilet-training may cause irrational fears in boys, some of whom continue to wet their beds as adults. Western insistence that genitalia must be private, never public, may instil in boys that privacy means dirty as well, and too shameful to talk about to their parents or guardians.

This paper examines from the motivational perspective of the Theory of Reasoned Action (TRA) how individual values and attitudes in a developing country influence purchase intention of a green product. It also investigates how values may affect attitudes towards environmentally responsible purchase intention. The study analyzed data collected from 257 working respondents who were asked their views concerning their value sets, attitudes and purchase intention of cloth diapers using the Structural Equation Modeling (SEM) technique. Findings indicate individual consequences relating to amount of effort and convenience of consumers is negatively related to intention to purchase green product. Environmental consequences are not a significant predictor of environmentally responsible purchase intention. Conservation value was found to be positively related to attitude on environmental consequences but less intensely with individual consequences while both self-transcendence value and self-enhancement value were positively related to individual consequences. Individual consequences and self-enhancement value were negatively related to environmentally responsible purchase intention. This paper has shown that the extended TRA is applicable and also this paper has enhanced understanding of predictors of environmentally responsible purchase intention in a developing country context.

The acronym for the public understanding of science, PUS, is serendipitous. Somewhere in the production and dissemination of scientific results for a public audience, the rot sets in, and basic scientific literacy is no guard against it. Take the professional classes, for instance, at whom Evolution, Gender, and Rape is presumably aimed and who make up one audience for Roger Lancaster's book, The Trouble with Nature: Sex in Science and Popular Culture. This imagined community composed of readers of such fare as the New York Times Science Times on Tuesdays is offered scientific results presented with far less context, fewer complicating factors, and dramatically less reflexivity than information they are routinely in the business of processing in other spheres of their lives. A story on page 3 of the Times might describe the expense and waste problems associated with disposable diapers in a poor country, the scarcity of clean water for washing cloth diapers, and mention that most children in that country are thus toilet trained by 18 months to two years of age. The reader then picks up the Science Times section and reads that scientists in the United States have shown that children are not ready to be toilet trained until close to three years of age. In the brief scientific , factors that might well affect toilet training readiness, such as the extraordinary efficiency of U.S. diapers, or the relative affordability of disposable diapers as a percentage of income, or the near invisibility of waste disposal in this country, or the child care arrangements that necessitate certain kinds of waste containment, are likely to be left out.

Occurrence of Candida spp. was determined in a population of 60 infants, 1-15-month-old, with diaper dermatitis, admitted to a neonatal intensive care unit in Hospital Saca (Kosice, Slovakia). Specimens were obtained from the perianal, pubic, inguinal, or gluteal areas that showed signs of secondary infection as manifested by erythema, oozing, vesiculopustular lesions, and pus formation. The most frequently isolated species was C. albicans (41), followed by C. parapsilosis (8), C. tropicalis (4), C. pulcherrima (4), C. guilliermondii (2), and C. zeylanoides (1). Other organisms present in the mixed culture from the diaper area were Staphylococcus aureus (6), Escherichia coli (3), and 2 strains of each group B and D streptococci, and Proteus mirabilis. Infants diapered exclusively in disposable diapers showed less rash than those diapered exclusively or sometimes in cloth diapers.

Background/aims: This study investigated the effect of specific, commonly used diaper types on scrotal temperatures in normal healthy, young boys. These included both modern disposable and reusable diapers as well as various types of protective outer coverings that are in common use in both North America and Europe Methods: Scrotal and skin surface temperatures were continuously monitored in healthy, young males using a computerized data-logging system based on temperature probes specifically designed for paediatric studies. These systems could be used either tethered to the PC or made completely portable depending upon the age and activity of the child being measured. Based on our results from several pilot studies, it became clear that the best way to determine if disposable and reusable diapers differ with regard to their impact on scrotal temperatures is to run these comparisons under controlled laboratory conditions where ‘diaper type’ was the primary variable. A 2-h time period was chosen to ensure that sufficient time had elapsed for thermal equilibrium to be established under the diapers. We also felt it necessary to study the impact of urination and simulated this condition over the last 15 min using standardized methods. In addition to the skin surface temperatures, we also measured the temperature of the tympanic membrane using an infrared thermometer as an estimate of ‘core’ temperature for each individual at various times during the session. Results and Conclusions: In this study, we have clearly shown that scrotal temperatures are the same whether the child is wearing disposable or reusable cloth diapers with a protective cover. The only situation in which scrotal temperatures were found to be lower is when the cloth diaper is used alone without a protective cover but this is not representative of how these products are actually used. We also found that on average scrotal temperatures are significantly lower than core for each diaper type. Occasionally, we did see individuals in which the maximal scrotal temperatures approached core temperatures but in every case the thermal sensors were soiled by a bowel movement. We also found that skin surface temperatures increased not only when covered by a diaper but also due to the thermal insulation provided by outer garments and blankets.

