Cloth diapers are available in several types of cotton fabrics and are made up into somewhat different types or forms of diaper. Let's discuss the cotton fabrics first, and then we are ready to discuss "types" of diapers.
For those of you who tried our "towels as diapers" experiment, you have already experienced this diaper fabric. Terry cloth is a looped cotton fabric that provides a thick, luxurious feel. Great for towels! Terry cloth diapers are super-absorbent, very fast in absorbing a wetting; their softness and comfort is without equal. But they are bulky! They are so bulky, in fact, that we can't really consider them practical for anything other than a night diaper worn only to bed. Those cotton loops hold a lot of air and that provides the thickness and springiness that we enjoy in a towel. We don't know of anyone making all-terry cloth diapers on this continent, but Drylife, Ltd in England makes them in the form of basic squares and provides folding instructions and offers larger than normal diaper pins which are needed for these thick bulky diapers.
Birdseye is a staple diaper fabric - and always has been. Some fabric stores will sell this by the yard as "diaper cloth". That's how intertwined the name "Birdseye" is with cloth diapers. Birdseye is best described as a "diamond" weave. When you closely examine the fabric, you will see the woven surface forms tight little diamonds. The cloth is durable, has good pinning strength and makes a good utilitarian diaper. Birdseye is one of the most common diaper fabrics, along with flannel. An excellent source for Birdseye diapers is Loving Comfort.
Gauze is another staple diaper fabric, now commonly found only in baby diapers. Gauze is distinguished by a straight square weave. Hold gauze fabric up to the light, and you can just about see through it. The cotton threads run straight up and down and from side to side, just like screening in your window or door. This square, loose weave makes for soft, cushiony diapers and for easy washing, as the soap and water can flow through the fabric easily for cleaning. At the same time, the fabric is not as strong or durable as Birdseye. Gauze diapers are available from Adult Cloth Diaper Co. and Angel Fluff Diaper Co.
Flannel is a great diaper material. It is characterized by a napped or fleece-like surface - nice and soft to the touch but still dense - not springy like terry cloth. This characteristic of density leads to the criticism by flannel opponents that "you can't get flannel diapers clean!" They may have had a point when mothers had to beat the diapers on the river bank with a rock, but in this age of washing machines and modern detergents, flannel diapers wash as clean as those of any other fabric. We feel that you get the most absorbency for the least bulk with flannel! Best source for all flannel diapers in the US: Angel Fluff Diaper Company; for Canada, Kins has a very good product. (Note: all suppliers will ship anywhere, but duty and customs charges will likely be added for cross-border shipments unless specifically marked as "incontinent supplies".)
Now that you've been introduced to the basic fabrics available, let's describe the types and styles of diapers that are being made from these various fabrics.
(Obsolete, pin-on, easy to launder, requires folding)
Both gauze and birdseye were used for diapers originally (and that was back in "prehistoric" times: i.e., before the 60's), and multiple diapers were always the name of the game. Babies' diapers hold bowel movements as well as urine, so mothers had to have easily-laundered diapers. Washing machines were still pretty crude devices with separate wringers. The light and thin birdseye and gauze both wash easily and dry quickly, especially outdoors, the common location for hanging for most moms in those prehistoric days before dryers.
Folding diapers had more to do with getting them ready to pin on (fit) the baby than making them neat to put away. The absorbency was gained by folding and by using multiple diapers. That thin layer you see in a birdseye or gauze diaper becomes many, many layers when folded and ready to pin on. Again, let's do a little easy math. A "flat" diaper for our size would be about 72" long and 36" wide. That is the equivalent of the obsolete 36" X 20" infant flat diaper. Our flat diaper would be folded into thirds to make a 24" X 36" diaper for us adults.
