We've completed our writeup of our Pampers Dry Max skin irritant testing and published a final report you can read online, download, print out, or share with others. We'll summarize a bit here, but the full ten-page report is useful for anyone who has cared about this issue, for anyone who cares about others who have been affected by it, and for anyone who thinks this whole issue is a media or corporate conspiracy. Read our study for yourself and see what you think.

• Measurement of Relative Skin Irritation of Pampers Dry Max Disposable Diapers

From the report:

We believe the most significant finding of our study is its demonstration that, when compared with a leading competitor or its own previous formulation, Pampers with Dry Max are more likely to cause extended irritation persisting long after the diaper is changed. Examining the behavior of this rash when the skin is repeatedly re-covered with another diaper which is then soiled or wetted on top of the persistent rash, was beyond the scope of this study; but it does not feel excessively speculative to posit that a rash so treated would be more likely to deteriorate further than skin that showed no signs of being compromised.

A more troubling finding, and a highly illuminating one, is that beyond this overall difference in performance, Dry Max Pampers from two different "batches" were associated with different levels of both initial and extended irritation. These differences were documented both by a blinded "scent test" and by their tracking codes. The batch linked to all cases of extended irritation, and which triggered the sole reaction to a urine-containing diaper in this study, was the batch that had been acquired from a consumer whose own child had suffered from severe diaper rash while wearing diapers from the same package.

Of all the people with whom we will ultimately come knocking to share our findings directly, we are most interested in sharing it with Procter & Gamble. We're interested in an ongoing dialogue with them and will be offering them the chance to follow up on our findings with some specific information that might shed further light on our testing and on their Dry Max diapers.

Read the study here, judge our methods and our analysis for yourself, and pass it on.

Thanks to all of those who sent or offered to send diapers for us to test, for those who read and commented on our draft versions of this study, and most of all to the readers who contributed financially to make this study happen.

Note: We're leaving comments off on this post because this report involved not only a lot of work but some personal sacrifice, and we'd like it to allow it to stand alone on our pages for consumers to access and come to their own conclusions about. That said, if you feel this report is meaningful or scurrilous, we encourage you to discuss, excerpt, reprint, distribute, analyze, and praise or pan on your own blog, with the lovers and haters on Babycenter, or anywhere else you see fit. If you talk about it on a blog, rest assured that we do read what other bloggers say about what we do, and we're sure your readers would enjoy the discussion as well. We are also always accessible to anyone upfront about their identity, and can be reached at editors (at) zrecs (dot) com with your questions, comments, and criticisms.

Don't know what this is about? Here's more ZRecs reporting on Pampers Dry Max than you can shake a stick at.

I can't stop staring at my right forearm. To be more precise, I can't stop staring at a very faint patch on my forearm, smaller than a silver dollar and way less defined. I have squinted at it, looked away and back again, wondering if that patch of faint pink irritation is really there. I wonder, because its implications could be big.

Sunday was D-Day for our Pampers Dry Max skin reaction test here at ZRecs HQ, and let me tell you, it was an interesting day. Twenty-four hours later, we've been making plans for a second round of testing to attempt to cast greater light on a highly suggestive finding from our eight hours of patch testing. But to explain the results of our testing so far - and why we find them so intriguing - you'll need some details about what we did.

Consumers voted with nearly $300 in donations to ZRecs to help us fund a comparative test of Pampers Dry Max diapers and their pre-redesign predecessors. Three hundred bucks may not seem like a lot, but in an age in which everything offered on the Internet is expected to be free, the fact that our readers - old and new - banded together to meet our project goal and fund our independent research into Dry Max diaper safety speaks volumes to us. It also doesn't surprise us, though - 100+ ZRecs readers searched for Target onesies and sent 14 in to the Center for Environmental Health last year (at their own expense) to provide actionable evidence of the excessive lead content of a "Green baby" Target onesie. (They have yet to be recalled, but Target issued a stop sale and pulled them from the shelves at the request of the Attorney General of the state of California.) Collective consumer action can be a powerful thing.

The idea

The basic idea behind our Dry Max testing is easy to sum up.

Testing a product's potential to irritate the skin is a matter for experts, which we are not. Adult skin differs from infant skin; extreme conditions are used to test materials, and findings must be interpreted using a lot of expertise and erudition.

But there is one thing we believe even amateurs should be able to prove, and that is whether, in a direct comparison between Pampers Dry Max and Pampers previous diapers, one of them will cause a stronger reaction, or a reaction in a shorter span of time, than the other. This single fact could make the difference between a parent's willingness to trust Dry Max diapers with their child, regardless of how the diapers compare with their competitors, and offers the opportunity to answer the question of whether or not the change in formulation may have had an overall negative impact in a quantifiable and concrete way.

Long story short, diaper dissections can only take you so far.

Sounds simple, doesn't it?