Disposable diapers today employ dramatically better fitting, less bulky, and more environmentally friendly features that deliver better performance and help provide protection for infant skin. Continuous innovations in technology and materials have resulted in new generations of disposable diapers that provide extended dryness and reduced leakage. Driven by studies on the skin’s response to inherent influences, such as overhydration and irritation, the qualities of disposable diapers today present significant enhancements for skin health compared with earlier disposable versions and even cloth diapers. Over the years, these enhancements in disposable diapers have helped lead to a reduction in incidence and severity of diaper dermatitis.

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An infant skin disease with clusters of nodules in the diaper contact area was reported as granuloma gluteale infantum. Recently, the number of elderly patients with this condition has increased, and it has been reported as diaper-area granuloma of the aged. These lesions are presumably caused by irritation from feces and urine. We observed similar cutaneous symptoms in six elderly patients, five of whom revealed clusters of nodules arranged in a circular pattern in the gluteal region presenting a peculiar clinical picture. They were all bedridden and wore cloth diapers. We speculate that wearing a cloth diaper seems to be a major factor behind this condition. Another factor was sitting during the day. A subject had lesions with nodules on the scrotum. The distribution of nodules appeared to be related to the body position and vigorous movement of the patient. In all cases, topical steroid therapies were not effective. They were all positive for bacteriuria. Chronic urinary tract infection further irritates the skin. It is necessary to reduce urine contact and keep the lesion clean.

Palm olein, a low-melting fraction of palm oil, and soy oil can be combined to obtain fat blends with proportions of palmitic and oleic acids similar to those of human milk. We compared the absorption of fat and calcium by infants fed a formula containing a blend of palm olein (53%) and soy oil (47%) (Formula PO/S) with that by infants fed a formula containing a blend of soy oil (60%) and coconut oil (40%) (Formula S/C). In a randomized crossover design, one study was performed with each formula in each of 11 normal infants ranging in age from 27 to 161 d. Six of the infants were admitted for 72-h metabolic balance studies. In the other five infants, feces (with some admixture of urine) were collected at home for 96 h by using acid-washed cloth diapers. Mean (+/- SD) absorption of fat was 90.6 +/- 1.6% of intake when Formula PO/S was fed and 95.2 +/- 1.1% of intake when Formula S/C was fed; the difference was significant (P < 0.001). The difference in excretion of fat by infants fed the two formulas was explained by the difference in excretion of palmitic acid. Absorption of calcium averaged 39.0 +/- 8.3% of intake with Formula PO/S and 48.4 +/- 10.3% with Formula S/C; the difference was significant (P < 0.01). We conclude that fat is less well absorbed from a mixture of 53% palm olein and 47% soy oil than from a mixture of 60% soy oil and 40% coconut oil, and that absorption of calcium is less from a formula containing palm olein, presumably because of the formation of insoluble calcium soaps of unabsorbed palmitic acid.

OBJECTIVES. Cloth diapers with front closure and all-in-one design were compared with paper diapers containing absorbent gel material for their influence on fecal contamination of the environment in licensed child day care centers. METHODS. One infant room and two toddler rooms in each of four day care centers were monitored for the presence of fecal bacteria. Microbial samples were taken from the play/sleep area, the diaper-changing area, and the hands of the caregivers and the children. Sampling was done twice weekly for two 4-week periods. Each center used either cloth or paper diapers during the first period, changing to the other diaper type during the second period. RESULTS. A total of 1722 samples were cultured, 881 during the first 4 weeks and 841 during the second 4 weeks. The frequency of isolation of fecal organisms ranged from a low of 12% of the total bacteria isolates at a center using cloth diapers, to highs of 46% and 45%, respectively, at a center using first paper and then cloth diapers. Sink faucets and the hands of the caregivers and the children were often contaminated. CONCLUSIONS. Analysis of the results of comparisons between cloth and paper diapers showed no significant difference in the frequency (F = .380, P < .535) or the intensity of fecal contamination in child day care centers.

