The word diaper originally referred to the type of cloth rather than its use. Diaper cloth was originally linen. The first known reference is in Shakespeare's "The Taming of the Shrew" "Another bear the ewer, the third a diaper". This usage stuck in America, but in Britain the word nappy (short for baby napkin[?]) took its place.
While awake most children no longer need diapers when past three years of age. However nighttime diaper usage is quite common up to the age of five or beyond. Some children have problems with daytime or more commonly nocturnal bladder control until a much later age. This may occur for a variety of reasons including difficulty managing a small bladder and emotional issues. Many older children also need diapers while travelling. These children may use standard but larger size diapers (youth diapers) or special diapers which mimic underwear and do not require pinning or adult assistance.
A diaper's ability to absorb liquid can be increased using extra pads. This is useful for children who wet their diapers heavily or when frequent changes are not possible, for instance while away from home. A very thick diaper between the legs may decrease the child's mobility, but this must be weighed against the need to avoid leakage.
A diaper should be fastened snugly and positioned correctly to function well. To improve comfort, diapers are also typically worn with plastic pants. Some children, especially older children, may accidentally adjust the positioning of the diaper. To avoid this, many plastic pants have special child proof fastening buttons or similar devices.
When to change a diaper is the decision of the caregiver. Some people believe that diapers should be changed at fixed times of the day to establish a set routine. To avoid skin irritation commonly referred to as diaper rash[?], the diaper should be changed as soon as possible after it is soiled (especially by fecal matter). During the change, after the buttocks is cleaned, some people use baby oil, barrier creme or baby powder to reduce the possibility of irritation. The most effective means to prevent and treat diaper rash is to expose the buttocks to air and sunshine as often as possible. There are also drying cremes based on such ingredients as zinc oxide[?] which can be used to treat diaper rash. Before disposing of a diaper, either in a diaper pail for washing or the garbage, fecal matter should be removed as much as possible and placed in a toilet to avoid landfill and ground water[?] contamination.
There are several cultures that forgo the use of diapers entirely. Parents or other caregivers adapt themselves to be sensitive to an infant's elimination schedules and signals. When it becomes evident that the infant needs to eliminate, he or she is taken to an appropriate area. In the West, this practice is often called infant potty training (though it is the parents which are being trained to detect the signals) or elimination communication.
Diapers may be made of absorbant layers of cloth or terry towelling fabric, or of disposable absorbant materials. The choice to use either cloth or disposable diapers is controversial. While cloth diapers are certainly cheaper than disposables over time, environmental impact, health and convenience also play a role in the decision. However all of the studies which started the controversy in the early 90s were funded by Procter and Gamble, which manufactures the vast majority of disposable diapers, and was facing growing criticism at that time.
Cloth diapers are washable and reusable and place less stress on landfills, however, they also require large amounts of washing powder[?] and water. Disposable diapers take a great deal of processing and their materials remain intact in landfills for many years. A recent development is a hybrid reusable / disposable system, with an outer plastic part which is re-used, and an interior absorbent part which is disposed and is fully bio-degradable.
Disposable diapers are laced with chemicals obtained unintentionally in production, as well as intentionally in order to improve absorbancy and pull wetness away from the skin. While this system works well in keeping skin dry, it also provides a potential skin irritant. Cloth diapers are most commonly made of industrial cotton, which is grown in conjunction with the heavy use of pesticides. The fabric is also usually bleached white. Alternative materials which are grown without pesticides, such as unbleached hemp and organic cotton exist.
Disposable diapers have the advantage of convenience (for the parent). Cloth diapers, however, have become more user friendly in recent years. Pre-formed cloth diapers with snaps or velcro and all-in-one diapers with wet-proofing exteriers are now available in addition to the older pre-fold and pin variety. Some cities offer a cloth diapering service which delivers clean diapers and picks up soiled ones for a fee. Cloth diapers in conjunction with elimination communication seem to be the method of choice when one wants the best of convenience both to the parent and child, while reducing environmental and health impacts to practically nothing.
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