Diaper Buying Guide

Originally, swaddles sufficed as diapers in the Western world. Unfortunately for those babies, they were kept in their swaddles, excrement and all, for several days before they were changed. In some South American societies, babies wore something closer to what we think of as diapers, with strips of cloth that were stuffed with dried grass for increased absorption, while in Japan, old clothing was cut and wrapped around a baby’s butt for protection. In the West, it wasn’t until the 19th century that cloth diapers as we know them today were invented, as working-class people had begun to purchase furniture that they didn’t want getting destroyed by their children’s bowel movements. These early diapers were only marginally better, and in fact, they were washed in toxins that occasionally poisoned babies.

The cloth diapers of today are much safer than those of yesteryear. They’re usually made from cotton, although some are now made with bamboo. Diaper covers, which are usually made of plastic, cotton, or terry, fit over the cloth diaper and help prevent leaks. Cloth diapers obviously have to be washed before they’re reused, a somewhat unpleasant task. Some parents opt for a diaper service, which regularly picks up dirty diapers and drops off clean ones. Prices vary depending on location, but one company that provides laundering services to Austin, Texas, and the New York City metropolitan area charges $38 to $48 per week.

Cloth diapers come in a few types. All-in-one diapers are a better option for beginners. They don’t require inserts, pins (picture old-fashioned diaper safety pins!), or even covers. Because they’re easier to use than other cloth diaper types, they’re a good choice for parents who share caretaking duties with others, such as nannies, family members, or day-care centers. They are, however, a bit more expensive than prefold and flat-fold diapers.

Prefold diapers are probably what you think of when you think of cloth diapers. These diapers use clips or fasteners to close. Despite their name, they require some folding and, therefore, a little bit of practice. They do, however, have different layers in different areas of the folds, with more in the middle region. They come in different sizes and often require covers.

Flat-folds are hardcore basic: They’re just a square of unfolded, single-layer fabric. As with prefolds, they require pins, covers, and folding. The particular benefit is that they can double as burp cloths.

Hybrids are just that: a hybrid of a cloth and a disposable diaper. They usually have a reusable cloth outer layer with a disposable insert. These inserts drive up the price a bit, though, compared with other types of cloth diapers. Pocket diapers are similar, but instead of disposable inserts, they have washable inserts.

The woman widely credited with developing the disposable diaper, Marion Donovan, was frustrated with soaked crib sheets that resulted from cloth diapers that she said “served more as a wick than a sponge.” She went on to eventually net $10 million in today’s dollars from her invention. That first product, which she called “The Boater” and earned a patent in 1951, was, in fact, a hybrid cloth diaper with a pocket for a disposable or regular insert. Executives were initially skeptical, though, and it wasn’t until 1961 that the first mass-produced diaper, from Pampers, became available.

Disposable diapers went on to change the world. An overwhelming majority of parents worldwide now use them (though the market for cloth diapers is expected to grow over the next few years). They have several layered components that are designed to achieve the end goal: keeping your baby’s bowel movements and urine in the diaper instead of outside of it. These components include “fluff,” also known as cellulose or pulp, that’s typically made from wood, a superabsorbent gel, and elastic, all of which keep babies comfortable and the crib dry, according to Natalia Richer, a diaper and absorbent hygiene products consultant at Diaper Testing International. 

You’ll probably embark on potty training when your child is between 18 and 24 months, although that’s flexible and dependent on the needs of you, your baby, and your family. Until then, you’ll notice that disposable diapers are all pretty similar in their basic design. They come in about nine sizes, ranging from “preemie” for babies smaller than 6 pounds to size 7 for babies 41 pounds plus. Preemie and newborn diapers often have cutouts that are designed to avoid the baby’s umbilical cord so that it can heal. If the diaper doesn’t have a newborn cutout, make sure to fold the diaper down beneath the area. 

Diapers can be scented, though they’re not always labeled as such. In rare instances, babies will have reactions to fragrance. If that’s the case, look for diapers that are clearly marked as unscented. “Some children do have sensitive reactions to some of a diaper’s components. This will usually show up as a rash that is distributed over the entire diaper area—or over the elastic leg openings,” says Heather Burrows, MD, PhD, a professor of pediatrics at Michigan Medicine at the University of Michigan in Ann Arbor. “In these cases, it may be helpful to try unscented diapers.” Some blogs mention the dangers of other materials in diapers, but Burrows says most parents don’t need to worry about this. “The components in modern disposable diapers are safe to use for most infants unless they have demonstrated a reaction to a particular diaper. Other aspects are really more about personal preference.”

Overnight diapers have a clear function. They have more pulp and superabsorbent gel than standard diapers, Richer says. Newborns require up to 10 diapers per day, which is about one diaper change every 2 to 3 hours; you’ll want to change your newborn’s diapers overnight after feeding. For many brands, overnights start at size 3, or when your baby is 16 to 28 pounds, at which point they’re more likely to be sleeping for longer stretches during the night. 

Though overnight diapers can be a boon for any exhausted parent who just wants a few hours of consecutive sleep, generally speaking, you don’t want to leave your baby sitting in their own poop for hours on end because it can cause diaper rash. “There are several causes of diaper rash," Burrows says. "The most common is a contact irritation. This is usually related to contact of the skin with stool or urine for some period of time.” Changing a baby’s diaper frequently can help prevent the problem. (Read more about diaper rash below.)