A life-cycle inventory of cloth and disposable diapers was conducted based on diapering habits in Canada The parameters evaluated were energy consumption, water consumption, raw materials consumption, atmospheric emissions, water-borne wastes, and solid wastes The results showed that cloth diapers consume more water and produce more waterborne wastes than do disposable diapers, whereas disposable diapers consume more raw materials and produce more solid wastes than do cloth diapers Sensitivity analyses proved these differences to be significant However, with respect to energy consumption and atmospheric emissions, the computed differences were assessed to be insignificant inasmuch as these may be offset by reasonable variations in cloth to-disposable diaper usage ratio, market sharing between home laundering and service laundering, number of laundry loads per week, laundry water temperatures, percentage of dryer drying and line drying, and drying time The Canadian inventory results were compared to those of three similar U S diaper life cycle inventories Although they differ numerically on the estimated rates of resource consumption and environmental releases, all the studies agree that cloth diapers consume more water and produce more waterborne wastes, whereas disposable diapers consume more raw materials and produce more solid wastes, their findings concerning energy consumption and atmospheric emissions were not as consistent The study concludes that neither diaper system can be considered absolutely superior environmentally

In recent years state and local governments, as well as private citizens, have become very concerned about the mounting solid waste disposal problem facing our nation. Special concern has been expressed over the presence of disposable diapers in the solid waste stream. Responding to the concerns, legislators in at least 25 states proposed actions regarding disposable diapers between 1990 and 1992. Several factors contributed to the number of legislative proposals regarding disposable diapers over the past few years. First was the public's and legislators' misconception about the contribution of disposable diapers to the solid waste stream. Second was an erroneous assumption held by the public and some legislators that biodegradation readily occurs in landfills. Third was the desire to increase demand for agricultural products by requiring the use of “degradable” products. These contributing factors and other issues surrounding the proposal and passage of environmental legislation pertaining to disposable diapers are presented in this paper and the relevant literature is summarized. To provide the necessary context, the paper contains a review of the literature concerning disposable diapers, their composition and usage; and their environmental impact and fate and a comparison of their performance and cost to those of cloth diapers.

Since the 1960s, cloth diapers have been replaced by disposable diapers. The evolution of healthier skin in the diaper area has been demonstrated in parallel to that of disposable diapers. The improve

Seventeen enzyme-detergent formulations, representing liquid, powder, and concentrated packet product types, were tested in a variety of fabric and garment exposure tests (i.e., wrist band, men's briefs, men's t-shirt, infant fabric wear and cloth diaper, and extended home usage tests). The results of these tests indicate that the presence of enzymes in laundry detergents does not introduce irritant properties to fabrics. The testing of fabrics laundered in enzyme-detergents for their effect on skin has been an essential aspect of dermal safety testing and provides relevant support for the skin safety of these products.

Superabsorbent disposable baby diapers are sophisticated, well-engineered products that provide many benefits including convenience, comfort, exceptional leakage protection, improved hygiene and skin care benefits compared with cloth diapers. Safety assurance is an integral part of the diaper development process at Procter & Gamble, with the goal of ensuring safety for both caregivers and babies. A systematic, stepwise approach to safety assessment starts with a thorough evaluation of new design features and materials, using the principles of general risk assessment including, as appropriate, controlled trials to assess clinical endpoints or independent scientific review of safety data. The majority of the diaper materials are polymers that are safe and do not have inherent toxicity issues. Trace amounts of non-polymeric materials, such as colorants, are assessed based on their skin contact potential. New materials or design features are introduced in marketed products only if they have been shown to be safe under the conditions of recommended or foreseeable use. The product safety continues to be confirmed after launch by means of in-market monitoring. This article provides a broad overview of human safety exposure-based risk assessment used at Procter & Gamble for absorbent hygiene products.

Skin wetness is proportional to diaper wetness, and with increased skin wetness, the potential for diaper dermatitis is increased. This study evaluated a wide range of infant diaper products. Eighty healthy volunteers wore 2-inch wetted diaper patches on their volar forearm for two hours. An evaporimeter was used to measure excess skin wetness attributed to the patches. The amount of moisture retained in the patch was also calculated. We found that superabsorbent (SA) disposable diapers kept the skin drier and retained more synthetic urine than cloth reusable and conventional disposable brands, and thus have the greatest potential for helping prevent diaper dermatitis. The SA brands evaluated did an equally adequate job in keeping the skin dry and in retaining moisture. Conventional disposable diapers were less able to keep the skin dry than SA diapers and were not superior to cloth products in most instances. Cloth diapers” performance depended on their composition. Those with several layers of the same fabric were less successful in keeping the skin dry than ones that contained middle layers of different nonwoven components.