Preparations

We purchased packages of Pampers Cruisers with Dry Max and Huggies Snug & Dry diapers from our local Target. We arranged with one of several readers who had a stockpile of pre-Dry Max diapers to send us a package through UPS. We purchased two three-ounce bottles of Spectrum Labs "Quick Fix" synthetic urine at $35 apiece, and paid extra for fast shipping, all so I could avoid putting real urine, presumably my own, against my skin and wearing it around for a day. We worked on our patch design, cutting up diapers and trying out different sizes and shapes to see how they'd fit on my arms and, in our initial plan, my chest and back.

Then two things happened that slowed us down a bit.

First, another reader contacted us - this one a parent offering a package of Dry Max diapers. We had already bought some at the store, but what she was offering to send was a pack of diapers that was actually known to have caused a serious skin reaction in a child. We realized that if Dry Max diapers had been changed at all since their initial "stealth" rollout eighteen months ago, even slight adjustments refining the production process could have unintended consequences. What if parents' inconsistent results with Dry Max diapers wasn't, or wasn't only, based on variations in individual infants' sensitivity? What if some Dry Max diapers caused more rashes than others?

We asked the reader to send them in, despite the fact that this meant a week's delay in our testing. I work outside the home, and wearing dirty diapers to work is not an option. So we shifted our testing date from Memorial Day weekend to Sunday, June 6.

The other unexpected event which dramatically affected our testing protocol was the call back from Pampers that we'd been waiting weeks for. We interviewed Jodi Allen and grilled Lisa Sanchez, P&G Baby Care's director of R&D. Sanchez gave us a few pointers on creating patch samples and explained P&G's product testing regimen, but the most important thing she said was something we did not want to hear. According to Lisa Sanchez, we were unlikely to get any skin irritation without the use of BM, i.e. poop, in the diaper patches. We weren't sure she was right, but after much discussion we decided that we had better go the full Monty on this testing, or we'd always wonder.

We arranged with a local friend who has a five- month-old baby to save Sunday's first dirty diaper for us to collect. Since the supplier had direct experience with Dry Max rashes, her mother was very understanding of our project, and gamely supplied me with a Ziplocked package when I showed up at her house late Sunday morning. (This made the purchase of synthetic urine feel a bit spendy, but can you blame me? Really?)

The test

By 1 p.m., I had four roughly inch-wide horizontal strips of Pampers Cruisers wrapped around each forearm - two on each saturated with synthetic urine, and two more on each arm with smears of baby BM, which is way, way more fragrant than I remembered. On my upper arms, fashionably encircling my blogger biceps, were two dry diaper patches. The twelve samples represented the three conditions - dry, urine-soaked, and BM-containing - for four diaper types - pre-Dry Max Pampers, Dry Max purchased from a store, Dry Max sent by a consumer whose child had reacted to them, and Huggies.

The wide strips cut from the diapers were designed to absorb and hold liquid without their shape getting too distorted as I moved, and to reduce the amount of medical tape that came into contact with my skin; we settled on using my arms only to ensure we weren't introducing an additional variable (skin condition) into the study. We used stickers to mark patch groups, an especially important consideration for our two sources of Dry Max diapers.

Our five-year-old daughter Z helped label the patch samples.




I had tested the tape by itself and had no reaction to it. Now we were using it to close the two long sides of the diaper we'd cut to make our sample; tape held it banded to my arm without making much skin contact, but I used additional tape to seal the sides to my skin and minimize air circulation. Remember, we're doing comparative testing - we want to elicit as much of a reaction as we can, and compare them, rather than to independently measure levels of irritation caused by any individual product.

Z helped affix the synthetic urine-saturated patches and the dry patches to my skin. I would not let her help in any way with the BM - not that she wanted to.


I planned to wear the diapers on my arms until 9 p.m., for a solid eight hours of exposure. (Some comparable skin testing can go as long as a month, but I'm sure they use smaller patches.) After an hour had passed, I was starting to feel uncomfortable. My arms were itching, in part simply from the bands of medical tape running along the edges of each sample. Additionally, my arms had a reasonable objection to having the skin breathability drop to near zero.


By four hours in I was feeling cagey and irritable. I felt like I was wearing dirty casts on my arms but no one would let me scratch around in there with a stick. For some reason I had thought there would be no smell emanating from these diapers, but by a few hours in all I could smell was the diapers' baby powder scent mixed with BM, although I believe the smell for outsiders was faint.

By seven hours I was alternating between two mental states: mild agony and a Zenlike acquiesence to a life of diapered arms, my cartoonishly thick forearms like those of a tragically flawed DC superhero.

At about eight and a half hours (Jenni got tied up getting Zella to sleep, and I needed her to immediately photograph anything we found on my arms, so I had to wait) Jenni took one final set of photographs to document the arm position of each color-coded diaper sample, and I slowly peeled them off one by one.

Results

The skin under all four dry diaper samples showed no reaction, although these, which had been on my upper arms, were among the most maddening to wear. There was a slight rash under only one of the urine-soaked diapers; the other three all looked very clear. I gently washed my arms under water with mild soap and returned for more photographs.

