Do Cloth Diapers Cause Diaper Rash? What the Evidence Says | Bayrli®

Do Cloth Diapers Cause Diaper Rash? What the Evidence Says

Nappy rash is one of the most common concerns parents have about cloth diapers. The assumption is understandable: cloth diapers hold moisture against the skin rather than wicking it away into a gel core like disposables, so surely they must cause more rashes? The evidence does not support this. In many cases, it suggests the opposite.

What Causes Nappy Rash

Nappy rash is primarily caused by prolonged contact between your baby's skin and moisture, particularly urine and faeces. Ammonia, which forms when urine breaks down, is a significant irritant. Friction from a poorly fitting diaper, exposure to chemicals in some products, bacterial and fungal infections, and food sensitivities can also contribute.

The critical variables are how long wet material stays against the skin, what that material is made of, and how breathable the overall system is. These factors, not the diaper type, determine rash risk.

How Cloth Diapers Compare to Disposables

Disposable diapers use a super-absorbent polymer (sodium polyacrylate) that draws moisture away from the surface and locks it into a gel. This is effective at keeping the skin surface feeling dry, and it is the primary convenience advantage of disposables. However, it comes with trade-offs.

The plastic outer layer of a disposable diaper is not breathable. It creates an enclosed, humid environment against the skin, which is precisely the condition in which bacteria and yeast thrive. Disposable diapers also contain chemicals, including dioxins, fragrances, and dyes, that can themselves cause irritation or allergic reactions. Contact dermatitis from disposable diaper chemicals is well documented.

Cloth diapers made from natural fibres are breathable. Cotton, bamboo, and hemp allow air circulation that the plastic layer in a disposable cannot. This breathability reduces the trapped heat and humidity that create conditions for rash. The trade-off is that without a gel core, cloth diapers do not lock moisture away from the surface as effectively. This makes timely changing more important.

Many parents who switch from disposables to cloth report that persistent rash resolves after the switch. This is a widely observed anecdotal finding, and it aligns with the expected result of removing chemical irritants and improving breathability.

The Role of Changing Frequency

The single most important factor in preventing nappy rash, regardless of diaper type, is changing your baby promptly when wet or soiled. A baby left in a wet disposable diaper for four hours is at higher risk of rash than a baby in a wet cloth diaper that is changed every two hours.

Because cloth diapers do not mask wetness the way disposables do, parents tend to change more frequently. This is sometimes cited as a disadvantage, but from a skin-health perspective, it is a benefit: more frequent changes mean less time with moisture against the skin.

Preventing Rash with Cloth Diapers

Change frequently. Every two to three hours during the day, and promptly after bowel movements. Overnight, a well-configured cloth diaper with a stay-dry liner should keep your baby comfortable for the full sleep stretch.

Use a stay-dry liner. A fleece or microfleece liner between the absorbent layer and your baby's skin wicks moisture away from the surface. Your baby feels dry even when the absorbent layers beneath are working. This is especially effective overnight.

Choose natural fibres against the skin. Organic cotton is the gentlest option. At Bayrli, all skin-contact surfaces are certified organic cotton. Avoid microfibre against your baby's skin; it can cause dryness and irritation.

Maintain a proper wash routine. Improperly washed diapers can harbour ammonia and bacteria, both of which cause rash. Our washing guide covers the correct routine. If you notice a strong ammonia smell from your diapers, they may need stripping.

Use cloth-safe diaper cream when needed. If you use cream, apply it over a liner to protect the diaper's absorbent layers. Creams containing zinc oxide or petroleum coat fabric fibres and can cause repelling if they reach the absorbent layers directly.

Allow nappy-free time. Brief periods without a diaper, allowing your baby's skin to air out, are the simplest and most effective way to prevent and heal rash. Even 10 to 15 minutes of nappy-free time after a change can make a meaningful difference.

When Rash Persists

If your baby develops a rash that does not improve with frequent changing and nappy-free time, consider:

Whether your wash routine is adequate. Ammonia buildup from insufficient detergent or low wash temperatures is a common cause of rash in cloth-diapered babies. Increase detergent, ensure your main wash is at 60°C, and consider stripping if the issue persists.

Whether your baby has a sensitivity to a specific material or detergent. Try switching to a different detergent (fragrance-free powder detergent is recommended) or a different liner material.

Whether the rash is fungal (yeast). Yeast rashes have a distinctive appearance: bright red with satellite spots. They require antifungal treatment from your GP. If you identify a yeast rash, bleach your diapers after treatment to prevent reinfection.

If in doubt, consult your GP or public health nurse. Nappy rash is extremely common and usually straightforward to treat, but persistent or severe rashes warrant professional assessment.

Frequently Asked Questions

Do cloth diapers cause more nappy rash than disposables? No. The evidence does not support this. Cloth diapers made from natural fibres are more breathable than disposables and contain no chemical irritants. Many parents find that switching to cloth resolves persistent rash caused by chemicals in disposable diapers.

What is the best cloth diaper material for sensitive skin? Organic cotton is the gentlest natural fibre for direct skin contact. Bamboo is also very soft and well tolerated. Avoid microfibre against sensitive skin, as it can cause dryness and irritation.

Can I use nappy cream with cloth diapers? Yes, but always use a liner between the cream and the diaper. Creams containing zinc oxide or petroleum coat fabric fibres and reduce absorbency. A reusable fleece liner or disposable paper liner provides a barrier that protects the diaper.

Why do my cloth diapers cause a rash when they didn't before? The most likely cause is ammonia buildup from an inadequate wash routine. If your diapers smell of ammonia, the ammonia is causing the rash, not the fabric. Review your wash routine, increase your detergent dose, and strip your diapers if necessary.