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 Table of Contents  
CME ARTICLE
Year : 2016  |  Volume : 17  |  Issue : 2  |  Page : 83-86

Advances in diaper technology


1 Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
2 Department of Pediatric Dermatology, Institute of Child Health, Kolkata, West Bengal, India

Date of Web Publication30-Mar-2016

Correspondence Address:
Sahana M Srinivas
Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-7250.179412

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  Abstract 

Diapering practices vary among different countries from the use of cloth diapers to the modern disposable diaper. In the last few decades, diaper technology has advanced significantly thus decreasing the prevalence of diaper dermatitis. Recent innovative techniques used in the manufacturing of diapers include incorporation of superabsorbent polymer gel that can absorb 30 times its weight in liquid. Recently, smart diapers have been developed which not only prevents diaper dermatitis but significantly has reduced the burden on parents. This article reviews how changes in disposable diaper technology have improved diapering practices.

Keywords: Diaper dermatitis, innovative technology, modern disposable diaper, super absorbent polymer gel


How to cite this article:
Srinivas SM, Dhar S. Advances in diaper technology. Indian J Paediatr Dermatol 2016;17:83-6

How to cite this URL:
Srinivas SM, Dhar S. Advances in diaper technology. Indian J Paediatr Dermatol [serial online] 2016 [cited 2019 Dec 7];17:83-6. Available from: http://www.ijpd.in/text.asp?2016/17/2/83/179412


  Introduction Top


Diapering practices vary among different countries. Usage of various diaper materials has evolved through the last decade from reusable cotton cloth to modern disposable diapers. Recent advances in diaper technology and advanced design features have led to prolonged dryness and decrease in frequency and severity of diaper rash. The advent of the modern day diaper has reduced the workload on the parents to a significant extent. It has in fact made the task of “changing the diaper” more difficult to remember than execute.


  Historical Aspects Top


The first disposable diaper was created by Marian Donovan during World War II in post-war baby room, in 1950 when there was shortage of cotton. She created the first plastic covering diaper made from shower curtain with layers of tissue paper as an absorbent inner material. These diapers were rectangular in shape with a bulky fit.[1] Later the pulp was substituted by paper with rayon sheet material as the outer layer of the diaper. The initial diapers did not have a tape, later new tapes were added for fastening and the shape was changed from rectangular to hour glass. March toward different innovations in the making of diaper began from 1960.


  Evolution of Diapers Top


A disposable diaper by definition consists of three layers, permeable top layer made of nonwoven fabric, an absorbent pad in the middle layer and an impermeable bottom layer [Figure 1]. In the last few years over 1000 patents related to diaper design and technology has been released. During the earlier times, mass diapers produced were made of cloth. From 1960 onwards researchers started investing about innovative techniques to improve the efficacy and design of diapers. The early disposable diapers used materials such as wood pulp fluff, cellulose wadding, fluff cellulose, or cotton fibers, but their absorbing capacity was less.[2] The cellulose is derived from pine trees and milled into fluff pulp that has the capillary effect to draw liquid.
Figure 1: Layers of disposable diaper

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Later on from 1980, modifications were made to increase the absorbing capacity, with better fitting and less bulky and with biodegradable products. During the recent years, absorbent polymers were incorporated in the diapers to increase its efficacy. Polyacrylate also known as superabsorbent polymer (SAP) gel was incorporated along with fluff pulp, which can hold liquid up to 30 times its weight. The advent of polyacrylate has also reduced the thickness of the diaper making more comfortable for the child. Leading disposables offer an acquisition layer and a backsheet that maintains the performance and skin health.[3]


  Physiology of Diaper Rash Top


Diaper dermatitis is an irritant contact dermatitis that is seen between the ages of 6 and 12 months.[4] Factors that are involved in the pathophysiology of diaper dermatitis are excessive wetness, friction, high pH, high enzymatic activity due to feces, urine that compromise the epidermal barrier function. The interaction between these primary factors results in inflammation and initiation of diaper rash.[5] Skin wetness and maceration increase the susceptibility to friction between skin and the diaper fabric causing physical damage. Fecal ureases catalyze the breakdown of urea to ammonia which increases the pH of the skin. Increased activity of fecal enzymes, proteases, ureases, and lipases are highly irritant to the skin producing erythema.[6] These enzymes also increase the permeability to other potential irritants.


  Diapering Habits Top


More than 90% of parents in western countries use modern disposable diaper. In India, the use of cloth diapers has been practised from ages. Till date, many mothers in India prefer using cloth diapers in day time and modern disposable diaper during the night and outings. Diaper material, financial status, belief, and child's comfort influence the use of diapers.[7] The water absorbing capacity of cloth napkin is very low as compared to modern disposable diaper which increases the chances of leakage and irritant contact dermatitis. Due to the use of cloth diapers the frequency of diaper change also increases. In India, there is a belief that cotton diapers give more breathability. However with the advanced designs and function of diapers, many parents are opting for modern disposable diaper than cloth diapers.


