Cloth Diapers: A Guide for Doulas
by Lara
Cloth diapers, if you’re not familiar with them, can feel daunting. There are SO many different options out there, and even more opinions. At the end of the day, there’s no perfect system (if there was, everyone would be using it), but there are some key things to know that can make navigating cloth diapers easier to understand, especially for doulas to whom they are a new concept.
As doulas, we enter the homes of many different clients. Chances are, you’ll come across a family who uses cloth diapers with their baby. Or maybe you have a client who is expecting a baby, is considering cloth diapers, and has questions. The first thing to familiarize yourself with is: what are cloth diapers and what are all the options about?
Cloth Diaper Systems
A cloth diaper is a reusable piece (or pieces) of fabric that can be washed and is used to soak up and catch urine and stool. Most of the time, the absorbent fabric is paired with some sort of waterproof or water resistant layer, such as a plastic or lanolized wool cover.
As for the absorbent bits, usually they are in one of the following forms:
Prefolds
Flat diapers
Fitted diapers
Pocket diapers
All in one diapers (AIO)
Prefolds and Flats
Prefolds and flats are pieces of fabric that are customizable to a baby’s body. Prefolds are rectangular pieces of fabric, usually cotton, bamboo, or hemp, that are composed of multiple layers of fabric sewn together.
Usually, the rectangle is broken into three “columns” and the first column has 4 layers, the second 8, and the third 4, again.
Prefolds come in different sizes and can be folded either around a baby to look like a traditional diaper, or folded into some form of rectangle and laid into a diaper cover, sort of like a pad. In either case, prefolds must be used with a waterproof outer cover to prevent clothes or bedding from becoming wet.
Flat diapers are single layer large fabric squares or rectangles, also usually made from cotton or bamboo.
Unlike prefolds, which are woven and not stretchy, flat diapers can be woven and therefore not-stretchy OR knit and stretchy. They can be folded into various shapes to be customizable to a baby’s body, age, and for how heavy a wetter they are.
Similar to prefolds, they need to be used with a waterproof outer cover. However, some people choose to forgo the cover for newborns who are not yet peeing in large quantities.
When using prefolds or flats, the waterproof cover does not necessarily need to be changed at each diaper change. Typically, it can be reused if the diaper was only soiled with urine, and thrown into the laundry after a few changes or once it becomes soiled with stool.
Fitted Diapers
Fitted diapers are shaped like you’d expect a disposable diaper to be shaped, but made up of several layers of absorbent fabric instead of something disposable.
Typically, this is either cotton, bamboo, or a blend (are you noticing the fabric trend so far?). They fasten around the baby’s waist with either snaps or velcro, or are without a built-in fastener and require something external to affix them in place, such as diaper pins or something called a “Snappi”.
They can be used as is, or additional layers of absorbency can be added in to make them more suitable for a heavy wetter, or for overnight use.
Similar to prefolds and flats, the waterproof cover part of this system does not need to be laundered each diaper change.
Pocket Diapers
Pocket diapers come with the waterproof outer layer built in, and are generally lined with microfiber fleece.
They are not absorbent alone, and have an opening or “pocket” on the inside which is then filled with inserts to adjust the absorbency. These can be pre-stuffed so that they are just snapped or velcroed onto the baby for each diaper change, without any need for folding or stuffing. For this reason they’re approachable and beginner friendly, but customizable, too. When the diaper is soiled, the inserts and the pocket diaper itself need to be laundered.
All-In-Ones
All in ones are just that–one piece! They come with the waterproof outer layer sewn to the absorbent inner layer or layers. They’re super beginner friendly because they require no folding or stuffing, and can be attached right onto the baby as you would a disposable. However, for this reason they are expensive, and the whole thing needs to be washed each change.
Diaper Covers
Diaper covers are frequently made of Polyurethane Laminate (PUL), a type of durable, waterproof fabric that is also breathable.
For people who are interested in only using natural fibers for cloth diapering, they may choose to use a wool cover. Wool covers need to be lanolized, so that they become water resistant (as well as odor fighting). Lanolizing involves replenishing or adding back lanolin (the natural waxy fat found in sheep’s wool) into the wool fibers.
Most commonly, diaper covers are secured over the absorbent portion of the diaper with snaps or velcro, but there are also some that can be pulled on like underpants. This variety is more often wool than synthetic, and is sometimes used in the place of other pants on the baby.
Sizing and Brands
Cloth diapers come in different sizes, just like disposables. However, for many people one of the perks of cloth diapering is the cost savings, and they may not want to purchase diapers in every size as they would with disposables. So, while cloth diapers can be sized, the size ranges are generally fairly wide, and many sorts of diapers also come in a one-size model. One-sized options are either adjusted by using additional snaps, or folding the fabric in a different manner.