So that's three layers with one diaper. It would be common to double diaper as a minimum and triple or quad diaper for longer outings and overnight. The innermost diaper or two would be folded narrow so as to act like a soaker strip. So 6 to 9 layers overall would be available for absorbency with perhaps another 12 or more layers in the soaker strip. There is some springiness to birdseye and a lot more with gauze...but that springiness is not as bulky as terry cloth. So a birdseye or gauze diaper the same weight as a terry cloth diaper will be much thinner and "easier" to wear and conceal.
Drylife Limited, in England, is the only source I know for flat diapers. Their terry-cloth flats are square, and we found it a bit of a challenge to fold a diaper that is comfortable for an adult. Visit their web site and especially look at the instructions on folding diapers. They do make squares in different sizes. If you really want to try them, be sure to also order DryLifes plastic pants! You are going to need oversize waterproof pants to fit over the British "nappies". Dry Life's plastic pants are very deep and have extra hip room. We do NOT recommend this as a way to start off with cloth diapers.
Bear Bottom in Canada does custom sewing and will make rectangular flat diapers from flannel to your size. I choose 72 X 36 and then fold it into thirds for a 24 X 36 rectangle ready to pin on.
If, by any chance, some of you want the real, original flat diaper, you'll have to make your own from "diaper cloth" sold by the yard in fabric stores or possibly an on-line fabric store.
Prefolds are the most common style, pin on, no folding but slower to dry. Prefolds came along to free moms from the "drudgery" of folding diapers, but now the prefolds which are just the flat diapers all folded to size, with soaker strips and stitched down. They don't come apart for washing and drying. Modern detergents had come along to replace the less effective soaps of "prehistoric" times, and dryers were increasing in popularity as the price came down. So prefolds pretty much wiped out the flat diapers during the late 60's, we presume.
The majority of adult diapers are prefolds. Most are rectangles of birdseye or flannel, offered in "standard" sizes. Let's assume a standard medium size is about 24" X 34". You'll find a prefold will consist of two or more overall layers that are 24" X 34" and then there will usually be additional 8" wide layers in the center section, called the soaker strip. Many companies such as Adult Cloth Diaper, Angel Fluff, Loving Comfort and Kins will tell you exactly how many layers of what fabric are used in making their various "weights" of diapers. Terry cloth is a common fabric for use in the soaker portion of a diaper.
Felt (a very dense and not very comfortable cotton fabric) is sometimes used in the soaker strip, but we've only seen it used in institutional diapers ...which, by the way, are terrible, but the patients/residents usually aren't in a position to complain.
Foam (or sponge) of various types can show up in the center soaker strip. This material provides good cushioning, hence adds to the comfort level. V. Jensen offers gauze prefolds with a sponge soaker strip which are extremely comfortable for the innermost diaper in a set of two or three diapers.
While it seems that every supplier is selling diapers these days, we'll suggest you start with a solid, well-known source such as Adult Cloth Diaper Company. The diapers are high quality and offered in simple sizes and weights that will be suitable for most users. They offer all the basics; birdseye, flannel and gauze with terry soaker-strips. This is the easiest way to get started with cloth diapers before you decide exactly what you will want to order in larger quantity.
We strongly suggest that you study what we explain in this primer and discuss any questions you may have on the internet forums to profit from ideas and others' input. Then slowly begin to purchase diapers. We say slowly because cloth diapers represent a costly investment ($20 to $35 each!) and you'll eventually need a minimum of 9 to 12 diapers even if you stick with disposables by day and will use cloth only at night. We suggest initially buying a couple of diapers at a time and to give yourself an opportunity to see how you like them.
Size and weight have everything to do with fit and comfort. After you have studied our material on fitting and pinning ...and done your homework in the way of experimenting in the confines of your residence ...and lived with them long enough to know this (size and weight) is what "works" for you and is comfortable and so on, then, and only then should you purchase by the dozen. We would much prefer that you buy two of one type and two of another to try for wear to be convinced of the favored style before going "all out".