Many disposable diapers these days are so exceptionally good at absorbing urine that it can be difficult to tell by feel alone if your baby has made good use of it. The super-absorbent gel in disposable diapers can absorb up to 50 times its weight in urine, according to Richer. Many diapers now have wetness indicators, which are strips on them that change color when your baby has peed. That said, you’ll still need to check for poop, Burrows says.

Pull-ups or training pants are a middle ground between standard baby diapers and cloth underwear. They’re slimmer than diapers but are made from absorbent material in case of accidents as your little one embarks on potty training. They differ in other ways from regular diapers, too. “Diaper pants, also known as training pull-ups, are designed with more elastic materials around the waist,” Richer says. This design allows your toddler to use the toilet on their own.

Notice red or pink inflammation on your baby’s bottom? Don’t freak out. It’s probably diaper rash, which is common. About half of all babies get it at some point, according to the American Academy of Pediatrics (AAP). Most of the time, it’s caused by a baby sitting in a dirty diaper for a little too long, Burrows says. Diaper rash can be worse if your baby has diarrhea or another gastrointestinal infection. Less common causes include allergic reactions, eczema, strep skin infections, zinc deficiency, or other systemic issues (though this is rare). Scented diapers can cause diaper rash for babies with sensitive skin, and research has found that natural botanical extracts, such as calendula, chamomile, and arnica, which are sometimes found in diaper wipes, can cause diaper rash in those with sensitive skin. For most children, though, “choosing a scented vs. unscented diaper is more about personal choice,” Burrows says.

There are many things you can do to treat diaper rash and lessen its recurrence. Changing your baby’s diaper more frequently can help. Clean the baby’s bottom with unscented wipes, a spray of water, or a quick rinse in the bath between changes, and slather the area with fragrance-free diaper cream or barrier paste. Creams with zinc oxide or petrolatum are your best bet here. “Using a barrier cream is also important to keep urine and stool off of the skin," Burrows says. “A thick coating, like ‘frosting a cake’ with each diaper change, is important.” Letting your baby hang out without a diaper on can help, too, she says. “This allows for increased air circulation and decreased friction, and keeps the urine and stool from contact with the skin.” Placing a waterproof sheet beneath the baby’s bottom can help with any mess.

Finding diapers that are labeled unscented can help if your baby has eczema or is prone to diaper rash. And make sure your baby’s diaper fits! A diaper that’s too tight can rub against their skin, while one that’s too big or too small can lead to blowouts. The diaper should come just up to the belly button or umbilical cord stump and should cover the butt entirely with no cheeks peeking out. The leg ruffles should flare out, not tuck in. Red marks around the baby’s legs will indicate that the diaper is too small or tight. To check, run a finger beneath the diaper along the leg holes. It should fit comfortably between the leg and the diaper.

If you typically use cloth diapers, consider switching temporarily to disposables while the rash heals. This is because cloth diapers tend to be less absorbent than disposable diapers, and more absorbent diapers are less likely to cause a rash.

Aside from the fact that patterned reusable diaper covers can be pretty cute, there’s one benefit to cloth diapers: They’re cheaper than disposables, particularly if you wash them yourself. (Using a diaper service will drive up the price.) 

They’re not healthier for a baby’s skin than disposable diapers, though, Burrows says. According to the AAP, cloth diapers aren’t as absorbent as disposables and therefore need to be changed more frequently. And according to Stanford Medicine Children’s Health in California, studies show that disposable diapers may lessen the likelihood of diaper rash compared with cloth diapers.

In our tests at Consumer Reports, we found that even the best cloth diapers don’t absorb liquids as quickly or keep the moisture in the diaper as well as the best disposable diapers we tested. That’s likely due to the fact that they lack the superabsorbent gel in disposable diapers, says CR test program leader Bernie Deitrick.

Among the cloth diapers we tested, flat-folds and prefolds tended to be less absorbent than the all-in-one diapers and pocket diapers because their materials were much thinner. 

What about the environment? That’s up for debate. While cloth diapers use less materials overall, they require water to clean and produce more waterborne waste (aka poop). This varies, however, depending on how you wash your diapers. Using cold water in a front-loading washing machine and line-drying them will have a lower environmental impact than throwing away disposables, according to the United Nations. Cotton, which most cloth diapers are made of, is an environmentally harmful crop, contributing to soil erosion; the contamination of water with pesticides, fertilizers, and minerals; water scarcity; and the conversion of natural habitats to agricultural land. According to McGill University in Montreal, cloth diapers come out on top when it comes to sustainability concerns—by a narrow margin. The AAP is more succinct with its analysis, stating that the sustainability battle between the two types seems to be “a wash.”

Disposable diapers are marginally pricier, and perhaps marginally worse for the environment, than cloth diapers. While using cloth diapers can use more water and produce more waterborne emissions than disposable diapers, disposables fill up landfills and use more natural resources. According to a 2017 Euromonitor report, more than 300,000 diapers are trashed, incinerated, or end up in the environment every minute. About 30 billion end up in North American landfills annually. Even compostable diapers are difficult to get rid of because composting facilities are often unavailable to consumers, and the term “biodegradable” isn’t universally defined. Plus, baby poop can end up in waterways.

Still, the benefit of cloth diapers, according to the current research, is slim, and there are reasons you may want to consider disposables if you can handle the amount of trash. Disposable diapers are more absorbent than cloth and may be better at preventing diaper rash. (Changing cloth diapers more frequently will substantially lessen the likelihood of diaper rash, however.) Disposables are also better at preventing leaks, according to Stanford Medicine Children’s Health.

In summation, here are some of the pros and cons of the two types of diapers.