Choosing the Right Diaper to Manage Bed-Wetting With Older Children, Adolescents, and Teenagers part 1

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One thing I have repeatedly mentioned in my articles is that there is not one-size-fits-all solution to manage incontinence. There are many different factors involved in choosing an incontinence product. The key factors that play a part in the decision making process are the following: the type and level of incontinence, whether or not the person prefers to use disposable or reusable garments, how a particular garment effects the user’s skin, ease of use which includes how easy and convenient it is to put on and take off(some people are non-ambulatory and need garments that are better suited for this issue), price, how comfortable the product is,whether the problems occurs during the day,night,or both,and how a particular product fits the user(which in turn has a bearing on how comfortable the product is and how effective it is at protecting both the individual and bed). Although these are important factors to keep in mind when purchasing incontinence products the two overriding criteria to consider are how effective the product is at keeping both the individual and the bed dry and how comfortable the product is.

When buying incontinence products it’s important to be aware of the different terminology for incontinence products. For example the term disposable briefs refer to disposable diapers for older children,adolescents,teenagers,and adults. These garments have the same fit, design, and style as baby diapers-they have tapes,elastic leg gathers,some have elastic waist bands, and they have either a plastic or cloth(also known as a non woven) outer cover. Regarding the outer cover there are manufacturers of disposable briefs who offer two models-one model has a plastic outer cover and the other has a cloth outer cover. Some manufacturers in turn only offer models with a plastic outer cover.

The most widely used type of disposable garments to deal with bed-wetting are “Goodnites” which are designed for older children,adolescents,and teenagers with bed-wetting problems and Huggies “pull-ups” which are designed for both children who are being potty trained and bed-wetters. The reason for introducing these products into the market place is that they look and fit just like regular underwear which is supposed to be less stigmatizing for an older child or teenager. The same type of design is used in reusable products as well. While it is true that these products work for some people, most people seem to feel that diapers are the better choice to manage heavy incontinence such as bed-wetting. However, because of the stigma surrounding diapers, most older children, adolescents, and teenagers are reluctant to wear them. The majority of the public feel that diapers should only be used for babies. I feel that the following quote from “Diapers Get a Bum Wrap”(which is the second chapter of The New Diaper Primer,a very good resource) sums up the current thinking about this subject perfectly: “This infantile image keeps many,if not most,incontinent children and adults out of diapers and struggling with leaks,wet beds,and so on. We can still cringe to hear the oft-told story of a bed-wetting youngster and the mounds of laundry daily with sheets,blankets,pajamas,not to mention the emotional stress and loss of sleep from interruptions during the night. But if we were to suggest it might be much easier on everyone if the youngster wore diapers to bed, the reply would be an astonished and/or indignant stare while maintaining that the youngster is too old to be wearing diapers. Again, that unshakable stigma!”

Many individuals buy pin-on cloth diapers to manage their bed-wetting and when using these diapers it’s necessary to buy waterproof pants to cover the diapers. This brings me to another term which you should be familiar with. Years ago waterproof pants were made of rubber and these were the diaper covers used by parents for their babies, then after the advent of plastic pants(which I believe was in the 50’s), rubber pants became less popular. Later on rubber pants were phased out completely for the baby market, although there are some companies that manufacture rubber pants for older children and adults. The term “rubber pants” began to be used as a generic term for waterproof pants, particularly vinyl pants(which in turn are more widely known as plastic pants-vinyl is a type of plastic so the terms are basically interchangeable). When most people use the term “rubber pants” they actually mean plastic pants. The same type of terminology is used by some people when referring to waterproof sheets-some people use the term “rubber sheets” as a generic term for waterproof sheets,although this usage seems to be more common when talking about waterproof pants.

Some people who have heavy incontinence during the day and night use both reusable and disposable garments. For example one individual mentioned that he used disposable diapers during the day and pin-on diapers wrapped with plastic pants at night. Another person with bed-wetting problems said he used pin-on diapers and plastic pants during the cooler times of the year and disposable diapers when the weather becomes hot.

A number of people with bed-wetting swear by both disposable briefs and pin-on diapers covered with plastic pants. These garments are particularly suited for heavy incontinence such as bed-wetting.In a situation like this it’s a good idea to experiment with different products in order to find the one that works best for you. Right now I’d like to talk a little more about pin-on diapers. The drawback of pin-on diapers and plastic pants is that some people find that they are uncomfortable to wear in hot weather. That being said, not everybody feels this way, in addition some cloth diapers(in particular those made from gauze fabric) are supposed to be very comfortable to wear in hot weather. The New Diaper Primer on the website has some real good information about pin-on diapers. There is a specific way to fold,layer,and pin the diapers on in order to provide maximum protection which is mentioned in The New Diaper Primer. I talk about pin-on diapers in more detail  in my article ” Information Regarding Pin-On Diapers for Older Children,Adolescents,and Teenagers with Bed-Wetting Problems.” An important point to keep in mind with  pin-on diapers is that they tend to be made of heavyweight material which makes them more absorbent.