If you find you like flannel for the fabric, Angel Fluff offers an incredible variety of weights and sizes without getting into custom or special orders. Once you've tried a "standard, basic" diaper and know you want it wider or narrower or longer or shorter...then you should look into the line of Angel Fluff flannel diapers as a trustworthy US supplier. For Canada, Kins offers two standard weights, night and regular, and several different styles.
Loving Comfort Diaper Company utilizes birdseye as their primary fabric and offer standard diapers in all-birdseye and in combinations consisting of birdseye and terry cloth. They also offer full layers of terry, not just central soaker layers. That adds the "springiness and fluff" of terry cloth loops to the birdseye material. On the down-side for terry cloth: just like the bath towel you used after your shower, it becomes pretty heavy when wet. The same holds for terry diapers. As you get them wet, they become really saggy. This is usually not a problem for overnight diapers, but terry cloth plies for day wear soon become heavy and may droop.
Loving Comfort is a great company to work with, once you know exactly what you want because they will happily custom-make diapers for you. We caution, however, that you should hold off until you develop some experience so that you will be certain of what you want. There are plenty of standard diapers to try.
Adult Cloth Diaper can offer custom-made diapers in gauze, which is a real boon for those of us die-hards that really like gauze and have not been able to find it until recently. They will happily make custom-size diapers for you in all gauze, including gauze soaker strips - no terry. It is this guru's opinion that you cannot beat real gauze diapers!
Contour diapers are a compromise between the rectangular flat diaper and padded briefs. Each supplier offers a variety of styles, with Velcro fasteners or the traditional pinning. When laid flat, contours are similar in shape to disposable diapers. When worn on the body, they resemble an oversize jockey brief. Because they follow the contours of the trunk, they are generally comfortable and are easy to put on and take off - very much like disposable diapers. But in contrast to disposables, they usually have elastic waist and leg openings - very much like well-made jockey underwear - with elastic firm enough to hold when the diaper becomes wet. Contours with Velcro fasteners are especially convenient for changing midday when flat diapers would be too cumbersome to pin on away from home.
Contour diapers vary in thickness and composition. Some are made of multiple layers of flannel. Others have a center "soaker" panel of extra layers of cotton, polyester or terrycloth. In general, the thicker the center layers, the longer the diaper can be worn. Thinner contours may last only 3-4 hours before changing. Thicker contours will last 5 hours or even longer before a change is needed. Contour diapers are somewhat more expensive than flat diapers because of the extra tailoring required for the closer fit.
Liners, in an hour-glass shape, may be added to the contour for greater absorbency. They allow at least an extra hour's wear. These are purchased separately, and may add $6 to $10 to the cost. Contours would be an option for night wear only if one or two liners were added for extra absorbency. So contours represent a more expensive cloth alternative for daytime use. They provide a comfortable fit and ease of changing.
One source for contour and fitted diapers is V. Jensen. Quality Care in the US is one source for a decent velcro on fitted diaper with inserts. This style is available in Canada both from Kins and from Bear Bottom, who will custom-make the diaper with varying thicknesses of flannel or terry.
Pull-On Diaper Pants are instant on convenience. They have many aliases: Pull-ons, training pants, all-in-ones, night pants, bed-wetter pants. Mostly the names represent an attempt to overcome the stigma of diapers. The usefulness of this type of diaper is mostly limited to youngsters who need some protection but who would never wear a "diaper" (heaven forbid!). As adults, we certainly have our hang-ups about diapers...we discussed that in the "bum rap" segment.
If you need a "real" diaper, however, most diaper pants are not up to the task for you. The primary problem is the elastic waist. How is that supposed to hold the pants up when they get wet and heavy? With elastic tension, that's how! Enough tension to hold the pants up when wet will be very uncomfortable, probably not even wearable for most, the waist would be so tight! So the elastic can't be too strong, hence the usefulness of the pull-on is limited to dry-diaper wear or wear to bed. Even for bed time, the adult pull-on diapers / training pants are better for "just in case" situations because they rarely are thick enough to provide adequate absorbency if you wet all night as you sleep. Most are typically a thick pair of underpants with a soaker strip sewn in the crotch, which in some cases doesn't even extend from waist to waist.
