As you may have heard, on 10 March, The White House (yes, the office of the President of the USA) launched a project about nappies #diapergap.  In the USA, 1 in 3 children are not having their nappies changed frequently enough.  This is a public health issue.  Babies and toddlers are experiencing severe nappy rash, UTIs (single-use nappies are being dried out and used again) and constipation (parents restrict fruit and veg in the diet so there are fewer soiled nappies) because they can’t afford an adequate number of disposable nappy changes.

I’m not aware of any data on this in the UK but anecdotally we have been aware of this for many years.  It’s one of the reasons why health visitors have welcomed Real Nappies for London and been willing to distribute our leaflets.  What we do is promote the use of washable nappies.  These nappies have an upfront cost but once bought there is no financial incentive to change infrequently.  They just need to go in the wash.  We are aware of course that some households, those in most need, may not have a washing machine or adequate drying space.  Affordable nappy laundry services could meet this need.

But there’s another benefit to cotton nappies; they can help children gain toiletting independence.  This is not automatic, but it tends to help.  Again this is a public health and education issue.  We don’t have national data for children arriving at school in nappies but Public Health England has made children being able to take themselves to the toilet 1 of 10 indicators of school readiness.  More shocking was a report on Channel 4 news in December 2015 in which a Stoke primary school teacher said that 35% of chilren arriving for school in September were still in nappies.

The promotion of washable nappies in the UK started 20 years ago with the first Real Nappy Week.  At that time disposable nappies enjoyed 95% of the market.  Over the last two decades there has been an incremental growth in the use of cloth nappies.  Most users are motivated by reducing waste.  Local authority recycling and waste prevention departments have funded schemes to make expectant parents aware that there are alternatives to disposable nappies.  In some parts of the UK this work is done by volunteers who have set up ‘nappy libraries’ so people can try before they buy.  The main thing for public health is that we talk about the need for a positive attitude to changing baby and potty training, the need for frequent changes and a healthy diet.

Nappy changing culture is a public health issues.  What’s important is that something is happening in your area.  It doesn’t have to cost much.  It’s all about spreading word of mouth about the need for frequent nappy changing, where to get affordable cloth nappies (yes, some are very expensive) and good potty training information ie not “wait until your child is three and a half your child will potty train her/himself.”

We are working with June Rogers, founder of the charity PromoCon to give parents the best information on how and when to potty train, based on the latest research and data.   This advice for parents has been edited by June.   Creative Homes, a social enterprise based in Lewisham, supported by the Design Council, is doing innovative public health work with families including potty training.

If you are a member of a CCG and want to talk about what needs to happen in your area to decrease the negative impacts of infrequent nappy changes and children arriving for school in nappies in your area please get in touch with Real Nappies for London.  We have a lot of experience of different things working in specific circumstances at a very low cost.

Hilary Vick,  March 2016

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