  Modern Disposable Diapers and Their Recent Technology Top


One of the recent advances in the manufacturing of modern disposable diaper is the development of acquisition layer which has specially designed fibers that absorb liquid and retains it while it's being absorbed in the diaper core that is made of SAP. The absorbent gelling material is made of fine particles of an acrylic acid derivative like sodium polyacrylate polymers.[8] SAP when dry looks like small, transparent crystals, but when they become wet the crystals unravels and swells transforming into a hydrogel material that can absorb 30 times its weight in liquid. Even though, SAP has high absorbing capacities, they are not water soluble and do not break during wet and hence they are extremely durable.[9] It can withstand high pressure to avoid rewetting even when babies are active. In most of the modern disposable diaper, this technology is incorporated. The nonwoven layer is made of either polypropylene or polyethylene that acts as a channel for the liquid to pass to the absorbent layer, thus keeping the outer layer dry.[8],[10] Clinical trials conducted in North America and Western Europe documented a significant reduction in severity and frequency of diaper dermatitis with the use of diapers with absorbing gelling materials.[11],[12]

Another important development in diaper technology is the introduction of breathable outer covers. They are made up of microporous materials that allow moisture vapor but not liquid water to escape from the inside of the diaper to the surrounding skin. This technology helps in reducing relative humidity and skin hydration. It is also associated with reduction in severity of diaper dermatitis and Candida albicans infection by 38–50%.[6],[13]

There are also recent innovated diapers that are designed to deliver petrolatum-based formulation to child's skin. In these diapers, petrolatum or zinc oxide are added to the outer layer in light strips without disturbing the absorbing capacity. There is a light coating of the skin continuously, thus maintaining the smoothness and also prevents contacts with irritants in the diaper area.[6],[14],[15] Synthetic material without latex is used for fastening and elastic is used in leg bands and cuff barriers to give flexibility for diapers. Recently, diapers without elastic bands have also been developed for easy wearing. In the past colors (dispersible dyes) were added to enhance the diapering experience, but it was presumed these would cause sensitization. Leading diapers have replaced disperse dyes with nonsensitizing pigments that are safe. These pigments have large molecular weight, insoluble in water and are embedded deep within the diaper material to minimize leaking out of the diaper and are not absorbed into the skin even the diaper is fully wet.[16] The cost of the diaper depends on different brands and their technology. Approximately in India, the cost of diaper packs ranges from 400 to 1300 Rs.


  Advantages of Modern Disposable Diapers Top


An ideal napkin does not exist, but numerous clinical studies have shown that the frequency of moderate to severe dermatitis is reduced by 50% with the advent of SAP.[8],[10] There is an improvement in skin hydration, skin breathability, and pH of the diaper area skin. The modern disposable diaper is 20% thinner than the previous disposable diaper making it more comfortable for the baby. Many studies have evaluated the safety of superabsorber diapers in means of toxicology and skin compatibility tests.[17] At present, diapers are developed with maximum biodegradability to prevent environmental contamination. Novel disposable diapers with continuous release of barrier creams provide better care of the diaper skin. Another important advantage of disposable diaper is it gives good hygiene and helps to limit fecal contamination in nurseries and day care centers. In a recent study conducted in China, 450 homes were tested for fecal contamination.[18] They found that hands of mother's and caregivers had high rates of fecal contamination using cloth diapers than those using disposable diapers.[19]


  Future Innovations in Diaper Technology Top


Further innovation in disposable diapers is the development of smart diapers. There is a small patch fixed in front of the diaper that contains four small, colored squares and this reacts differently when they come in contact with certain proteins, water content, or bacteria. If an abnormal reaction occurs, the squares will change colors signaling caregivers to change diapers. The advantage of these smart diapers is less frequency of diaper change is required relieving the tension of parents. Few manufacturers have also developed an application that alerts parents when their baby wets the diaper. A sensor is incorporated in the diaper which senses humidity and notifies the parent through a smartphone application. Although these smart diapers have a lot of advantages, they are 30% more expensive than normal diapers and are still in prototype phase.


