From time to time, we hear from would-be cloth diaper users that Day Care Centers won’t accept cotton diapers from our Austin diaper service customers or San Antonio. The following information may be helpful in giving you (and possibly the day care center you are considering) a better understanding of the effect of different diapering methods in a Day Care setting.

In 1993 Bonnie Holaday (RN, DNS Professor of Nursing at the Vanderbilt University School of Nursing) and Sidney Harshman (SCD, Professor of Microbiology and Immunology at the Vanderbilt University) did a study entitled, Fecal Contamination in Child Day Care Centers: Controlled Comparison of Cloth and Paper Diapers. Below are their findings.

Introduction

The objective of this study was to compare the modern front-closure cloth diapers versus the paper diapers with absorbent gelling material to see what effect their use might have on the contamination of the environment with fecal organisms.

Materials and Methods

Study Participants -- Four day care centers with a total of 109 children aged six weeks to twenty two months. Twenty-five child care givers participated. All eligible providers participated and 95.4 percent of eligible children participated.

Diapers - Three types of diapers were studied that meet the 1992 standards recommended by the American Public Health Association (APHA) and the American Academy of Pediatrics (AAP). They are: a paper diaper with absorbent gelling material and 2 types of cloth diapers: a single reusable diaper system with an inner cotton lining attached to an outer waterproof covering, and a cloth diaper worn with a modern front closure waterproof cover.

Sampling - Three general areas were sampled in each of the three rooms at each of the four day care centers: a) children’s sleep/play area; b) the diaper change area; and c) the hands of caregivers and children.

Results

Fecal contamination of the environment in licensed child care centers is a common event, but diaper type, cloth versus paper, does not correlate with either the frequency or the intensity as measured in the play/sleep area, the diaper change area, or on the hands of the caregivers and children. The study should refocus child care professionals and concerned parents on the fact that the key to wellness in child care centers is hand washing and hygiene practice, not diaper type. According to the APHA/AAP guidelines, “reusable cloth diapers worn with a modern front closure waterproof cover” and “single unit reusable diaper systems with an inner cotton lining attached to an outer waterproof covering” meet the criteria established for use in child care centers.