Nighttime Bedwetting

Here are some interesting issues to consider if your child is wetting the bed at night:

Girls are easier to potty train than boys. And, fewer girls wet the bed at night. In fact, two-thirds of all child bedwetters are male. And most bedwetters – nearly 80 percent, in fact – have a parent who was a bedwetter, too. What are the reasons for the preponderance of male bedwetters or for inheriting bedwetting from a parent? Actually, there is little research to explain it, only anecdotal evidence, mostly from pediatricians and parents.

There is much debate – and little agreement – on exactly why children wet their beds at night, when they are asleep. Some think that bedwetting is caused by an underlying physical or emotional problem, yet many disagree with that theory and say, instead, that the number of children whose bedwetting is caused by a physical problem is only 1 out of 3 of every bedwetter. Now, children who have already gained bladder control at night but relapsed into bedwetting are more likely to have a medical cause for their relapse than children who never gained bladder control at night. And there are medical problems that can cause nighttime wetting, or enuresis. The most common are urinary tract infections, diabetes, and spinal cord problems.

Many experts on enuresis believe that the majority of bedwetters, especially adolescent bedwetters, are sleeping too deeply. One sign of this is this is their trouble waking up in the morning, their mood swings, and their signs of ADD or ADHD characteristics, even though they don’t suffer from those disorders.

One of the newest theories about bedwetting that is gaining traction is the theory that it is caused by constipation, which puts extra pressure on the rectum, which in turn puts pressure on the bladder to release – at night! What’s plausible about this theory is that the modern American diet is so full of constipating foods, from too many refined carbohydrates to too little fiber, especially in the form of fresh fruits and vegetables.

Treating enuresis with medication or alarm systems (to awaken a child who has wet the bed) are also highly debatable subjects. Some physicians suggest medicating a bedwetter who is older but others wholeheartedly disagree with that treatment, especially those treating enuresis with behavior modification.

Some experts believe children should wear a nighttime diaper until bedwetting stops. Others, including the Mayo Clinic, say children past a certain age should never be diapered at night.

Some experts suggest using an alarm to wake children who are bedwetters; others say never to use an alarm for bedwetting.

That’s the list of basic issues, including many of the debates. If you have a bedwetter, and if you take comfort in knowing that you are not alone, consider that, according to the American Academy of Pediatrics, children who are toilet-trained during the day may still wet the bed two to three times a week – until they are 5 years old. Even then, about 1 in 4 children will still wet the bed at night. By age seven, 1 in 7 children will still be bedwetting, by age 10, that statistic goes down to 1 in 20 who will have occasional bedwetting incidents. Oy! What’s a parent to do?!!

Find the cause of your child’s bedwetting
Ah, as the previous section suggests, finding the cause of a child’s bedwetting at night is easier said than done, since experts and even parents disagree so much on the issue, and since both toilet training – and children – run the gamut, too!

First comes the debate about whether a child should be having liquids just before bedtime or sipping liquids throughout the night. Some say that it’s okay – and even good – to be drinking water or liquids, especially water or breast milk, before falling asleep, and that through the night, the child’s bladder should be mature enough to hold the liquid until morning, or the child should be able to awaken and go to the toilet to void. Others say that liquids, including breast milk for toddlers, should be limited before going to sleep and that a major cause of bedwetting is drinking before bedtime or during the night. One theory.

Another theory is that children who wet the bed at night have an undiagnosed medical problem, such as a urinary tract infection, diabetes, or a back problem that causes the nerve to the bladder to be pinched. While this is true for some bedwetters, as you learned in the first section it is true for only a very few of them – less than 3 percent. Still, if you think your child might have a physical problem, then take your child to the pediatrician or even to a pediatric urologist. You’ll sleep better having ruled out a physical problem and sleep better dealing with the situation if there is one.

Sometimes a trauma in a child’s life can cause a bedwetting problem, for a few days or even longer. This trauma could be a death in the family, a divorce or even the birth of another sibling. And dealing with such emotional causes of bedwetting, to be honest, are beyond the scope of this blog; instead consult with a physician or counselor or someone with experience treating it.

Still another theory, and one of the most common, is that enuresis is caused by a sleep issue that prevents the child from either staying dry through the night or prevents the child from waking up to void in the toilet if the child does need to urinate. These sleep problems include sleeping too deeply or not going through enough of the REM sleep cycle.