If you decide to use pin-on diapers to manage your youngster’s bed-wetting you must use waterproof pants to cover them. The most popular type of waterproof pants are plastic pants. Some plastic pants are thicker than others. In general the thicker plastic pants tend to last longer. Some brands of plastic pants that have good reputations are the Comco plastic pants,the Suprima plastic pants,and the Gary plastic pants. For further information about these pants and where to purchase them see my article “Brands of Plastic Pants for Older Children, Adolescents, and Teenagers with Bed-Wetting Problems.”

When buying diapers look on the website and check out the size range of the products. As far as disposable briefs are concerned they tell you which hip and waist size the briefs will fit. For youth sizes they sometimes also give the weight range the products will fit.

With cloth diapers they give the waist size the diapers will fit as well as both the length and width of the diapers. A customer service rep from Angel Fluff Diaper company told me that in order to get the appropriate size you should measure the waist from the belt in front to the belt in the back and through the crotch. In addition you should also know your thigh measurements. The simplest thing to do is to familiarize yourself with what measurements are required from the company you’re planning to buy from then when you’re ready to purchase the item, ask them if there’s any other information they need. This applies to disposable briefs, plastic pants, and cloth diapers.

As discussed before there is tremendous stigma associated with the use of diapers. It’s a shame that most people only use garments such as pull-ups/pull-ons and “Goodnites” to deal with their bed-wetting and won’t even consider trying other options. Options that in some cases can offer better protection thereby making the child feel more comfortable and secure. I’ve talked with customer service reps from The Bedwetting Store, Continence Connection, HDIS,  and other places that sell incontinence products and the ones I spoke with felt that the disposable briefs tend to be more absorbent and provide better protection than garments such as pull-ups and “Goodnites” although some people I’ve spoken with said that both briefs and pull-ups are equally effective at protecting the user,it’s just a question of personal preference. That being said, the consensus from both customer service reps that sell both types of garments and people from incontinence forums who experience bed-wetting seems to be that disposable briefs tend to offer better protection for this particular type of incontinence.

At this point I’d like to talk about some of the reasons that the disposable briefs tend to be more effective for heavy incontinence such as bed-wetting. One of the reasons for this is that there tends to be more padding in the briefs. One customer service representative told me that many briefs have a highly absorbent polymer and high capacity padding which extends to the wings and side panels. Another customer service representative told me that the disposable tape on briefs tend to have more padding in the front and back and the pull-on garments tend to have less padding in the waist area. A third customer service rep told me that the briefs have padding all around whereas garments such as pull-ups and “Goodnites” don’t. In general it seems that products such as “Goodnites” tend to not have padding on the sides which means they’ll most likely provide less effective protection particularly with those people who tend to sleep on their sides. In fact one person on an incontinence forum mentioned that he didn’t find the pull-up style disposable diapers effective for bed-wetting. He said that they didn’t have enough protection on the sides and he frequently experienced leaks. I was also told that with a tape on brief there’s more flexibility in getting a snug fit because you have the ability to adjust the tapes on the brief thereby making them fit more snug .This in turn should help prevent leaks. That’s the reason disposable briefs have refastenable tapes, in case you need to make any adjustments to the brief to make it fit better. The author of the Diaper Primer in the section on disposable diapers has this to say regarding pull-ons: “As a general observation,we would say that pull-ons are not really “you know whats”(i.e. diapers) and cannot afford the same protection afforded by the “ah-hem.” If they are going to get used and wet,they are going to become heavy,and the elastic waist will not be able to keep them up or comfortable. This writer’s opinion is that they are very useful and valuable for those who do not plan to get them wet and are wearing protection primarily for peace of mind or for that “just in case situation” and “The capacity of pull-ons is less than a full diaper brief.” There are several brands of disposable briefs that are highly regarded by many people especially for heavy incontinence such as bed-wetting. These include Molicare Super Plus Fitted Briefs, Abriform X-Plus briefs,the Unique Brief(which is made by First Wellness and is also known as the Wellness brief), Eurobrief made by Mediprime,Secure X-Plus briefs, Tranquility All-Through-The Night disposable briefs,Tenas, and Dry247 briefs. These are just some of the brands of disposable briefs available. Other brands of disposable briefs include the Wings brand by Kendall, Prevail by First Quality, Whitestone, the Dignity brand made by Humanicare, At Ease, Attends, and Nightingale.