There were rashes under all four of the BM diapers, mostly contained in the area where the BM had made direct contact with the skin. They were difficult to photograph well, especially since the testing concluded at night and we were shooting indoors. I have adjusted the brightness and contrast of these photos to show the areas the rashes occurred.




All four of these locations showed redness and irritation in a oval shape with varying levels of swelling. One had a very slight welty edge, which was raised slightly higher than the surrounding, basically irritation-free skin. In two others, the entirety of the BM oval had slightly raised skin. In one of the four, the irritation seemed to spread slightly from the BM area out into a slightly larger swath of skin. The difference was slight but noticeable, and made the spot stand out from the others. After diagramming the position of each of these reactions and describing them in writing, we used our camera to match up the positions of the different colored samples with the types of diapers that had manned each irritated position on my forearms.

I must stress that all four BM samples had irritation, and differences were not dramatic; Jenni and I were only able to identify slight variations and were hard-pressed to determine their significance. But close examination of these rashes, with all assessments made prior to matching them up with their originating diapers, revealed a surprising coincidence.

First, the only diaper patch that had caused irritation when soaked with urine and held against my skin for nine hours was the Dry Max diaper that had been sent in by a reader. The other Dry Max diaper showed no irritation, as did the Huggies diaper sample, as did the pre-Dry Max sample. Was it just chance that the consumer-provided Dry Max diaper performed differently than the one we had bought at the store?

We noticed too that the one rash that appeared to spread slightly from its point of BM origin was also the Dry Max sample sent in by a consumer. Again, the Dry Max diaper we had purchased ourselves did not appear to perform any better or worse than the Huggies diaper or the pre-Dry Max Pampers diaper. It was difficult to really assess whether we were seeing something significant; the slightly different rash pattern we saw could have just been a result of a slight variation in the way the BM was spread on the sample, although checking the sample yielded no such clues. Another coincidence?

We went to bed unsettled, unresolved but excited. It looked like we needed to design another test to suss out these results and see if they could be amplified. Longer test durations? Surely we could narrow down the samples? And would we (groan) have to deal with baby BM again?

The next morning, the rashes seemed to have disappeared. The previous day's testing was receding in my mind like an unpleasant dream, one I knew would be recurring in some form in the week ahead. But I was driving at lunch when I noticed something on my forearm.

It was faint, barely visible, so subtle that I wondered if I was imagining it. The slightest blush, combined with an increased roughness of the skin, seemed to persist in one spot, and just one; the rest of my arms had no sign whatsoever of any rashes from the day before. I could not stop looking at that spot all day, with puzzled self-doubt, like when you stare at a printed word and it decouples from its meaning and sounds and looks alien. The initial rashes had been hard enough to photograph; this thing was so faint it was unphotographable and, as I said, so faint as to make me doubt my senses.

As a test, I turned to my daughter, Z, at dinner on Monday. She knew about the project generally but had been privy to none of the details of which patches had been from which diapers, and hadn't been privy to any of our discussion of our findings; she had been asleep when we removed the patches, hadn't seen the photographs, and hadn't even discussed the testing with us. I held my two forearms side by side, their white underbellies turned to catch the light from the window at our table at the delicatessen. "Look at my arms," I said to her, without explanation, background, or any leading pointing or direction. "If you were going to pick out the spot on my two forearms that was more red than any other spot, what spot would you pick?"

She pointed to the spot I had been looking at all day.

"You see it too?" I asked.

She nodded. I explained to her that that was the spot where I'd put the poopy diaper that had been sent in by a reader of our blog.

Z beamed and hugged me. "You solved the problem!" she called out joyfully.

"No," I said, "I did not solve the problem. But we may be on to something."

Next steps

What we have seen so far needs to be seconded with another test, but we will not simply repeat the previous test. Instead, we are going to reduce the number of different diapers (which exactly we'll eliminate we haven't quite decided yet) and do them dry only, or dry and with water. We will use smaller patches so I can wear them throughout my regular activities, and I will wear them for several days. Fewer patches, greater adaptation to my regular schedule, longer periods, and timing so we can end testing during daylight hours and get the best photos possible of the results. We don't need any additional funding; we have plenty of diapers, and although we haven't tallied all our receipts and costs yet, I think we have a little funding to spare.

If there is a difference in skin irritation between the Dry Max diapers currently on shelves (or at least the package we bought locally) and the ones sent in by a reader, we should be able to amplify that difference by making some element of the overall condition more extreme. We're hopeful that dry diapers will cause irritation given enough time, and that we will be able to develop more pronounced results that can offer more dramatic comparisons that either lend further credence to what we've seen so far, or discredit these initial results.

We'll also do dry testing of the elastic leg cuffs and waistband of Dry Max diapers against my skin, and check out the pH of both pre- and post-Dry Max fluff pulp.

Whether we demonstrate that our initial findings are linked to a meaningful difference within batches of Dry Max diapers, or invalidates that theory by providing inconsistent or unreplicated results, remains to be seen.