Time out for a basic sleep lesson. There are basically two kinds of sleep: non-REM and REM. Non-REM is the sleep cycle that occurs first and which is referred to as “restorative sleep” since it is the cycle where the body tends to restore itself. In contrast, REM cycles are for dreaming and for taking what you studied or learned before you went to sleep and incorporating it into your brain. It’s the longest period tends to occur at the end of sleeping, just before waking up. Infants, perhaps because they are learning so much and their brains are growing so much and so rapidly (they triple in size in a year), do more REM sleeping than an adult, which may be why an infant sleeps so much during the day. But don’t quote me on this – I love reading and learning about sleep but the person to read if you want to know more about sleep is Dr. Michael Breus, author of a number of books about sleep; my favorite is The Sleep Doctor’s Diet Plan: How to Lose Weight through Better Sleep. Back to the topic of bedwetting.

One of the reasons that critics chastise use of an alarm to help cure enuresis (the alarm goes off when the pad it is attached to gets wet from urine from a nighttime bedwetting accident) is that the alarm tends to wake up the parents, but rarely awakens the sleeper who is the bedwetter! They are so deep in their non-REM sleeping that they never hear the alarm and when someone wakes them up after the alarm goes off, they are often disoriented. On the other hand, the Mayo Clinic recommends using alarms but states that they can take 2 weeks to 3 months to be effective.

Whatever the cause of bedwetting, both experts and parents are divided over what to put on a child who is wetting the bed at night.
As you can see in any store that sells disposable diapers, today there seems to be countless sizes and categories of diapers, even within the same company, with varying degrees of absorbency. The nighttime diapers and diapers for older toddlers are the most absorbent, of course. Being extra absorbent allows more urine to collect in the diaper, which allows the sheets to stay dry and prevents the child from getting a diaper rash, since the urine gets wicked away from the skin. Hey, even the choice range for adult diapers takes up more shelf space than ever before.

The Big Divide, if you want to call it that, is whether to put a bedwetting child in a diaper, in an extra absorbent panty, or to allow the child to sleep in regular bed clothing, on a waterproof pad that is either on top or underneath the bed’s bottom sheet. Even that issue has its debate: over whether to use disposable pads or pads that get laundered again and again! As stated earlier, the Mayo Clinic suggests using pads, not diapers. But some children sleep better knowing – and having the security – that they may wet the diaper but not the bed. Thus, wearing a diaper allows them to sleep through the night. Much depends on the particular child, as this shows. Is it better to be a bedwetter who sleeps through the night or a light sleeper who doesn’t wet the bed? And honestly, that’s too complicated for a short blog article and is better as a carefully considered decision, so discuss it with your pediatrician, parents and other wise and informed souls.

Bladder Training
Some parents find bladder training for their child helpful. For this “remedy” the child is taught how to perform exercises that strengthen the bladder and help coordinate the muscles that connect the bladder to the urethra, the tube the urine that travels from the bladder to either the penis opening or out the vagina. These techniques include determining how much urine the bladder is capable of holding (if it is small, the therapy will help the child increase the bladder’s capacity, which means holding more liquid and urinating less often). Other techniques that can be helpful include stretching the bladder, which as the previous sentence suggests, helps delay urination. Some experts suggest drinking more fluid during the day, then less before sleeping, and not at all during the night. Still another technique is to teach, through biofeedback, how to wake up when a bladder is full and needs to be voided, then how to easily get back to sleep (counting sheep?).

What I’ve learned about bedwetting from raising children, reading books about the issue, and scouting advice on websites devoted to the issue
Most children wet the bed because they are sleeping too deeply, but it is important to have a bedwetter checked by his pediatrician, a pediatric urologist or the specialist in order to rule out a physical problem, such as a urinary tract infection, diabetes or other serious medical problems.

Take into consideration your ability to change wet sheets, launder more than usual and even launder large items, such as bed quilts, blankets, and mattress covers. Weigh those considerations against your child’s particular personality and needs. Some children are comfortable in nighttime diapers while some would be appalled to wear them, especially when visiting a friend or even relative overnight.

Never resort to punishment for bedwetting: for some it is a physical problem they will often outgrow, or an emotional problem, but sometimes need help with; for most it is a problem that needs intervention such as bio-feedback but not punishment! Punish a child who intentionally does the wrong thing, acts aggressive or obnoxious or inappropriately but refrain from punishing, or even scolding a child for bedwetting they can’t help.

Try the bedwetting behavioral programs before trying medicine. Some experts don’t believe in giving medicine for bedwetting; others believe in giving it only when a child is on an overnight visit and the threat of teasing and psychological pain is worse than the medicine.