As far as buying a brief with a plastic outer layer or a cloth layer is concerned this is a personal preference. There are people who prefer the diapers with a cloth like outer cover and there are those who prefer the diapers with a plastic outer layer. Some of the complaints about diapers with a cloth like outer covering that were mentioned in the Diaper Primer are abrasion between the legs and a feeling of clamminess. Other people prefer the cloth like outer cover because they feel it’s more comfortable. There are a number of reasons why most manufacturers seem to be making diapers with a cloth like outer cover. One,is that they could be more cost effective for the manufacturers to produce. Two,they are supposed to be more discreet to wear-some of the diapers with the plastic outer cover make a loud crinkling sound whenever the user moves around. Third,the cloth like outer cover is supposed to make the diapers more underwear like in appearance which makes them more acceptable to wear for many people. Fourth,these diapers are supposed to be more breathable which means they’re supposed to be healthier for the individual’s skin. Finally,all of these reasons might be involved in the decision to make these kinds of diapers. That being said, there are companies that make both styles of diapers and there are companies that only make diapers with a plastic outer cover. I personally think that the reason most diapers for older children, adolescents, teenagers, and adults are made with a cloth like outer cover is that these diapers look more like underwear than the ones made with a plastic outer layer. As far as the rustling sound is concerned, I understand that there are ways to get around this problem and if the person is only wearing diapers at night this shouldn’t be a concern. Furthermore, even certain brands of disposable diapers with a cloth like outer cover can make some degree of noise. It should be pointed out that products and brands evolve over time-for instance a brand that might have had a bad reputation with members of the incontinence community years ago may improve and vice-versa. Another point to keep in mind with disposable briefs is that some people buy disposable liners to increase the absorbency of the brief. Disposable liners are known as booster pads or “diaper doublers” and can be purchased from mail order companies such as HDIS ,National Incontinence,Continence Connection among other places that specialize in incontinence products.

In the story “Which book will help me become a better parent?” Frank Devlin has the following to say which I feel can be applied to the case of bed-wetting and choosing the most effective product to manage it: “The Family Project panel believes the way to approach parenting books is not to find the one book that is “right” They say: Take bits of advice from various books that make sense to you,add techniques your own parents,friends,or relatives might have used that you endorse,and come up with your own strategy” and “Don’t get hung up on following parenting books to the letter. Take bits that make sense to you from each book and work them into your overall parenting style. Be skeptical of books that preach that one single method can work with a myriad of problems or children’s personalities.”

The last sentence in particular applies to bed-wetting and wearing the appropriate diaper to manage it. In this case the single method that is touted by many people, both parents and medical professionals, is the use of garments like “Goodnites.” As I have stated elsewhere, I am not against people using products such as “Goodnites” to manage bed-wetting if they happen to offer effective protection, however,  this isn’t always the case. What I am against is all this emphasis on the image of incontinence products as opposed to how well the product protects both the individual and the bed.

Every product has certain advantages and disadvantages. For instance all in one diapers,which are reusable diapers, are noted for taking longer to dry and being difficult to clean properly. People are different in how they look at the pros and cons of various things in life and choosing an incontinence product is no exception. For instance some people might consider the fact that you have to wash cloth diapers and plastic pants a big enough disadvantage that they don’t want to use the product whereas another person might feel that this factor is offset by the comfort and security they provide. So even the advantages and disadvantages of a product are subjective to a certain extent.

There are many sources you can use to obtain information on different incontinence products. Incontinence forums and chat rooms are one such source. The best way to get information in this way is to pose a question to the forum or chat room. You can ask if anybody has an opinion on what types and brands of diapers are a good choice to use for a problem such as bed-wetting. One person on an incontinence forum said that he found pin-on diapers and plastic pants to be real effective in managing his bed-wetting. He especially had problems with side leakage and said that they worked very well at managing this issue. For instance,he was able to fold,layer,and pin the diapers in a way that made them more effective in dealing with this particular concern. This is one example of the type of information you can get from incontinence forums.

Once you get an answer you can look up the products the person suggested and find out what companies sell those products. You can then call them up and ask if they have any sample packs. HDIS has a sample pack of disposable briefs for heavy incontinence for $9.95. It might be worth it to purchase a pack. Other sources include organizations such as the Simon Foundation for Continence,who are in the process of writing a book that deals with the management of incontinence and the NAFC which stands for the National Association for Continence. The NAFC has a guide for incontinence products called the NAFC Resource Guide. Some of the products listed in the guide are reusable products,disposable products,skin care products among other items. The guide lists contact information for companies that sell these products including telephone and fax numbers as well as website information. To find out more information about this guide go to the online store of the NAFC website(which is on the bottom of the page),click on “consumer booklets and kits” on the left hand side of the website,then click on “educational booklets”,then click on “resource guide”. The resource guide is $16.00.

