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Diapers and Day Care-Reply

Ardythe L. Morrow, PhD, MSc; Rory Van, DrPH; Chuan-Chuan Wun, MS; Larry K. Pickering, MD
JAMA. 1991;266(17):2372-2373. doi:10.1001/jama.1991.03470170059017.
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In Reply.  —We have categorized the issues raised into several subheadings.

Protocol Issues.  —We compared commercially available paper diapers with cloth diapers that were provided by an experienced diaper laundry service that used a seven-step laundering procedure. Prior to the study, all day-care centers used paper diapers, which contained absorbent gel material and had elastic leg bands. During the cloth-diaper phase, two standard-thickness cloth diapers and plastic pants with elastic at the legs were used for each change. Cloth diapers were disposed of within the centers in an equivalent manner to disposable diapers. Soiled cloth diapers and plastic overpants were removed from children and were immediately placed in sealed containers that were emptied daily by the diaper service. Plastic overpants were worn once and then were laundered before reuse. All rinsing and laundering of cloth diapers and overpants were done professionally outside the centers. The suggestion that cloth diapers in


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