After a long, cold winter, it seems like babies are everywhere. There have even been a few born to staffers here at C&EN, so the Newscripts gang decided to help out the new parents in our midst by wading into the surprisingly intense debate on cleaning cloth diapers. The argument centers on detergent residues left behind on a diaper after it’s been washed. Some additives, such as perfumes and color-brightening fluorescent dyes, are designed to stick around. Others, such as gels, thickeners, and enzymes, are meant to rinse away but can persist after washing. Some parents worry that the additives might affect how well a diaper absorbs waste. Another concern is that residues might cause diaper rash and bad—or worse—smells in the warm, moist, and sometimes nitrogen-rich conditions in a diaper. Pat Slaven, a research engineer specializing in laundry at Consumer Reports, says that dyes decrease the absorbency of cotton ...

Mice were monitored with pneumotachographs while they breathed emissions of three brands of disposable diapers (described herein as brands A, B, and C) and one brand of cloth diapers for 1 hr. The authors used a computerized version of the ASTM-E-981 test method to measure changes in the pattern and frequency of respiration. In response to two brands of disposable diapers, many mice exhibited reduced mid-expiratory airflow velocity, sensory irritation, and pulmonary irritation. During the peak effects, brand A caused sensory irritation in 47% of the breaths and reduced mid-expiratory airflow velocity in 17% of the breaths (n = 39 mice), whereas the respective percentages noted for brand B were 20% and 15% of the breaths (n = 28 mice). The effects were generally larger during repeat exposures to these emissions, with up to 89% of breaths showing sensory irritation in response to brand A and up to 35% of breaths showing reduced mid-expiratory airflow velocity with brand B. A third brand of disposable diapers caused increases in respiratory rate, tidal volume, and mid-expiratory airflow velocity. The emissions of cloth diapers produced only slight SI and slight PI. Chemical analysis of the emissions revealed several chemicals with documented respiratory toxicity. The results demonstrate that some types of disposable diapers emit mixtures of chemicals that are toxic to the respiratory tract. Disposable diapers should be considered as one of the factors that might cause or exacerbate asthmatic conditions.

We studied the relationship between decubitus ulcers and changes in skin blood flow with respect to the presence or absence of a decompression medium. We also studied the relationship between decubitus ulcers and the results of biochemical tests that reflect nutritional status. Two groups of inpatients with decubitus ulcers in areas other than the sacral region were studied: One used cloth diapers and the other used paper diapers. Skin blood flow was measured with a laser Doppler blood flowmeter and a sheet of polyurethane (decompression medium) in the sacral region. Data were also obtained from patients with and without decubitus ulcers, and whose levels of albumin, total cholesterol, and triglyceride for three months were known. When the decompression medium was used, skin blood flow changed significantly after body position was changed in the patients who used paper diapers. Nutritional analyses showed significant differences in the levels of albumin and total cholesterol between patients with and without decubitus ulcers. The levels of albumin and total cholesterol were lower in the patients with decubitus ulcers than in those without decubitus ulcers. Because the cloth diapers acted as a compression factor, even an externally applied decompression medium did not suppress the reductions in skin blood flow.

