Solving Your Diaper Dilemma

Cloth vs. disposable: It's the great diaper debate, but is one type of diaper really better for baby and the environment? Experts weigh in.

Medically Reviewed by Jennifer Shu, MD on September 15, 2015
4 min read

What else besides lack of sleep and feeding after feeding does a parent have to look forward to during baby's first year?

Diapers. Mounds and mounds of them.

Some moms and dads know from the get-go that they'll love the convenience of disposable diapers. And some know there's something just right about the fluffy feel of cotton nappies against their newborn's skin.

But other parents find themselves in a quandary. Are cloth diapers more eco-friendly? Are there worrisome chemicals in disposable diapers? Which diapers will keep Junior drier and hence, less prone to diaper rash?

WebMD asked experts to weigh in on the diaper dilemma.

Most U.S. families -- by some estimates, up to 95% -- use disposable diapers. But there are some parents who are convinced that cloth diapers are more Earth-friendly. Experts, though, say the answer isn't clear-cut.

Research has suggested that both disposable and cloth diapers affect the environment negatively -- just in different ways. For example, disposable diapers require more raw materials to manufacture. And they generate more landfill solid waste that can take an extremely long time to degrade. But cloth diapers use up large amounts of electricity and water for washing and drying. Plus, commercial diaper service delivery trucks consume fuel and create air pollution.

Nebraska pediatrician Laura A. Jana, MD, FAAP, agrees that there's no clear winner in the diaper debate. She researched the controversy while co-writing the American Academy of Pediatrics book, Heading Home with Your Newborn: From Birth to Reality. "When we were writing the book, we tried to get to the bottom of [the debate]. And -- with a sort of pun intended -- it kind of came out a wash," Jana says. "More power to parents who are trying to do the right thing," she adds. "But I'm not convinced from an environmental standpoint that there's a huge benefit to cloth diapers."

Ultimately, parents are left to make their own personal choice. The American Academy of Pediatrics takes no position on cloth vs. disposable diapers.

Nor does the Environmental Protection Agency (EPA). While proponents of cloth diapers worry that germs in disposable diapers might leach from landfills to contaminate ground water, an EPA spokesperson told WebMD in an email that the agency didn't consider them a hazard: "Disposable diapers fall under the category of municipal solid waste, which means the material is safe to be disposed of in a U.S. municipal solid waste landfill. In the U.S., modern landfills are well-engineered facilities that are located, designed, operated, and monitored to ensure compliance with federal regulations which aim to protect the environment from contaminants which may be present in the solid waste stream."

Despite the lack of consensus, parents can still go green. Some buy a flushable hybrid diaper. The soiled, biodegradable liner is flushed down the toilet into the sewage system, rather than sending yet another diaper to the landfill. Then parents insert a new liner into the reusable cloth pants.

Others parents prefer chlorine-free disposable diapers, which cut down on toxic dioxin. Dioxin is the result of using chlorine to bleach disposables white. Parents can also buy organic cotton diapers. Organic cotton uses no pesticides during growing.

It's important to pay attention to research that points out potential harm, Jana says. But she reassures parents that she has not seen long-term health problems related to disposable diapers. And pediatricians do not caution parents against their use. "It just doesn't hit the radar screen," Jana tells WebMD.

Diaper rash can stem from several causes: friction, moisture, urine, and feces. Sometimes, the culprit is infection from yeast, such as Candida albicans.

Again, there's no consensus on whether disposable or cloth diapers are best for reducing risk of diaper rash. But according to Tanya Remer Altmann, MD, FAAP, "Most pediatricians do feel that disposable diapers prevent irritation diaper rashes. That's because they keep the baby's bottom drier." Altmann, a California pediatrician, is editor-in-chief of the American Academy of Pediatrics book, The Wonder Years, and a clinical instructor at the Mattel Children's Hospital, UCLA.

Altmann tells WebMD that parents who use cloth diapers can also cut risk by minimizing the amount of time that babies are in contact with urine and feces. "If you're good about changing your baby's diaper very frequently, as we recommend that parents do, you can prevent diaper rash with both types of diapers."

A 2005 study published in Pediatrics found that some babies can develop rash as an allergic reaction to dyes in colorful diapers. Parents can switch to dye-free diapers to remedy the problem.

For convenience and health reasons, many day care centers require disposables and will not accommodate cloth diapers. So parents may not have much choice.

"You're really talking about hygiene and minimizing potential for spread of infection, for example with diarrhea," Jana says.