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Jodi Allen is the Vice President for North America of Baby Care products under Procter & Gamble brands. Allen has served as the most public face of the company in addressing consumer concerns over Pampers' new formulation, a design change which has led to widespread consumer complaints of skin irritation and severe diaper rashes that now fuel a Facebook group nearly 11,000 members strong, near-daily reports in television, print and web news outlets, and multiple lawsuits seeking class-action status.

Pampers has relied on a range of voices, from R&D team member and "regular mom" Kerry Hailey to community manager and social media face "Tricia@Pampers," to tout the benefits of the Dry Max absorptive core, which uses less paper pulp and significantly more petroleum-based superabsorbent polymers. But when the BM hit the fan, the brand began relying heavily on statements from Jodi Allen as well as from P&G Baby Care external relations director Bryan McCleary.

We first contacted both Bryan McCleary and multiple colleagues of his several weeks ago, when we first began researching the Dry Max issue. So we were pleased to get a call back from McCleary late last week offering us a chance to speak with McCleary and with R&D director Lisa Sanchez - and, as it turned out, Jodi Allen herself.

We grilled Sanchez for details on Pampers adult skin testing protocols, because our Pampers Dry Max research proposal has now been fully funded by consumers - and, in a public gesture we aren't overlooking, significantly overfunded - and we are working hard to be ready to do the bulk of our testing this weekend.

We also collected official comments from Jodi Allen (we have done the same, in times of crisis, with SIGG CEO Steve Wasik and Carter's CEO Michael Casey), because interview opportunities like this offer a rare chance to get company heads on the record on details that have been swirling about (and swirl still). Getting CEOs "on the record" gives us a fix on the facts as the company sees them, which we can then research independently to confirm or refute.

Here's what we got from Jodi Allen. If you've read our previous reporting on the Pampers Dry Max story, you'll see some statements that surprise you - statement's we're working to corroborate as you read.

ZRecs: Tell us how you rolled out Pampers Dry Max. Our readers are very interested in understanding the transition.

Allen: By the fall of 2008, we began shipping Pampers Dry Max diapers [in packaging that did not promote a new absorbent core]. We did not ship both types of diapers within single packages - every package had either one or the other [i.e. the old or the new]. We converted one manufacturing line at a time until we had converted them all. By November 2009, we had fully converted our production. We have two U.S. plants, and a small percentage of Pampers are made in Mexico - those sourcing the West Coast.

ZRecs: Interesting. Have you found any patterns of complaints that might be tied to a particular distribution chain or factory?

Allen: We have mined the data in every way we can. Every single diaper we sell has an individual code we can track not only to a given facility but to ingredient lots, the crew on the line at the time the diaper was produced... There was nothing done for supply chain reasons. Some consumers indicate that we did this to save money. It was a major investment on our part! We planned it out so we could absorb the cost effectively without raising prices.

ZRecs: We heard complaints that Pampers were being sold in the "original packaging" with graphics or marketing copy indicating a mesh liner was present, but that Dry Max diapers inside did not have the liner.

Allen: We changed the packaging so that is not the case.

ZRecs: You removed references to a mesh liner?

Allen: Yes. But this idea of new product in old packaging, this is standard industry practice. It is a product improvement, and product improvements do not require labeling changes. We would never put features on a package that is not in the diapers - we have never had a feature advertised that is not in there.

ZRecs: So there were no diapers sold without the mesh liners in packaging that showed the mesh liner as a feature - even diapers that had had the mesh liner removed but did not have the Dry Max core?

Allen: Any [Cruisers] diaper with a mesh liner has the previous core. There is no interim design with the old core but no mesh liner. There is one change we made later in the development - the coloring of the core. The dye used is a very safe product, and passed all the safety tests. Dry Max is a great new invention, but the materials are the same materials we were already using. [Update: After questions from readers, we asked for and received clarification from Pampers on this point. Cruisers have had the mesh lining removed, but Swaddlers still contain it.]

ZRecs: I'm curious to hear your views on the role of Facebook and other social media channels in communicating with consumers. We've heard stories of people being banned from Pampers' Facebook "fan page" after complaining about the new diapers.

Allen: The only reason anyone has been banned from our page is for violating stated policy, and our policies are clear and public and consistent with Facebook recommendations. We believe social media is an important tool for us to engage with parents. Our Pampers.com site is robust and useful to interact with parents on. We have a great relationship with consumers there starting three years ago when we created the site to interact with them. ...

Interestingly, the [Facebook group "Bring Back the Old Pampers Cruisers and Swaddlers"] was created out of frustrations that we put new product in old packaging, and it had a very low membership. Then it shifted to the fact that the diapers leak. Then it moved to cost savings, accusing us of making the change to the diapers in order to save money. Then it moved to diaper rashes. Sometime in April the term "chemical burn" was introduced. That's when things started taking off.

ZRecs: We read that you initially joined the group and discussed the issues with them.

Allen: We want to talk to consumers. I thought the right thing to do was to engage. But they kicked me [out of the group]. Over time the membership grew and I felt we needed to re-engage, but I had been blocked from the group. So I created a second ID, very transparently, then joined again, and tried to join the discussion. [Allen was kicked out of the group again.] Honestly I wish we still could engage.

