466 Insufficient evidence for disposable nappies in preventing dermatitis

September 26, 2015

written by Brian R McAvoy

Clinical question
How effective are disposable napkins in preventing napkin dermatitis in infants?

Bottom line
Although the included studies appeared to favour cellulose-core disposable napkins over cloth ones, absorbent gelling material over cellulose-only core napkins, breathable outer-shell over occlusive outer-shell napkins, and linings impregnated with formulations over plain linings, all of these studies were open to bias due to flawed methodology. There was not enough evidence from good quality randomised controlled trials to support or refute the use and type of disposable napkins.

The suboptimal methodology descriptions and poor follow-up and outcome data limited interpretation of the studies. None of the studies gave any quantitative data comparing the study groups at baseline. All of the studies were performed in the US.

Napkin dermatitis is a common condition that occurs in otherwise healthy infants. It causes discomfort to infants, anxiety to parents and caregivers and contributes to the load on the healthcare system. A large variety of napkins, disposable and non-disposable, are available.

Cochrane Systematic Review
Baer EL et al. Disposable nappies for preventing napkin dermatitis in infants. Cochrane Reviews, 2014, Issue 12. Art. No.: CD004262.DOI: 10.1002/14651858. CD004262.pub2. This review contains 17 studies involving 3301 participants

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.