Wednesday, August 20, 2014

Cloth diapering a baby or toddler with Down syndrome

I recently heard that some physical therapists have cautioned mothers of babies with Down syndrome against using cloth diapers out of concern that bulky diapers could hinder gross motor skill development. While their concern is genuine and worth taking into consideration, a blanket ban just seemed like overkill to me. So I dug a little deeper, and after talking to some friends who are physical therapists and some fellow cloth diapering moms of little ones with Down syndrome, including Heather from Cloth Diaper Outlet, here's what I think seems like the most sensible approach to using cloth diapers with babies and toddlers with Down syndrome. 

my son in an adorable Wolbybug pocket diaper from Cloth Diaper Outlet

Why cloth is great for kids with DS
Modern cloth diapers are so convenient and so cute that they're rapidly gaining in popularity among all parents. Just like any family, families with a baby with Down syndrome may be attracted to cost savings, reduced environmental impact, not *having* to shop for diapers as often, and how adorable they are!
Additionally, babies with Down syndrome often have thinner skin than typical babies, so parents may find that babies who have sensitive skin and get rashes from disposable diapers have much healthier skin when they use cloth diapers! Our son with Down syndrome has definitely seen a dramatic decrease in diaper rash since switching to cloth diapers. 
Momma Jorje's son as a baby in pre-folds. So cute!!

Primary concerns
The biggest concern cited by physical therapists and parents is that excess bulk will exacerbate the tendency to splay hips too widely and could hinder gross motor skill development. As far as I know, there is no research into whether this is a valid concern or not; perhaps it'd be a good topic for future studies in the physical therapy field. 

What works
The easiest solution seems to be to make sure your diapers are relatively trim! There are several ways to search for cloth diapers that will not be excessively bulky.  Heather suggested that pocket diapers with a hemp insert are the very trimmest option, but sometimes not quite absorbent enough.  Next up would be a trim AIO (all-in-one)-Heather's favorite is Simplex and is what she uses about 50% of the time on both her babies. She also loves simple prefolds and covers and recommends the "premium short" prefolds from Cloth Diaper Outlet. They are made the same length as the cover, so you just fold in thirds, lay in cover, and are good to go! Heather said you can also fold them even skinnier so they are more trim--they won't be quite as trim as a disposable, but much more trim than a standard prefold.

I also checked in with several other mamas of cloth diapered little ones with Down syndrome to find out their favorites:
Jorje from Momma Jorje used prefolds and covers and elimination communication with her son who has Down syndrome. 
Drea from the Maiden Metallurgist reports that her favorite diapers for her year old with Down syndrome have been fitteds and wool. 
Lisa, another mom of an adorable toddler with DS who also sells cloth diapers says her favorite trim diapers are a Smart Bottoms and Tidy Tots brands (side note: Tidy Tots are manufactured in the US at a company that employs people with developmental and intellectual disabilities. So your baby with Down syndrome could be wearing a diaper sewed by an adult with Down syndrome!)
At 18 months old, my son is currently in a mixture of pocket and hybrid diapers and they all seem to fit fairly well without being excessively bulky.

The general advice is to try several different brands when you are first starting with cloth diapering so you can figure out which work best for you without a huge investment in any one brand, and I think that's all the more true when you're dealing with the challenges presented by special needs. I think it's also worth noting that there is a wide range of available sizes of cloth diapers, including diapers that fit babies as small as 4 lbs and up to 50lbs and beyond (through adult sizes). One brand with this wide range of sizes is Snap-EZ (which is run by a super sweet mom of 13, including two preschoolers with Down syndrome!!) I love that this broad size range means even preemies and very small newborns, and kids who are in diapers later than many of their same-age peers can find options that work for them.

Drea from the Maiden Metallurgist's son as a newborn in a woolie! Ovaries aching yet?!?

One other option is to pair cloth diapers with Hip Helpers. These special compression shorts are designed to help kids with special needs keep their hips from splaying too widely. If you have a physical therapist who objects to cloth diapers on these grounds, using hip helpers some of the time may be an acceptable compromise for both of you. 

So can you use cloth diapers on babies and toddlers with Down syndrome? My answer is a resounding "yes!" in almost all cases! It sure works well for us!

Interested in natural parenting for a little one with Down syndrome? Check out my other posts on Babywearing and Down syndrome and Gentle Parenting through Blood Draws!

*I am not a doctor, physical therapist, or any other type of health professional and I've never met your child. Please consult with your child's care team to adapt or even completely ignore my suggestions based on your individual child's needs and the advice of your care team. 

1 comment :

siouxbhoney said...

I've also found flats --kite folded or jellyroll fold, to be a very trim and leak - free option. I'm also hoping that cloth diapering will help with potty training. I keep being warned that potty training will be difficult with my child with DS.