One natural, over-the-counter treatment is a melatonin supplement, used for people whose waking pattern is more nocturnal than daytime. Other common medications used for treating bedwetting that require a prescription are desmopressin, usually administered as a nasal mist, imipramine, which acts on both the brain and the urinary bladder and helps with incontinence but is only totally effective in about 1 out of 5 people taking it, and a class of medications called anticholinergics, which are used to control muscle spasms that may cause an overactive bladder. By the way, never borrow a medicine from another bedwetter; always ask your doctor before even trying over-the-counter remedies.

Some experts say a child should not be exposed to the toxins in the plastic and other materials used to manufacture disposable pads. Others, including the manufacturers of such pads, strongly disagree. Like organic milk, butter and yogurt, it may be prudent not to prove them right or wrong, but to take the “safe road,” as the saying goes, and use flannel-covered rubber sheeting. If you or someone you know can, stitch an old sheet to the top of the rubber sheeting. Then it looks less like a pad and more like a sheet – to the child and to his or her friends or siblings. Or, it is probably possible to buy rubber-proof pads that are covered with sheets or decorative fabric.

In conclusion
This was an interesting topic to research but clearly one that requires far more than a short or even medium-length article. For many parents, bedwetting is one of the most challenging aspects of childrearing, especially for parents who have more than one child wetting the bed in the household or who have too much laundry and other responsibilities to do without the added burden of all those wet bed linens. Parents who suffered bedwetting themselves may be more compassionate and more tolerant, but not necessarily more knowledgeable about solving the problem. Yet as the research shows, they will be more likely to have a child who is also a bedwetter and to put that compassion to work. All parents who deal with enuresis, however, are dealing with a challenging issue in parenting, regardless of what style of parenting they are embracing. It is especially challenging issue when on vacation, visiting family or friends, or when the rest of life seems overwhelming or challenging.

A few years ago I read comedian Sarah Silverman’s memoir, The Bedwetter, a surprisingly good read, so good that I often recommend the book to others, both to friends who want to study standup comedy or put more humor into their writing, and to parents whose children are bedwetters, especially who are still wetting the bed during their adolescence, since she was a bedwetter until she was 16 years old. Ms. Silverman’s book offers a serious look at the effect of the issue on her personal life, as well as other issues including her parents’ divorce. But most important to this discussion, her story is a reminder that bedwetting is far more common than many people realize, and as difficult and embarrassing as you would expect it to be. Or maybe you hadn’t thought much about it if you were lucky enough not to suffer from it, even occasionally.

There are numerous books for children about bedwetting, though primarily picture books for younger children, not teenagers (which is why Sarah Silverman’s book is so good). You can read them to your child even if your child doesn’t wet the bed. Why? For the sake of teaching understanding and compassion for those who are bedwetters.

General parenting books include the topic and there are also books by experts on the issue, available at numerous websites devoted to bedwetting and toilet training.

As I said before, I have experience with the topic but am no expert on it. Still, it is interesting to see how much information is out there; interesting, too, to see how little agreement there is on some of the ways to treat bedwetting. It helps to remember that if your child is a bedwetter, and especially if they are an older bedwetter, that neither you nor your child is alone. It also helps knowing that the overwhelming odds – 99 to 1 – are that “this, too, shall pass.”

How to Diaper Your Son After His Circumcision

How often to change his diaper
It’s important to change a wet diaper at least every two hours or so, and important to change a dirty diaper as soon as possible. That’s because diapers, especially disposable diapers wick the urine away and also, because a wet diaper is not as germ-infested as a dirty diaper. The urine can, however, irritate a penis healing from a circumcision, especially if the penis isn’t covered by a protective gauze or still coated with petroleum jelly.

In contrast, dirty diapers contain germs and bacteria that can cause serious infections, both to the sensitive skin on the glans that is healing and to his urinary tract. In fact, even after the circumcision has healed, it is wise to change a dirty diaper as soon as you can. While urinary tract infections are especially rare in circumcised boys, when one does occur in a circumcised infant boy, it tends to be immediately following the circumcision, as the penis is still healing.

Although it varies from infant to infant, most newborns and infants urinate an average of 20 times a day, requiring more frequent diaper changes than an older baby or toddler. Cloth diapers are less absorbent than disposable diapers, though the some of the newer cloth diapers are more absorbent than cloth diapers of the past. Therefore, since it takes only takes a few days to little over a week for the average circumcision to heal, it may be wise to use disposable diapers until the penis has healed from the circumcision. And remember to change your his diaper at least every 2 to 2-1/2 hours, and to change a dirty diaper as soon as possible.