  Conclusions Top


Overall the significant innovations in diaper technology are the development of SAP, breathable outer layer and barrier cream impregnated diapers. Most of the leading diaper brands have these advanced technologies thus improving the skin hydration, performance and decreasing the severity of diaper dermatitis. Education to care givers about the advantages of using modern diapers than cloth diapers through media is necessary. New generation disposable diapers with their recent innovative technology provide better and safe diapering practices.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

 
  References Top

1.
Erasala GN, Merlay I, Romain C. Evolution of disposable diapers and reduction of diaper dermatitis. Arch Pediatr 2007;14:495-500.  Back to cited text no. 1
    
2.
Erasala GN, Romain C, Merlay I. Diaper area and disposable diapers. Curr Probl Dermatol 2011;40:83-9.  Back to cited text no. 2
    
3.
Counts JL, Helmes CT, Kenneally D, Otts DR. Modern disposable diaper construction: Innovations in performance help maintain healthy diapered skin. Clin Pediatr (Phila) 2014;53 9 suppl: 10S-3S.  Back to cited text no. 3
    
4.
Kuwayama M, Kon Y, Yamamoto K. New etiological factors in diaper dermatitis: Skin irritability and focal irritancy as major causes of diaper dermatitis. J Pediatr Dermatol 1992;11:93-102.  Back to cited text no. 4
    
5.
Stamatas GN, Tierney NK. Diaper dermatitis: Etiology, manifestations, prevention, and management. Pediatr Dermatol 2014;31:1-7.  Back to cited text no. 5
    
6.
Odio M, Thaman L. Diapering, diaper technology, and diaper area skin health. Pediatr Dermatol 2014;31 Suppl 1:9-14.  Back to cited text no. 6
    
7.
Thaman LA, Eichenfield LF. Diapering habits: A global perspective. Pediatr Dermatol 2014;31 Suppl 1:15-8.  Back to cited text no. 7
    
8.
Odio M, Friedlander SF. Diaper dermatitis and advances in diaper technology. Curr Opin Pediatr 2000;12:342-6.  Back to cited text no. 8
    
9.
Helmes CT, O'Connor R, Sawyer L, Young S. Disposable diaper absorbency: Improvements via advanced designs. Clin Pediatr (Phila) 2014;53 9 suppl: 14S-6S.  Back to cited text no. 9
    
10.
Clark-Greuel JN, Helmes CT, Lawrence A, Odio M, White JC. Setting the record straight on diaper rash and disposable diapers. Clin Pediatr (Phila) 2014;53 9 suppl: 23S-6S.  Back to cited text no. 10
    
11.
Campbell RL, Seymour JL, Stone LC, Milligan MC. Clinical studies with disposable diapers containing absorbent gelling materials: Evaluation of effects on infant skin condition. J Am Acad Dermatol 1987;17:978-87.  Back to cited text no. 11
    
12.
Lane AT, Rehder PA, Helm K. Evaluations of diapers containing absorbent gelling material with conventional disposable diapers in newborn infants. Am J Dis Child 1990;144:315-8.  Back to cited text no. 12
    
13.
Akin F, Spraker M, Aly R, Leyden J, Raynor W, Landin W. Effects of breathable disposable diapers: Reduced prevalence of Candida and common diaper dermatitis. Pediatr Dermatol 2001;18:282-90.  Back to cited text no. 13
    
14.
Odio MR, O'Connor RJ, Sarbaugh F, Baldwin S. Continuous topical administration of a petrolatum formulation by a novel disposable diaper 1. Effect on skin surface microtopography. Dermatology 2000;200:232-7.  Back to cited text no. 14
    
15.
Odio MR, O'Connor RJ, Sarbaugh F, Baldwin S. Continuous topical administration of a petrolatum formulation by a novel disposable diaper 2. Effect on skin condition. Dermatology 2000;200:238-43.  Back to cited text no. 15
    
16.
Evans EB, Helmes CT, Kirsch T, Ruble KM. Colors in disposable diapers: Addressing myths. Clin Pediatr (Phila) 2014;53 9 suppl: 20S-2S.  Back to cited text no. 16
    
17.
Dey S, Helmes CT, White JC, Zhou S. Safety of disposable diaper materials: Extensive evaluations validate use. Clin Pediatr (Phila) 2014;53 9 suppl: 17S-9S.  Back to cited text no. 17
    
18.
Campbell RL, Bartlett AV, Sarbaugh FC, Pickering LK. Effects of diaper types on diaper dermatitis associated with diarrhea and antibiotic use in children in day-care centers. Pediatr Dermatol 1988;5:83-7.  Back to cited text no. 18
    
19.
Odio M, Jing W, Baoping Z, Liu J, Guan Y. Fecal Coliform Contamination in the Domestic Environment in Chinese Infants: Effects of Newborn and Diaper Practice. Presented at the 2013 Excellence in Pediatrics Conference, 2013; Qatar.  Back to cited text no. 19
    


    Figures

  [Figure 1]


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  In this article
Abstract
Introduction
Historical Aspects
Evolution of Diapers
Physiology of Di...
Diapering Habits
Modern Disposabl...
Advantages of Mo...
Future Innovatio...
Conclusions
References
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