We wish to emphasize that the pull-on is not a "full-fledged diaper". Like the lesser disposable products, it is the lesser cloth product. For those with milder forms of incontinence, such as stress or lighter "urge", and who wish to avoid the high cost of disposables, the diaper pant will be a good choice. You probably won't get them very wet, so the waist elastic will be able to hold the pants up until you can change them. When you can get to a rest room, it's easy for you to pull them and the plastic pants down to use the toilet without dealing with fasteners such as snaps or Velcro.
There is one "stand out" in the diaper pant category of which I am aware at this time. Loving Comfort offers pull-on pants along with many other companies. They call them "Pull-on Briefs". The "stand out" out is called a "Pull-on Diaper" and it really is! While it suffers the same elastic-waist disadvantage of any, it is much closer to being a full-fledged diaper, and for overnight wear to bed it could be a perfect solution for many who don't wish to deal with pins, snaps or Velcro. That same person may wish to wear the Loving Comfort diaper pant by day, choosing to wear Joe's Suspender Briefs (see the "What to Wear Segment", Ch. 11) to support them as they get wet.
I can't endorse "All in Ones" for us adults. When you read about waterproof pants you will learn how longevity is not the strong suit for most waterproof materials. So, a pull-on "diaper pant" complete with a waterproof layer will become a leaky situation long before the cotton "diaper" portion wears out. You can also understand that they are harder to wash and really slow to dry due to the waterproof barrier that makes up one side of the garment. While you like the quick and easy convenience of the pull-on pant, we can't really imagine why you would object to the five additional seconds to pull a pair of plastic pants over them. An added bonus of separate plastic pants is the ability to tuck the leg and waist bands into the leg and waist elastics of the diaper pant, providing improved leak protection.
For the die-hards who have to try an all in one, the best out there is at Angel Fluff and is covered by their "blue ice" vinyl which is heavy duty and fairly long lasting. Priva makes all in ones which I would rate as "institutional". We'd never wear them, but the brand might have a following. They are available in some catalogues ("Health/Personal Hygiene") and in some home-care specialty stores, and you can easily find them on the web.
The variety of fabrics and types not only creates a shopping list. It offers you the opportunity to develop your own "mix and match" options for diaper wear. These options allow you to vary the type of diapering at different times of the day and for different occasions.
For night, for example, we find that at least three layers, each of a different type or fabric, provides the necessary thickness and absorbency for a whole night's leak-free rest. That mix might be flannel, birdseye or gauze diapers of differing and heavier weights, topped by a thinner diaper for softness. A morning mix might use two, rather than three layers, possibly with a thin cover layer on top. The afternoon might be lighter still or a switch from prefold to fitted contour if you need an easier change situation without pins.
The great advantage of cloth diapers is the flexibility to add enough layers for absorbency and to change that thickness when you change diapers throughout the day. If you follow that overall strategy, we can guarantee that you will be leakproof until your next scheduled change some hours away, regardless of the amount or type of liquids you consume. That claim cannot be made for any disposable - there is always the chance of leakage after as little as two hours or two wettings.
In short and without too much oversimplification, we have found this principle to be tried and true:
If you want to forget about your incontinence you need to wear cloth diapers!
If you wear disposable diapers to manage incontinence, you must pay constant attention to what you are doing, drinking and how wet the diaper is
Let us conclude by indicating that you will find an incredible number of sources for diapers, both disposable and cloth, and for waterproof pants (see next segment, Ch. 8). We can't begin to "rate" all of them and only hope that we are able to give you some basic information that will serve you well as you sort out the claims and various products offered for your incontinence problem. Internet forums can be a useful place to ask for help and share experiences, both good and bad, with incontinence products and sources for same.
©2005 Incontinence Support Center