Modern Diapers and Kidney Infections in Uncircumcised Babies

During the first year of life, an uncircumcised boy is 10 times as likely to develop a kidney infection as is a circumcised infant. These serious infections are caused by fecal bacteria binding to the moist undersurface of the foreskin and moving up the urinary tract. The predominance of kidney infections in uncircumcised infants was first described in the 1980's coincident with an increasing move from cloth, to paper-lined to super-absorbent polymer diapers. Leakage of loose stools, common with cloth and paper-lined diapers, is prevented by the new polymer diapers.

Superior fluid absorption means that the diapers remain dry longer, necessitating less frequent diaper changes. Infective fecal bacteria are thus kept closely in contact with the foreskin for a longer period, increasing the chance of infection. Kidney infections in uncircumcised infants below the age of 1 year can result in kidney scarring and abnormal kidney and hormonal function. Further, the infection can spread to the bloodstream and have fatal consequences, particularly in babies below the age of 2 months.

The health risk of efficient absorption of body fluids was pointed out over 20 years ago, following an outbreak of "toxic shock syndrome", a severe often fatal infection. It was noted that this disease followed the introduction of super-absorbent vaginal tampons, which promoted longer retention of the tampon in the vagina. Pathological bacteria were given more time to grow and produce dangerous toxins, resulting in shock, and death in some cases. The super-absorbent tampons were recalled from the market.

There is evidence that the risk of kidney infections in uncircumcised infants is increasing. In the 1980's it was found that about 1% of uncircumcised infants developed kidney infection. Recent studies from California and Sweden indicate that this has risen to 2% of uncircumcised infants. Can this disturbing trend be tied to the increasing use of super-absorbent polymer diapers? Answering this question may prove to be difficult, given the continued efforts of the multibillion-dollar disposable diaper industry to develop increasingly absorbent diapers (New Yorker magazine, November 26, 2001) and the current absence of relevant research studies on this issue.