ZRecs: We received a written response to a question we posed to Pampers through one of the bloggers you brought in for your Dry Max tour, addressing the discrepancy between numbers of rashes we had seen reported. Pampers stated that the two per million figure was the number of complaints of rashes, while the one in five million figure was for "severe" rashes, and that you do track rash severity in your complaint reporting. Do I have that right?

Allen/McCleary: Yes.

ZRecs: Do you know how many consumer complaints the Consumer Product Safety Commission has received regarding Dry Max diapers? Do they share those numbers with you?

Allen: We do not have those numbers. When they call the CPSC, the CPSC gives them a special number they can call to follow up with us. I don't have the exact number of those calls, and we don't know if every consumer who calls the CPSC then calls us. But the number of calls we've received on that line has been less than 2,000.

Lisa Sanchez, R&D (also in on this call): The level of complaints has not been unusual. We have a baseline level of complaints that occurs with any product change. When we changed from non-Sesame Street to Sesame Street graphics, for example, leakage complaints went up. Based on over ten years doing this I can predict how the change in any feature of our product will affect the level of complaints. And the number of complaints we have received for Dry Max has been below my predictions.

Allen: Regardless of that, every consumer who calls us, we take their complaints very seriously and we follow up. Diaper rash in babies is a quite common occurrence. Disposable diapers significantly decrease the incidence of rashes. And 10% of all diaper rashes are quite serious.

We're all parents - the large majority of our team here are parents. If I thought there was one iota of a chance that our diapers were causing diaper rashes, we would be doing something about it. But I can tell you with 100% certainty that Dry Max diapers are not causing diaper rashes, and they certainly are not causing chemical burns.

ZRecs: Will you be adding Dry Max technology to Baby Dry diapers? To any other Pampers products? If so, when?

Allen: I don't feel comfortable making statements that would indicate our future plans, for reasons of competition. But I can say that different moms want different choices. Our Baby Dry product does not have Dry Max technology in them, and we want to make sure we offer choices to moms.

ZRecs: I guess the same would go for Luvs?

Allen: Again, I am not comfortable making statements regarding our future product plans.

Stay tuned for results from our DIY Pampers Dry Max tests, which we'll be starting Sunday to test samples of Pampers previous Cruisers diapers and the new Dry Max version on one lucky adult volunteer (me) to check for differences in skin reactivity. And yes, we will ultimately be commenting on the impact of social media on this issue, as promised! There is a bit more information we'd like to gather first. All we can say for the moment is that this story has not ceased to yield interesting avenues for exploration...

That's right, folks - we only need $100 more in donations to fund our proposal to subject yours truly (and anyone else I can convince) to repeated patch testing using Pampers Dry Max and previous Pampers diapers. Thanks to consumers like you, we now have our:

• Urine money: We've identified a brand of synthetic urine which "contains all the ingredients normally found in urine and is balanced for pH, specific gravity, creatinine, and several other urine characteristics," as well as satisfying the very important criteria of probably not smelling like urine!


• Dry Max diaper money: One small package should do it.

The other $100 we need to fund this project will cover bandages and medical tape to construct patches, a dermatologist co-pay to address any nasty rashes, and the cost of having a reader ship pre-Dry Max diapers to us to use as our control group. Our goal is not to replicate the kind of heinous rash parents are reporting from using Pampers Dry Max diapers; we aren't even sure that would be possible to replicate in adult skin testing (elbows and wrists, thank you very much). Our aim is to do comparative patch testing of pre- and post-Dry Max diapers under a variety of conditions - dry, wet, and wet with synthetic urine - to see if either of them cause a rash on an adult subject and, if so, if one of those rashes is worse than the other. If Dry Max diapers cause bigger, longer-lasting, or faster-acquired skin rashes, we think we'll have some significant user experience and a compelling story to contribute to the Dry Max debate.

But this project can only move forward if concerned consumers can chip in another $100. The $130 we've raised so far has come in five, ten, twenty, and twenty-five-dollar increments. If you're interested in seeing this proposal become a reality, click here to join us. The funds raised are used solely to cover our material expenses for this project, not to pay us for our time or efforts. That's on us. All donors will be provided access to a private newsletter sharing our ongoing progress on ZRecs Research projects, and we'll seek advice from the group as we develop new ones.

Now that we've discussed how and why Pampers brought Dry Max into the world and made an argument for three ways Pampers is understating the Dry Max problem, we're ready for the third installment of our four-part investigation into Pampers Dry Max. In this post we will address differences we see between Dry Max and the previously sold Pampers diapers, and how the reformulation might create potential hazards that could explain the widespread reports we are seeing online of unusually severe rashes associated with the use of Dry Max diapers.

Dry Max is different, unless that bothers you

Throughout the nearly month-long debate over the safety of Pampers' new "Dry Max" diaper design, Procter & Gamble has walked a tightrope between two contradictory claims.

