Choosing The Right Diaper To Manage Bedwetting With Older Children And Teenagers
One point I have repeatedly emphasized 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.As I talk about below and have mentioned in other articles, most people use garments that are underwear like in appearance. I have decided to take a different approach with this article. I've decided to focus on diapers,specifically pin-on cloth diapers covered with plastic pants and disposable tape tab diapers. The reason for this is twofold. In my readings on this subject I've noticed that these styles of diapers are given short shrift by the public including parents of bed-wetters,pediatricians who write about bed-wetting,and other professionals. The second reason for focusing on these types of garments is that many people feel that these styles offer superior protection for heavy incontinence such as bed-wetting. I point out the advantages of these types of products later on in this article.As a case in point, one parent who had a youngster who wet the bed was a heavy wetter and went through several pull-ups per night. The father could not afford to spend the money on the amount of pull-ups required and switched to pin-on diapers covered with plastic pants. The majority of the public have always had a negative opinion of diapers and I believe it's high time we take a more pragmatic approach to this issue and use the type of protection that is most effective at keeping both the bed and the youngster(or adult) dry. If that means using diapers(which in many cases are the best option),then diapers should be used.
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 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. It's also important to remember the terms used for different types of incontinence. This helps you in choosing what type of product to buy. In the case of bed-wetting the clinical term for this form of incontinence is "nocturnal enuresis". I have also heard people refer to bed-wetting as just "enuresis." So if you're on a website that sells incontinence products and it says that a particular product is suitable for "nocturnal enuresis" or "enuresis" you'll know that the product is suitable for bed-wetting.
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 incontinentsupport.org 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. The web address for incontinent support is www.incontinentsupport.org.
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 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,and 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. As far as obtaining opinions about bed-wetting products from customer service reps, although there is the potential for bias in this area and people should exercise a certain degree of caution when evaluating the information presented to them(as is the case in any other transaction), the companies that I did gather this information from have been around for a number of years and are highly regarded by many people. In addition it would not be in the best interest of these companies to recommend products that didn't work. I suspect that in general,the people who operate mail order incontinence companies tend to have a high level of integrity(of course as with everything else in life there are exceptions to the rule) and want to instill these values in the staff who are responsible for providing information about what the best type of products to buy based on the customer's needs. Like any other sales person they have to responsive to the needs of their customers otherwise they'll soon be out of a job and if the company gets a reputation for recommending products that don't meet the consumer's needs they'll soon be out of business.
At this point I'd like to talk about some of the reasons that the disposable tape tab briefs tend to be more effective than products such as "Goodnites" and pull-ups 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. Finally,the owner of XP Medical in an email to me had the following to say regarding disposable tape on briefs versus pull-ups: "Tape tab briefs are almost always more absorbent than pull-ups,and therefore better for heavy incontinence. As you mentioned the reason for this is twofold: 1.)There is more padding because there is not so much elastic using up space in front and back. 2.) The tapes allow the product to be fixed more firmly so that they will stay in place even when wet. Pullups will fall down if too heavy."
He went on to say that some people may find it difficult to fasten the tapes on a tape on diaper such as a person who suffers from arthritis or Parkinson's disease. In a situation such as this it would be better to use garments such as pull-ups. That being said if your bed-wetter does not have any cognitive or physical impairments that would prevent or make it difficult for him or her to fasten the tapes on a tape tab style disposable brief,it would be advisable to have the child or teenager wear disposable tape tab briefs instead of pull-ups. As far as choosing a diaper with a cloth like outer cover versus one with a plastic outer cover he had this to say: "The Air-Plus diapers(a diaper with a cloth like outer cover made by Abena) have the advantage of being quieter and allowing some airflow through the material. On the other hand, many customers do not like them because the cloth like material 'grabs' on clothing and can allow odors to seep through." Although this happened with a particular brand of diaper, this problem can occur with other brands of diapers. One person mentioned that he found that the diapers with the cloth like outer cover tended to stick to the sheets when he moved around in bed and since he moved around a lot at night he preferred the disposable diapers with a plastic outer cover.
To get back to the advantages of disposable tape on briefs versus pull-ups,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 made by Abena ,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. Abena Abriform also has a model called the "Super" brief which is not as absorbent as the X-Plus model but is available in an extra small size for those youngsters who might not be able to fit into the X-Plus briefs. I'd also like to mention another brand of disposable brief. The company that manufactures these briefs is called "Provider's Choice Daytime Plus." They make two models of briefs. One model is the Provider's Choice Daytime Plus Premium Brief and the other model is the Active Ultra Plus Brief. I just found out about this brand and I thought I'd inform my readers about this brand as well. Apparently they're new so I don't know how effective they are. The website mentions that the Active Ultra diaper is designed for extended wear time and enables a person to sleep through the night without changing. The only problem is that they don't make a small size for these briefs. They make a medium and a large size. The medium size fits a waist size of 32-44 inches which may fit a larger child or teenager. The Daytime Plus Premium Briefs on the other hand are available in smaller sizes. The small size of the Daytime Plus Premium briefs fits waists of 20-31 inches. The customer service representative I spoke with said that although they're not as absorbent as the Active Ultra briefs she said that people have used them for overnight use. To quote the website- "The super-absorbent core system insures extended or overnight periods of dryness." The company has samples of the Active Ultra Plus Brief but not the Daytime Plus Premium Briefs. As mentioned the company that makes these briefs is called Provider's Choice Daytime Plus. Their web address is www.providerschoicemed.com and their toll free number is (888)287-1052. Although they don't sell directly to the public they have free samples but at this time they just have samples of the Active Ultra Plus Brief. Although currently they don't make the Active Ultra Plus brief in a small size I was told that they might make a small size in the future.
Other brands of disposable briefs include the Wings brand by Kendall, Prevail by First Quality, White
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