Parents, scientists, and environmentalists have debated long and hard about the diaper question: Are disposable plastic or reusable cloth diapers better for the environment and for the babies themselves? The answer isn't always easy. We researched the best options and came to the conclusion:

Organic cotton cloth diapers are still the best option, unless water conservation is a big concern in your area. If it is, choose a diaper with the most biodegradable content possible (see the end of the article).

Disposable v. Cloth Diapers

Americans throw away 27.5 billion disposable diapers a year, with the EPA estimating that 4.15 million tons of diapers went to the landfills in 2017. Imagine the amount of petroleum-based plastic and wood pulp that goes into manufacturing those diapers, and then think about the super-absorbent polymers and deodorizing chemicals many companies add to the mix. Cotton, reusable diapers probably sound like a much better choice.

But are they? Cloth diapers must be washed in hot water after each use—and some sources recommend washing your diapers twice to kill germs. That’s a lot of water, energy, and detergent, which could be an issue in areas where water is scarce and must be carefully conserved. And if that cotton isn’t organic, tons of harmful pesticides were undoubtedly used to grow it.

So what’s a concerned parent to do?

After looking carefully at the available research and considering both the environmental and health impacts, we still pick cloth, except in extenuating circumstances: Here’s why.

The Studies

Back in the early 90s, disposable diaper manufacturers and cloth diaper services each commissioned studies aimed at pinpointing whether cloth or disposables were the most eco-friendly. Not surprisingly, the studies commissioned by the single-use diaper companies concluded that disposables were no worse for the environment than cloth diapers. The studies sponsored by the National Association of Diaper Services showed that cloth had the clear environmental advantage.

A 1993 study sponsored by The American Paper Institute (disposable diapers are made from paper and plastic) found that the ecological differences between the two types of diapers were less dramatic than in earlier studies. After analyzing the results, the Union of Concerned Scientists (UCS) encouraged people not to “waste a lot of time or energy trying to decide which type of diapers to use based on environmental considerations,” since the differences aren’t particularly dramatic. If you live in an area with landfill issues, choose cloth, and if your community suffers water shortages, choose disposable, they say.

Paula DeVore, who started an organic cotton cloth diaper company Babyworks (no longer in business online) in 1990 to combat the landfill problem, disagrees. “If the environmental impact of disposables really is the same as that of cloth diapers, then why haven’t comparable studies been done for other products? Why aren’t we using more paper plates and cups instead of washing our reusable dishes, for example?”

New Info on Diapers and Health

What the 1993 study didn’t take into account, DeVore says, is the use of potentially harmful chemicals to bleach disposable diapers and enhance their super-absorbent capabilities.

Those of us who have recently changed an infant may have noticed a gel-like substance in the diaper that definitely didn’t come from the baby. That gel is a result of the sodium polyacrylate crystals, a superabsorbent polymer (SAP) that is used in disposable diapers for absorbency. Sodium polyacrylate can hold up to 300 times its weight in water and to date, no studies exist as to whether it is dangerous to children when absorbed through the skin. However, some experts have pointed to the SAPs in tampons as the possible cause of toxic shock syndrome, so some consumers are wary.

Of greater concern to many is the presence of dioxin, a highly toxic carcinogen and endocrine disruptor, in disposable diapers. Dioxin is a byproduct of the chlorine bleaching process, and the Archives of Disease in Childhood reports that trace amounts of dioxin are present on disposables. Some diaper services use chlorine bleach to whiten their cloth diapers, but conscientious consumers can ask questions to avoid those services.

A study published in late 1999 by Anderson Laboratories found that lab mice exposed to various brands of disposable diapers experienced asthma-like symptoms, as well as eye, nose, and throat irritation. Cloth diapers did not cause respiratory symptoms.

Dr. Rosalind Anderson, lead author of the report, says chemicals like xylene and ethylbenzene, suspected endocrine, neuro-, and respiratory toxins; styrene, a suspected carcinogen and respiratory toxin; and ispropylene, a suspected neurotoxin; were among those released from the disposable diapers. Anderson notes that human surveys will be needed to determine how important the link between diapers and asthma is to infants and asthmatic parents, but parents should be cautious.

In addition, a 2001 UK study published in the Archives of Disease in Childhood suggests that infant boys who wear disposable diapers could experience impaired fertility as adults. The researchers found that the temperature of the scrotum was almost 2oF higher in boys who wore disposables diapers rather than cloth. This temperature increase, they say, may negatively impact future fertility. Experts agree that disposables do keep babies warmer because of the plastic and insulation, but the link to infertility has not been further studied.

In short, there may be reasons to be concerned about the health effects of disposables, though we’re still years away from hard evidence that can tell us once and for all how serious these concerns are.

Cloth Diapering Tips

You may be leaning toward cloth diapers but fear the added costs and inconvenience. Here are some ways you can ensure the best diapers for your baby—and the most convenience for you:

• Go Organic: Organic cotton diapers are available from several small, responsible retailers. By going organic, you’ll ensure that no toxic pesticides or herbicides were used to grow the cotton for your diapers. And, since organic cotton diapers are unbleached, you don’t have to worry about dioxin exposure.
• Go Leak-Free: Cloth diapers, if you look for quality product, can approximate the absorbency of any disposable brand,” says DeVore. Cloth diapers come in different sizes, with snap and velcro closures and fitted leg openings, and can be tucked inside a cloth and vinyl diaper cover for extra leak protection. (The diaper covers should last through several changes.)
• Take Advantage of Liners: Although throwing human waste in the garbage is prohibited by law, most parents don’t shake the contents of their baby’s disposable diapers into the toilet. With cloth diapers, you pretty much have no choice—you have to wash them properly. To make that chore easier, some parents choose to line their baby’s cloth diapers with thin, unbleached, 100 percent biodegradable paper liners. These liners are flushable, and they make cleaning messy diapers a snap. Just remove the liner and flush it down the toilet, and the diaper itself is ready to be washed.
• For overnight protection, many companies sell organic cotton “diaper doublers,” a thick piece of cloth you can tuck inside a cloth diaper for extra absorbency.

Another Option

If you’re committed to disposables, consider purchasing from an environmentally responsible company like Naty by Nature Babycare. This woman-owned company manufactures Nature Boy & Girl diapers, which are made of GMO-free plant-based plastics and are 70 percent biodegradable. (Most disposables are no more than 40 percent biodegradable.)

People are already able to compost used diapers. Earth Baby and Tiny Tots both have diaper pickup and composting services available in San Francisco. gDiapers sells flushable and compostable diapers, available anywhere. A quick search of "diaper composting in [region]" can be fruitful.