The first of these ideas is that Dry Max is profoundly different than previous diapers, that its impact is significant and meaningful to consumers and that it represents a technological advance that makes Pampers stand out from its competition.

The second is that any criticism or questioning of Dry Max technology is either naive and misinformed, or vindictive and self-serving, because Dry Max is similar to previous diaper designs in every meaningful way.

As we have watched the drama unfold - first with mainstream media attention, then with government regulators and plaintiff's lawyers getting involved - Pampers has shifted from one to the other of these claims as it dealt with competing constituencies, placating mothers with "all we did was" while crowing to the press that they have invented the future of disposable diapering, then going into damage control mode and mixing up their messages even further.

This yin-and-yang approach to a product launch is remarkably flexible; given the position of perpetual cultural amnesia from which major newsmakers engage with transitory public stances of corporations, Pampers may, if forced, abandon one of these themes entirely for the purposes of self-preservation, and call the other a public misreading of their corporate message. For the moment, however, the company is maintaining that they have created a game-changer without breaking any of the old rules. Our task today is to take a closer look at these new diapers and, in the process, address that apparent paradox.

How (most) disposable diapers work

To examine the diapers with us, you'll need to become an armchair expert in disposable diapering, a ZRecs-acquired skill that will serve you well alongside your abstruse knowledge of bisphenol-A leaching levels, your ability to identify unlabeled plastics and their associated properties, and your familiarity with drop-side crib politics. Once we're all up to speed with our newly-acquired knowledge of disposable diaper engineering, we'll compare Pampers Dry Max to the company's previous design in a comparative diaper dissection, to see what clues we can find to identify what might be causing such serious reactions in babies.

A disposable diaper is like a miniature aquifer designed to channel and control the flow of human waste.

In the typical disposable diaper, a top layer of plastic, or "nonwoven fiber," is treated with a surfactant that helps draw liquids into the diaper and away from the skin, and this one-sided coating also makes it more difficult for those liquids to come back out. The chemical composition of this surfactant is not publicly shared. Materials Safety Data Sheets (MSDS) are available only to those buying the chemical (like Pampers).

A hydrophobic (water-resistant) material, typically polypropylene, is used around the leg cuffs and at the top of the diaper, to discourage liquid from exiting the diaper.

An "acquisition and distribution layer," or ADL, creates a path that shifts liquids from areas where the liquid is most likely to be deposited towards other areas of the diaper.

Wood pulp (cellulose, also called "fluff pulp"), typically from U.S. pine sources, is layered below the ADL as an "absorptive core" to store the liquid, with small pieces of sodium polyacrylate, a superabsorbent polymer, mixed into the pulp.

Since the introduction of SAPs in the 1980s, manufacturers have played with the ratios of these two absorptive materials, as each has its own benefits. The pulp, which actually absorbs liquids into the capillary spaces between the fibers, naturally distributes liquids throughout its mass, and can hold several times its weight in liquid. But the liquid also squeezes out of the capillaries when the cellulose is put under pressure (which a baby is constantly doing from one angle or another, whether sitting or lying down), which means liquid can be pushed back through the hydrophilic top layer or leak out the sides of the diaper.

To simplify the chemistry involved, SAPs like sodium polyacrylate are curled up in their dry state and have salts hanging onto them. When exposed to liquid, the salts dissolve, the sodium polyacrylate chain unfurls, and the hydrogen in water molecules takes the place of the salts, thus becoming "locked" to the SAP. Polyacrylates are "cross-linked" to create longer chains and help distribute wetness along their length.

Sodium polyacrylate can hold much more liquid in suspension than wood pulp can, forming a three-dimensional gel-like structure, but it isn't as "cooperative" as fluff pulp - it isn't able to shift liquids around to areas that are not yet saturated as easily as fluff pulp.

The diaper is finished with a backing layer (the outside of the diaper) made of polyethylene or another plastic.

Layers of the diaper are glued together with "hot melts," mixtures of resins and oils derived from wood and/or petroleum-based sources. These adhesive cocktails are applied to the plastics in a molten state, and their composition is also a closely guarded trade secret. Again, Materials Safety Data Sheets (MSDS) are available only to those purchasing the actual materials from chemical companies.

So there's your crash course. Now we can look at the diapers, and identify both what has changed and what hazards it might expose infants and toddlers to that could be behind these rashes. Ironically, many parents whose children have not had reactions to Pampers Dry Max diapers are also frustrated by them, based on how they function; this no doubt makes up a significant portion of the social media advocates clamoring for a return to the previous design. We'll address some of those criticisms along the way.

Dissecting the diapers

Pre-Dry Max diapers are a rare commodity these days; since Pampers began gradually substituting the old diapers for the new ones a year ago, we are now at a point in the transition when diapers appear on many store shelves both with and without the Dry Max seal and marketing information, but contain the same reformulated diapers. So when we learned that Alexis (one of yesterday's two Dry Max case studies) still had some of the old Pampers Cruisers on hand, we quickly asked her if she'd do a side-by-side dissection of the two versions of the diapers. Here's a breakdown of what has changed in both Swaddlers and Cruisers; you'll find these changed diapers both in boxes labeled as "Dry Max" and boxes that look like they should have the old version of the diapers in them.