How to clean the infant during a diaper change
Wash your own hands first. Always wash your own hands before (and after) changing a diaper. If you can’t wash them, then use a hand sanitizer that is at least 60 percent alcohol. But know that washing your hands kills 99.9 percent of your germs; sanitizer is less effective.

The best way to wash your hands is with plain, not anti-bacterial, soap and warm water, rubbing them for 15 to 20 seconds, then rinsing them with water before drying them.

Get supplies for diapering ready, then put the infant down, take off his clothes, and then remove his wet or dirty diaper. If he is wearing protective gauze on the end of his penis, remove that, too. Now, using plain, warm water, clean his penis and then his buttocks. If you need to use soap, especially to h clean up a messy bowel movement, be use only an infant-safe soap; then rinse the area with a wet washcloth. Do not use diaper wipes, since they can irritate the area while it is healing.

What is important, as suggested, is to make sure that any bowel movement be cleaned thoroughly, especially from the penis and especially from around his urinary tract opening, or meatus, as it is called, since that can cause a urinary tract infection.

If he did have protective gauze on the end of his penis, ut on a new one, remembering to smear petroleum jelly (Vaseline is the most popularly jelly) on the new gauze, then wrap that around the penis. Never tape the gauze on, though, since tape can irritate his sensitive skin.

Also, remember not to use diaper wipes or paste ointments, such as Desitin, until the circumcision has healed. And remember to be gentle when removing the diaper and cleaning the area. That’s because if you rip a diaper off too quickly, you risk hurting the infant. Instead, if his penis is sticking to the diaper, you might try releasing it painlessly pouring warm water or using a wet washcloth.

Vaseline and gauze
Speaking of sticking to the diaper: Keeping the area covered with gauze that has been covered with petroleum jelly or Bacitracin ointment will help the area heal, but more importantly, will prevent the penis from sticking to the diaper, as the penis heals. Some circumcisers recommend applying petroleum jelly (Vaseline) directly to the skin instead of using gauze. Do what you think is best or what your circumciser or physician instructs, but remember to never tape the gauze in place; as mentioned previously, because sticky tape can hurt a newborn’s sensitive skin.

Blood, swelling, pus
Immediately after a circumcision, an infant’s diapers may show bloodstains and/or pus, and his penis, especially near the acorn-shaped end, called the glans, might be swollen. All this is normal, and should clear up within days of the circumcision. However, when  there is a lot of blood, particularly bright red blood, or a foul smell, or a lower than normal body temperature or fever, or when there seems to be an unusual amount of pus, then take him to your doctor or medical provider to be checked. Another reason for concern may be too little urination or an absence of bowel movements.

When the circumcision has healed
When the circumcision has healed, it is still important to remember good hygiene:

  • Change dirty diapers as soon as possible.
  • Change wet diapers at least every 2 to 2-1/2 hours, more frequently if your baby has sensitive skin and suffers from diaper rashes or allergies, less frequently at night, of course, and when he is an older baby or toddler and needing fewer diaper changes.
  • Always wash his genitals with soap and water, and the rest of his buttock area, too.
  • Always wash your hands – before and after diapering.
  • Always flush his bowel movements down the toilet; don’t save them for the landfill!
  • If your son shows sign of a urinary infection – a foul smell, fever, urine that seems to have blood in it, or call his the presence of pus, let a medical professional see him. After all, it is always better to be “safe than sorry.”
  • Teach him hygiene, both for his hands and his genital and anal region.

A lesson on diaper hygiene

Let’s start with one of the single best habits you can do for yourself, your child and later teach your child to do for his or herself: wash your hands after going to the bathroom. Every single time. Washing hands is one of the single best habits you can get into, in fact, because just washing hands just three times a day have 40 percent or more fewer infections and illnesses. In one study, 40,000 U.S. Naval recruits instructed to wash their hands five times a day cut down their respiratory illnesses by 45 percent. Clearly, simple hand-washing is one of those small habits that can add up to a big difference over time.

Wash your hands with plain soap and warm water, rubbing them for 15 to 20 seconds, which is as long as it takes to sing a song such as “Happy Birthday,” a timeless tune, but you can probably think of a more contemporary song to sing or to teach your child.