Unfortunately many people are more inclined to buy a product that they consider to be more “adult like” rather than buy a product that offers the appropriate level of protection given their particular circumstances. It’s imperative that people not fall into this trap. In this situation the person has to tell themselves that they are the one who has to deal with this problem not anybody else so,it shouldn’t make a difference what anybody else thinks-they’re going to buy the product that is best for them. The primary factors that a person should consider are the following-is the product comfortable and does it provide effective protection,not what other people think about the choice or what the public thinks. A large number of people are reluctant to wear diapers for bed-wetting. For strategies on how to motivate and encourage a youngster who is embarrassed to wear diapers to bed see my article “Ways Parents Can Encourage Older Children,Adolescents,and Teenagers to Wear Diapers to Bed for Bed-Wetting.”

Right now I’d like to digress for a little bit and talk about the main barrier that prevents people from buying diapers to manage bed-wetting. That barrier is the stigma that these garments have. In this regard I think it would be helpful to reprise some passages from one of my other articles entitled “Reasons for the Stigma Surrounding Diaper Use in Older Bed-Wetters and Ways We Can Reduce this Stigma.” The first passage has the following quote which I believe is particularly relevant to this topic. This quote is from a forthcoming book about standing up to authority and experts by the social psychologist Sharon Presley. The purpose of this book is to help people become more independent in the decisions they make in their life and not to rely too much on experts. Here is the quote which I think might help both the parents of bed-wetters and the bed-wetters themselves be more open minded in their decision about what type of garments to wear to bed to manage the problem: “Another important tool to help you deal effectively with experts and authorities is critical thinking. “Critical thinking,” say Brooke Noel Moore and Richard Parker,authors of the textbook Critical Thinking, is the careful,deliberate determination of whether we should accept,reject,or suspend judgment about a claim and of the degree of confidence with which we should accept or reject it.” Regardless of the situation,applying the principals of critical thinking can help you sort out the real from the false,manipulation from facts,inappropriate pressure from simply good advice. You won’t always be right. You’ll sometimes make mistakes. But making your own decisions based on critical thinking,even if you’re wrong,strengthens you psychologically and makes you better able to withstand pressure from authorities and sharper at spotting expert bamboozling.” The purpose of quoting from this book is to help parents of bed-wetters and adult bed-wetters think more independently about this issue and not be pressured by either medical professionals,friends,family members,and relatives, or the public about their choice of protection to use to manage their bed-wetting. For example, a parent of a bed-wetting youngster could say the following to themselves: “Although most pediatricians and other medical professionals recommend not using diapers for a child over the age of 4 or 5 that wets the bed,in my particular situation these are the garments that I feel will be the most effective at keeping both my child and the bed dry which will keep her more comfortable.” In the same vein an adult bed-wetter could say the following: “Although most experts feel that it’s better for an adult’s self-esteem to wear underwear like products for bed-wetting, in my case I find pin-on diapers covered with plastic pants(or whatever type of garment the person feels is best at managing the bed-wetting) to offer the most effective protection and therefore provide the most comfort.”

I feel that the book “The Future and Its Enemies” by Virginia Postrel also has some ideas in there which I feel are applicable to the issue of relying too much on the opinions of experts, the public,and relatives and friends when choosing what form of protection a youngster should wear for bed-wetting. On a related note, I feel that the book has some ideas in there which hopefully will make people consider purchasing garments to deal with their youngster’s bed-wetting based on the youngster’s needs and not on the popularity or image of the product(in this regard products such as pull-ups and “Goodnites” spring immediately to mind). Although this book does not deal directly with the issue of bed-wetting and what types of products to use to manage the problem,the philosophy of the book is consistent with having a more tolerant attitude in this area. The following passage from the book is particularly effective in illustrating how we should be more flexible and independent in terms of decisions we make and in our philosophy of life: “As individuals, dynamists may have strong opinions about the best way to do things-from the best way to run companies or raise children to the best way to cut hair or make music. But they realize that they may be wrong, and that someone may come along with a better idea tomorrow. They understand that what seems like a great idea in theory may turn out to have terrible results in practice. And they accept that, in some cases, what is best for one person may not be best for another.” This is another passage which I feel illustrates perfectly the need to be more open minded in this area.

Right now I’d like to return to how to go about choosing a diaper to manage your child or teenagers bed-wetting. The important thing to do is to look at your current needs. Bed-Wetting is a heavy form of incontinence so the focus should be on products that are highly absorbent. The second aspect to consider is whether or not you want to use disposable or reusable garments or if you want to use both styles. As I talk about below some people alternate between both types of diapers. Finally, you should look at your budget. Once these issues are considered you can contact various companies to get a feel for the price range of different products and look at the absorbency of different products. Some websites and mail order companies compare the absorbency levels of different incontinence items. Another option would be to do a Google search. You could type in absorbency levels and ratings of different incontinence products either with or without quotes and see if you are able to get any valuable information.


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