A question you may find your clients asking is: what brand of cloth diaper should I choose? There are so many options, all varying widely in price. Some questions you might ask your clients include:
Do they plan to cloth diaper from day one? Some parents choose to use disposables at the beginning, either until the baby has passed all their meconium or until they are stooling less frequently as they exit the newborn phase. For families that are going to wait a while to start cloth diapering, they can save some money by avoiding purchasing newborn sizes, which are usually similarly priced to other sizes but used for a very short amount of time.
Are natural fibers important to them? Has their baby shown any signs of allergy or reaction to certain materials? If so, they may want to avoid pocket diapers or other inserts which are made from microfiber or other fabrics that irritate their baby’s skin.
Will they be sending their child to daycare? If so, does the daycare have any requirements about what kind of cloth diapers they will use? Some childcare spaces will not be willing to use cloth diapers, and others will only be willing if they are very easy to use, such as pocket diapers or all-in-ones.
What is their budget? There are some really affordable options on the market, one of which is to buy used! Even for folks who choose to buy a high-end brand of cloth diapers and purchase an entire stash up front, it will be significantly less than paying for disposable diapers month after month. However, not everyone can afford that sort of up-front financial commitment. You can assure your clients that they can still access cloth diapers–it is perfectly safe and sanitary to buy used diapers. People can also choose to buy part of their stash at a time (such as buying a smaller size and then sizing up later).
How important are aesthetics? What are their reasons for cloth diapering? Admittedly, there are some very cute cloth diapers on the market. But, in order to work well, cloth diapers need not look fancy! The simplest ones can work marvelously. And remind your clients–every baby is different, so what works for one family may not work for them. Ideally they can try a variety before going all-in on a big purchase of several of the same kind.
Washing Instructions
Preferences around how to wash cloth diapers can vary depending on the type of diapers, the type of washing machine, how many diapers a family has, whether they diaper full- or part-time, if the baby is eating solids yet, and just personal preference.
So, if you are working with a family who is already cloth diapering, it’s best to follow their lead! However, if you’re working with folks who have questions about cloth diapering, including questions about washing, there are some general guidelines.
Cloth diapers should be washed every few days; typically every 2-3 days makes sense for people so that their washing machine is full enough to effectively wash, they don’t have to own too many diapers (after all, a perk about cloth diapering for many families is the financial savings), and the diapers don’t get stinky. Usually, the first wash cycle is a pre-wash, meant to agitate the diapers and remove heavy soil. Then, a main wash cycle is run, usually with hot water. Diapers can then go into the dryer or air dry.
Fun fact! Sunshine is an excellent tool for naturally bleaching cloth diapers, especially when they’re stained with poop from human-milk-fed infants.
When babies are still having liquid poops, before starting solid foods, the diapers can generally go right into the washing machine without removing the stool. Once stool becomes more solid upon introducing food, the solid stool must be removed. It can be scraped off into the toilet, or sprayed off with a handheld sprayer, or swished around in the toilet. Many parents feel apprehensive about this, but after a couple of transitional weeks, a new routine usually emerges without issue.
P.S.: It is also perfectly sanitary to use a laundromat or shared washing machine to clean cloth diapers.
Supporting Families Who Use Cloth
If you are working with clients who like their system: awesome! Follow their lead. If they are new to cloth diapering or want to change up how they’re doing it, you can reassure them that there are a plethora of options out there, and since every baby is different, perhaps a change could help!
Some cities have cloth diapering programs, including reimbursement for purchasing reusable diapers. There are also cloth diaper rental services in which parents opt in to paying for laundry pickup on a regular basis, thereby outsourcing all the laundering needs. This is an example of such a service. There also exists “cloth diaper libraries” where folks can rent or borrow diaper materials to try it out. These are great options for folks who want to try out cloth diapering but either feel intimidated or don’t have easy access to laundry. Here is an example of a cloth diaper library.
Conclusion
Cloth diapers can seem intimidating at first! There are so so so many choices out there, and it seems everyone has a strong opinion about why their way is best.
You do not have to be an expert to support your clients in using cloth diapers.
With a little research, open-mindedness, and some practice, you’ll get the hang of it in no time, and you’ll have some great tips to pass onto your next clients, too.
Resources
Fluff Love University - resource for learning more about cloth diapering, including extensive information about laundering cloth diapering down to information for specific machines and detergents
Clean Cloth Nappies - resource for learning more about cloth diapering, including laundering and how to get out tough smells
The subreddit /clothdiaps has some excellent information and people who are happy to answer questions
About Lara
Lara (they/them) is the Project Manager and Core Teacher here at BADT. A full spectrum doula specializing in supporting queer and trans folks through fertility, pregnancy, and postpartum, they also offer lactation support, childbirth education, and mentorship for other birthworkers. Lara is the parent of a baby whom they are currently cloth diapering! You can connect with Lara on their website or social media @theplanteddoula.