Now dry your hands with a clean cloth towel, paper towel or air. Air-drying them in one of those hot blasts of air machines in a public restroom, however, is not always a great idea as they can harbor germs when they aren’t cleaned properly. Sorry. Hate to burst your bubble on that one but you are better off with the paper towel or letting them cool-air dry.  And when you are using the bathroom in an airplane, be the most careful—those airline bathrooms tend to harbor the most germs! You think you get sick breathing the stale air in an airplane when it could be touching the faucet on one of their sinks that makes you sick.

How often to change a diaper
Babies shouldn’t be sitting in either wet diapers or dirty diapers for any length of time, although at nighttime, with a baby sleeping through the night or at least for a longish stretch, it is quite difficult to weigh their sleep—and your sleep—against the benefits of a clean diaper! The general “rule” is to change wet, daytime diapers on infants every 2 hours or so but to change dirty diapers as soon as they occur and to change nighttime diapers less frequently, especially if using a more absorbent, nighttime diaper.

Most, but not all, cloth diapers tend to be less absorbent than disposable diapers, so they may need to be changed a bit more frequently. And since toddlers tend to urinate less often (their bladders being able to hold more urine and their diet is not solely liquid anymore), their diapers can be changed less frequently—an average of every 3 to 4 hours or so instead of 2 hours or so.

If your child tends to have more sensitive skin and be more prone to irritation, then change the diaper more frequently. Also, if your child tends to get urinary tract infections, change the diaper more frequently, and never let such children sit in a dirty diaper if you can help it (or a dirty bathtub, for that matter).

Back to diaper changing
Wash your hands. Before you change a diaper, wash your hands – properly. Using soap and water, not hand sanitizer. That’s because soap (regular soap; anti-bacterial soap will kill the germs but is contributing to the rise in bacteria that are antibiotic-resistant). And the sanitizers you use should be composed of at least 60 percent alcohol in order to be effective.

Gather your supplies. You will need: a clean diaper, a warm, wet cloth or wet wipes, a burp cloth, a safe place for changing the child (floor, bed or changing table and remember to use the safety straps on the changing table), a changing pad to protect the surface of the bed or floor. Baby powder, diaper rash ointment and lotion are all optional, of course.

Put the baby down. Place the baby down on the surface, making sure you have put a protective pad on a bed, floor or elsewhere that could be damaged if the baby accidentally urinated or pooped on it. If it is a changing table, use the safety straps. Now remove the baby’s clothes, then untape, unsnap, or unpin the soiled diaper.

Cover the baby to avoid accidents. Once you have removed the baby’s clothes, cover the baby with a burp cloth to prevent any accidents from spraying in either your face or your baby’s face, and remove the wet or dirty diaper.

Remove wet or dirty diaper. If you are removing a dirty disposable diaper, it is best to later dump the waste in the toilet, not wrap it up in the diaper – better for the environment – in the long run, given that in a landfill that poop can seep into the ground and pollute the water or never seep anywhere and stay there for too long.

Wash the diaper area. Wash the baby with a gentle soap and a warm wet rag. For girls, wash from their vagina down to their buttocks, so you don’t risk infecting their urinary tract with any extra germs. For boys, make sure you wash their genitals thoroughly. This helps prevent urinary tract infections, which boys get far less than girls, but tend to get them the first six months of life, when the germs from stools gets into their urinary tracts, especially if their diapers aren’t changed frequently enough or if proper genital hygiene is overlooked. And if the boy has his foreskin, only pull it back—gently—to clean underneath when it has separated.  If it hasn’t, gently clean around it but never force the foreskin to separate from the the end of the penis or you can cause pain, bleeding and an infection.

If your baby has extra-sensitive skin or is prone to diaper rashes, you may want to apply a lotion or protective gel, such as Desitin. You may also want to dust the baby with some baby powder. And of course, you may be talking or singing or joking with the baby during this entire process!

Put on the new diaper. Finally, it’s time to place the new diaper on the baby. Lay the diaper under the baby, then pull the front of the diaper through your baby’s legs. Use one hand to gently hold it against the baby’s stomach while you secure one side. Then secure the other side. Make sure the diaper is neither too tight nor too loose, by sliding two of your fingers on the top front of the diaper. Redo the diaper if it is too tight or too loose.

When you are finished putting on the diaper (and perhaps a diaper cover)
When you are finished putting on the diaper and diaper cover, be sure to wash your hands again and to wash your child’s hands – as they may have gotten their hands dirty during the process and they tend to put those dirty hands in their mouth, ears, nose or in your mouth. The point here is simple: clean hands equals less chance of getting sick. And yes, it’s truly that simple.

