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Clinical and microbial effects of cloth, cellulose core, and cellulose core/absorbent gel diapers in atopic
Insights
Infants with atopic dermatitis (AD) experienced more severe diaper rash, especially with cloth diapers. Absorbent gelling material (AGM) diapers reduced rash severity and bacterial counts in AD infants.
Area of Science:
- Dermatology
- Pediatrics
- Immunology
Background:
- Atopic dermatitis (AD) is a common inherited inflammatory skin condition in infants.
- Infants with AD are more prone to irritants and infections, including diaper dermatitis.
- The impact of diapering materials on diaper rash in AD is not well understood.
Purpose of the Study:
- To compare diaper dermatitis severity in infants with and without AD.
- To investigate the relationship between diaper materials and diaper rash in AD.
- To assess the influence of various factors on diaper dermatitis in AD.
Main Methods:
- Recruited 87 infants with AD and 90 age/sex/weight-matched controls.
- Assigned infants to subgroups using cloth, cellulose, or absorbent gelling material (AGM) diapers.
- Monitored atopic parameters, diaper rash severity, bacterial/candidal colonization, and other factors.
Main Results:
- Statistically significant differences in atopic parameters between AD and control groups at all visits.
- Higher mean diaper rash grades in AD infants using cloth diapers compared to AGM diapers.
- Significant correlation between AD severity and diaper rash scores, particularly in the cloth diaper group.
- Lower bacterial counts in AGM diaper areas compared to cloth diaper areas in the AD group.
Conclusions:
- Diapering materials significantly influence diaper rash severity in infants with atopic dermatitis.
- Absorbent gelling material (AGM) diapers appear to be superior to cloth diapers in managing diaper rash in AD.
- Further research into optimizing diapering strategies for infants with AD is warranted.
Abstract:
Atopic dermatitis (AD) is an inherited cutaneous inflammatory condition which may affect 10% of infants. Persons with this diathesis are more susceptible to irritants and to superficial infections. Little is known about diaper rash and diapering materials in AD. In this study we set firm criteria to identify a large group of infants with AD for comparison with a nonatopic, normal control group in terms of severity of diaper dermatitis; relationship of diaper dermatitis to diaper materials; and influence of modifying factors (bacterial and candidal colonization/infection, diarrhea, antibiotics, other illnesses, food allergy or intolerance). Babies with eczema were recruited and, from a group of 2,443 respondents, 87 satisfied carefully defined criteria for atopic dermatitis. A similarly sized (90) control group matched for age, sex, and weight was selected for absence of features of atopy or familial atopic history. Infants were assigned into balanced subgroups wearing cloth diapers, conventional cellulose diapers, or diapers containing cellulose and absorbent gelling material (AGM). Assessment of grading for atopic parameters showed statistically significant differences between the AD and normal groups at every visit. Mean diaper rash grades, as assessed by the same physicians at each visit, were significantly higher in the AD group wearing cloth diapers compared with those in AGM subgroups at five of eight visits. There was significant correlation between AD severity and diaper rash scores overall and in the AD cloth group, but not in other subgroups. Quantitative total bacterial plate counts were significantly lower in AGM than cloth diaper areas on three of eight sampling periods in the AD group.(ABSTRACT TRUNCATED AT 250 WORDS)