Travel abroad provides a challenge for even the most seasoned traveler, but the introduction of the special needs of an infant or child into the equation creates an even more complicated situation. It is an old adage that "children are not merely small adults" and no where is this more evident than in traveling to an undeveloped country where every step, every bite, and every breath could be potentially life-threatening. Adults have well-developed immune systems to protect themselves against many pathogens, but, more important, they have the life experiences and thought processes that enable them to avoid danger and when threatened to find a solution for survival. Infants and children, in addition to being particularly vulnerable because of a naive immune system and developing physiologic protective mechanisms, depend on adults to make decisions for them and anticipate possible dangers. With appropriate planning, however, travel abroad may even be safer than staying at home. 12 Preparation for travel must begin weeks before traveling by selecting a travel advisor and obtaining necessary immunizations and counseling. It continues through the process of travel with risk assessments made along the way based on a thorough understanding of the child's special needs. And it does not cease when the family arrives home, because chemoprophylaxis may need to be continued and a heightened awareness for illnesses acquired while traveling must be maintained. Parents will need to be counseled regarding choice of a travel advisor. Travelers frequently receive incorrect information, 8 which may result in preventable morbidity and mortality. Therefore, it is preferable to obtain information from a travel medicine center if one is available. An appropriate center to evaluate children for travel will be familiar with the particular needs of children traveling, provide information about risk reduction, provide prescriptions for chemoprophylaxis, have a mechanism for follow-up if necessary, and have in stock the commonly used vaccines for travel. Yellow fever vaccine requires a special license. An ideal travel medicine center counsels about not only health-related factors and disease prevention, but can provide information about obtaining resources about obtaining passports and visas, foreign health insurance, and advisories about political unrest in the country. Planning needs to begin about 6 to 8 weeks before travel. Routine immunization schedules are complicated and may need to be altered to provide the maximum immunity before traveling, for example, measles vaccine is not normally given until 12 months, but a dose may be given earlier if measles is endemic in the area of travel. After discussion, it may be necessary to postpone travel until an infant can be appropriately immunized or have the infant join the family later. For example, in an area of endemic pertussis, it would be unwise to travel with an infant younger than 6 months of age who has not received the three primary immunization series. Administration of live virus vaccines in combination with others complicates the immunization schedule even further so careful logistics are necessary to ensure that all recommended vaccines can be given before departing. Parents will need advice on a number of topics. Preparation for travel even across the state to grandmother's house can seem daunting, what with diapers, formula, toys, car seats, and other extra equipment, but this is amplified when traveling overseas. Many of these common items are not available at the corner store, so to avoid both overpacking and being caught unprepared, research should be done about what is available. The most important item to plan for is food. It is estimated that one third of travelers from industrialized countries to undeveloped countries will have travelers diarrhea. 10 Planning is especially important for infants on formula. Concentrate and powdered forms are most convenient, but a clean water supply must be available. This may require purchasing a system to purify water and knowing its limitations or learning how to make water pure yourself. Disposable diapers are not generally available in undeveloped countries and are bulky to pack, so it may be necessary to purchase cloth diapers and provide for laundering them. If possible, when reserving rental cars, vehicles with seatbelts should be requested and car seats should be brought by the family, because availability is not guaranteed. Traveling with portable cribs and high chairs is not practical in most circumstances, so imaginative solutions are needed, for example, using a drawer from a dresser as a bassinet. Assembly of a medicine kit is essential. Based on the child's age and history, most needs can be anticipated. See Table 1 for a sample kit. In addition, an adequate supply of any regular or intermittent medications should be brought. Examples of these would be medication for a seizure disorder and antibiotic prophylaxis for otitis. For diabetics, insulin and a mechanism for keeping it refrigerated must be insured, as well as an adequate supply of needles. In addition, a letter from a doctor stating that the needles are to be used by a diabetic may be required in some countries. A copy of a prescription for corrective lenses or if travel is anticipated to be lengthy, an extra pair of glasses or contact lenses should be brought. Ideally, these are carried in the carry-on luggage, which is less likely to be lost. Children with hearing aids or limb prostheses provide an added challenge, and facilities should be identified in advance to handle these needs. Traveling is stressful for children, and appropriate emotional preparation needs to be done. Even if the family is traveling for a short time, the details of tying up loose ends and packing are time consuming and often involve short tempers, such that attention to a child's normal needs gets overlooked. This is amplified with the child "acting out" and the cycle worsening. As a result, everyone boards the plane exhausted and overwrought. In situations where the family is going overseas for prolonged periods or are relocating, the stress level is even higher. Additionally, there are the issues facing any child who is moving such as fear of the unknown and grieving over the anticipated loss of friends and contact with familiar people and places. In both of these situations, attention to the child's needs will lessen the anxiety. Specifically, having the child choose a favorite toy to take along, allowing the child to ask questions, and (when age appropriate) discussing fears and anxieties are all helpful.

In this study, modern all-in-one, front closure, reusable cloth diapers were compared with single-use, disposable paper diapers for their effect on fecal contamination in the child day care environment. Four licensed child day care centers were surveyed from which 1722 bacterial samples were cultured. The frequency of isolation of fecal organisms ranged from a low of 12% of the total bacterial isolates at a center using cloth diapers to a high of 46% and 45%, respectively, obtained at a center using first paper and then cloth diapers. Diaper type, cloth versus paper, when the method of application and the handling are made comparable, showed no significant difference in the frequency or the intensity of fecal contamination in child day care centers, as measured in the play/sleep area, the diaper change area, or on the hands of the care givers and children. Future studies to control microbial contamination in child day care centers should focus on effective ways of reducing contamination of sink faucets, hands of the caregivers, and hands of the children.

To evaluate an office-based educational intervention to promote the use of cloth diapers, we randomly assigned parents of 193 infants either to the intervention group or to a control group. The intervention consisted of physician advice and written material on cloth and disposable diapers at the 2-week office visit. Midway through the study, one of the birth hospitals switched to the exclusive use of cloth diapers. The results indicate that the diapering decisions of parents can be influenced by practices in hospitals and by office-based physician and nurse counseling.