Not the end of the story
Changing a diaper is only one part of diaper hygiene. The other part is what to do with wet or dirty diaper. As explained in the previous section, the “dirt” from a dirty diaper should always go into a toilet, never into a landfill. Granted, this disposal of feces is much harder to do with breast fed babies who aren’t on solid food yet, since their stools are quite loose. Still, it’s worth trying. If a child has diarrhea, then the chance that stool has germs is stronger, and that stool should go into the toilet, as well. But, as the saying goes, “we’re only human,” so do the best you can, and at least feel a tinge of guilt when you can’t!

If you are using cloth diapers, put the wet or dirty-minus-the-stool diaper into a receptacle for holding these diapers. It’s best to launder them at least twice a week, in order not to build up an ammonia-smelling receptacle, especially when you are changing diapers frequently, as you do with an infant. Just keep the diapers separate from the rest of the family laundry is the advice here. Yes, your underwear is not clean, either, and neither is anyone else’s in the family. But take note of the advice in the next paragraph because it’s worth knowing (or gloating over if you already know it).

Even if you are using cloth diapers largely as an environmental issue and want to save on electricity, if you have a dryer, use it on the diapers. Why? It’s the heat from the dryer that kills most of the germs and bacteria, and kill them it does. So the advice promised in the preceding paragraph is this: dry all items in the house that tend to harbor germs that can infect, the kind of germs you really want to kill. This includes the family’s underpants, dishtowels, and dish rags (wash those frequently by the way because wet ones that have washed dishes or counters harbor the most germs and grow the most bacteria!), dust cloths, wash rags, hand towels, cleaning rags and any other item likely to be in contact with germs, especially when wet.

What kind of detergent to use. Some detergents are more gentle on a baby’s skin. Others leave a residue that can irritate the skin. Ah, life was so simple decades ago, when there were only a few unscented, mild detergents marketed for use with babies and children, and hyper-allergic individuals. Today, especially in the big box stores, there are dozens upon dozens of detergents to choose from. Add Internet sales and the choices are overwhelming. Add Internet sites such as The Diaper Jungle, however, and you can make your own choice, based on efficiency, cost per load, enzymes, brightener, dyes, fragrance, softeners and bleach. The people who run that site have done the research for you—all you have to do is decide what is important to you and your child.

When you do use disposable diapers, dispose of them in a receptacle meant for trash—one with a tight cover that keeps out the air and holds in odor and germs. While a busy person is going to occasionally dump a dirty disposable diaper in a regular trash receptacle, remember your manners and who might come across it—including the family pets, your mother or mother-in-law and anyone else who might be grossed out by its appearance or odor. Okay, this advice isn’t necessarily health advice, but it is advice of the Emily Post School of Manners, or the Spiritual Perspective on Decent Living, or even your-home-in-the-entire-universe, hippy perspective, all of which have some merit when you think about the bigger picture in life and the fact that you do have running water, access to a choice of diapers, and a baby to love and nurture (the most important gratitude recipient.

If you are worried about the environment but not on a strict budget, the ideal diaper system to use is cloth diapers, through a diaper service. That’s because diaper services know how to get diapers really clean, and their industrial machines actually use less energy per diaper accomplishing that feat.

When you are out, sick, or someone else is babysitting your child, say, it’s okay to cheat on disposables, and when you are working, can afford them, and want a break, use disposables, but maybe give a generous donation to some environmental group to assuage your guilt.

If you decide to use only disposables, know (seriously) that the difference between the two diapers, as far as the environment is concerned, is pretty clear cut. Not so when it comes to one’s personal life. Understood. This line of reasoning can be applied to many situations and issues. It’s called relativism – relative to what you believe! As compared to situational ethics—what the situation calls for. In a time of emergency, use disposable diapers without feeling any guilt, but feeling much appreciation for the trees, the dump, the plastic, and the environmental cost. Cloth menstruation pads versus disposable pads? Not even “going to go there,” as the saying goes!

Remember that good hygiene—yours, what you do with your child, and later, what you teach your child—can make a big difference in your health, your child’s health, and anyone else’s you or your child come in contact with. In fact, hygiene is as important as what you eat and the air you breathe. So remember it when you change a diaper, dispose of a diaper, clean a diaper, and smile at your child, even though you have changed hundreds, and in a short time, thousands of diapers. For by the time your child is only 2-1/2 years old and ready to be toilet-trained, you and others in his or her life will have changed nearly 7,000 diapers! Surely it’s time to write that next blog, about the diaper-free movement, which is gaining traction among parents today. Hey, who knew genital hygiene and diaper issues could be so complicated—and so interesting?!!