Below are two versions of Pampers Cruisers, side by side. The lefthand diaper is a Pampers Cruiser with the mesh lining from about April 2009, size 4. Alexis has had it in a storage bin (along with outgrown baby clothes) since that time. On the right is a Pampers Cruiser, size 5, from a recently opened package. Many parents, including Alexis, have reported to us that these diapers are much stiffer than the previous ones, and (at least on the exterior) are rougher to the touch.


Here is what the two diapers look like when opened. Note the color difference between the two diapers.




The removal of the mesh liner, shown in the older diaper, above, is one of the biggest non-rash complaints parents have expressed about Dry Max diapers. The liner was designed to contain bowel movements, keeping them from leaking up the back of the diaper and controlling their spread throughout the diaper's interior. Note its absence below.


In the photo above you can see that the color in the interior of the Dry Max diaper is not from a dye on the skin-contact surface of the diaper, but is inside. Is the color present in both, but simply showing through better when there's less fluff pulp? Alexis cut open the two diapers to separate the inside layers and see what's going on in there.


With the image below, we arrive at the other key functional criticism parents have of Dry Max diapers: Pampers put total faith in its superabsorbent polymer for the back section of the diaper, and removed all fluff pulp. Hello, BMs up the back.


Here is the inside of the old design of the Pampers Cruiser, and here's where your new disposable diaper engineering knowledge starts really coming in handy:


From right to left (interior to exterior) we see the mesh liner, the acquisition and distribution layer, the fluff/SAP layer, and the backing. The hydrophilic layer might be classified as the mesh itself, or the outermost portion of the ADL.

With your newfound knowledge of disposable diaper engineering, you should now see that the above represents a significant departure from the layering you'll find in every diaper that competes with Pampers.


First, there is no acquisition and distribution layer at all. There is a top layer that brings the liquid in, and then a thin layer of fluff pulp that is itself affixed to a backing layer with a markedly different color.

The sodium polyacrylate SAP used in Pampers Dry Max diapers is actually adhered to the bottom layer of the diaper. "It was difficult to remove the pulp from the new version of the diapers," Alexis reports. "I was scraping it with my nails…but managed to remove most of it. These did not have the numerous layers like the mesh diaper did. Really had to pry these apart."

The main benefit to this is that it can then be distributed in a pattern and held in place, rather than mixed into the fluff pulp in a uniform distribution. Thus specific areas of the diaper can have more or less, in theory reducing the need for an acquisition and distribution layer to channel liquid to different areas of the diaper.

We believe the Dry Max absorptive core is made in one of two ways: Either an additional (and no doubt differently formulated) hot melt adhesive is used to affix smaller particles of sodium polyacrylate to the backing layer of the diaper, or the acrylic acid used in the production of sodium polyacrylate was itself affixed to the diaper, and then polymerized on the material itself. We'll explain a bit more about that in a minute, but suffice to say this is the area of the diaper that has changed the most and is the most likely possible cause of the "extreme rashes" parents are reporting after using Dry Max diapers.

Here's the amount of wood pulp found in each diaper.




As shown above, some of the beads of SAP can be separated from the fibers in the old version of the diaper. None can be separated from the Dry Max diaper, because they are not mixed in with the fluff pulp.

Possible sources of the problem

What follows is our shortlist of the changes that could potentially cause a child wearing a Dry Max diaper to have a significantly more serious and debilitating diaper rash than experienced with most diapers. Everything else in this post - the explanations of how diapers work, the teardowns - have been leading up to this, so feel free to reference the above as we discuss these potential hazards.

1. The missing mesh liner

Why did Pampers remove the mesh liner? The company's public explanations of the change dismiss the liner as "unnecessary," but surely it was put there for a reason. Was it really removed just to make the diaper thinner?

We'd like to propose an alternative possibility: The reliance on SAP and a small amount of fluff pulp without the use of an acquisition and distribution layer was incompatible with the layer of mesh; the hydrophilic top layer just didn't love water enough to successfully draw wetness away from the skin and/or far enough into the diaper, or the mesh layer interfered in some other way with the manner in which the liquid could best be distributed using a SAP-coated backing layer. Removing the mesh layer puts the baby's skin directly in contact with the top layer (treated, remember, with a surfactant), which could change the chemistry of the diaper-to-skin contact considerably from the old to the new diaper.

2. The hot melt adhesive

If the SAP is directly applied to the backing of the diaper, it seems likely that Pampers had to turn to an additional adhesive in order to attach the SAP to the backing layer; if the color is a guide, the design uses it quite liberally. Adhesives have long been a suspect ingredient contributing to diaper rashes, particularly because they are present in large quantities at the elastic leg cuffs of the diapers and this is a common area for diaper rash to spread from. We have no idea what the adhesive that Pampers has added actually is, but it could be derived from either wood or from petrochemicals, and is clearly a new substance in a diaper that has raised concerns with consumers for causing severe diaper rashes. There is also less fluff pulp to potentially shield the skin from whatever is on that bottom layer. Also, if the extent of the adhesive is indicated by the presence of the bluish color that is absent from the old Pampers diapers, this material is also present in the leg cuff areas of the diaper, further extending the potential area of exposure.

3. Fragrances

Pampers has stated in private emails to consumers that "small amounts" of "masking perfume" are "Added between the core and backsheet to mask the natural odors of diaper ingredients." Many parents (with or without infant rash issues) have complained about Dry Max diapers having a very strong chemical smell. If this odor comes from the sodium polyacrylate or the adhesive now used in the backing layer, it is possible that a larger amount of fragrances are used in an attempt to mask a stronger chemical smell. These fragrances might be irritating to the skin and lead to more severe rashes.

4. Acrylic acid

Sodium polyacrylate is made of acrylic acid that is polymerized using any of a number of other chemicals. Although Pampers officials have stated that they are using the same superabsorbent polymer they've used in the past (and admitted separately that sodium polyacrylate is indeed what they use) it is possible they are polymerizing the acrylic acid using a different chemical. Since polymerization of any substance is by definition incomplete, traces of the nonpolymerized substances remain in the material.

In addition to potential irritation from a new polymerization agent, if Pampers is polymerizing the acrylic acid on the backing layer itself rather than applying already produced sodium polyacrylate, the polymerization might result in differing levels of residual acrylic acid, or in acrylic acid being left in the material of the diaper, which could then mix with urine and create a more acidic environment in which diaper rash might be more severe. Sodium polyacrylate itself is classified as a non-toxic chemical, but acrylic acid is corrosive. Infant and toddler skin might have differing abilities to adjust to this higher level of acid.

5. Excessive dryness

Pampers have promoted Dry Max diapers as being "their driest ever," and discussions of diaper rash cite moisture against the skin as the leading cause of diaper rash. However, many parents who have reported severe diaper rashes with the use of Dry Max diapers (like Casey's story discussed yesterday) tried more frequent changes to see if it would solve the problem, and it failed. Could it be that the power of so much SAP being used in a diaper makes a baby's skin too dry? This might be consistent with the raw, cracked, and bleeding skin described by many Dry Max users.

We have other theories of possible hazards, but the five areas above are the ones we feel are most plausible, based on our research and understanding of the issue to date. Our point in presenting them is to show how simplistic statements like "we have not changed the superabsorbent polymer" or "we have not added any chemicals" are insultingly simplistic.

Conclusions

We believe that the most reasonable explanation for what is happening is that something in the design or materials used in Dry Max diapers are likely to be causing a dramatically increased severity of diaper rashes among users. We believe this because we believe mothers (and their doctors) can tell when a diaper rash is significantly worse than what a child has had previously, and believe that there are many cases in which linking causes and effects are far less complex than interested parties might like us to believe.

We base our opinion on our long-term reporting on how toxins introduced from multiple environmental sources can contribute to larger and longer-term health effects. We also suspect that in at least some cases individuals exhibiting allergic responses to products may be the "canaries in the coal mine" that alert us to underlying exposures that some of us do not exhibit symptoms of, but may be affected by nonetheless. We have no way of knowing if Pampers Dry Max is such a product or not, so have focused our reporting on what might be causing the symptoms described by parents using Pampers Dry Max - namely, more serious diaper rashes than they have seen with competing brands or, most tellingly, after switching from the previous version of Pampers to the Dry Max formulation.

We are not doctors, and our opinions should not be substituted for medical advice. That said, we believe that the best solution for any parent is to avoid Pampers Dry Max diapers - if not now, then when it's time to buy diapers again.

In our fourth and final installment of this series, we'll discuss the social media component of this story and its implications for the future of consumer activism and consumer research, as well as the future of disposable diapers.

Update: An update and safety note, and something we can only do with your help.

Miss a previous installment of this series? Read Part 1 and Part 2.

In our last post, we discussed the history of disposable diapering in the United States, and how Dry Max represents a new spin on a trend Pampers has been pushing for a quarter of a decade. But the heart of this issue, for us, is in defining the problem and advising parents based on what we see. So it's time we got to the heart of the matter. What is it that Pampers Dry Max diapers appear to be doing to some of the infants and toddlers who wear them that goes so far beyond "everyday" diaper rashes that parents speak out, form groups to help spread the word, and demand a product recall? Is it even possible that a company would invest millions of dollars in pushing an idea so far that it can cause significant harm?

We had planned to cover both that topic and our diaper teardown and analysis in a single post, but we get into a LOT of detail in our teardown and analysis, and we've also seen a lot of push back from Pampers in the media regarding whether or not potential problems with Dry Max are even a legitimate issue for discussion. (They are "insulted.") Because of this, we've decided to dedicate a full post to what appears to be happening to kids, and how Pampers is spinning it, before we publish our analysis of why all of this might be happening. Defending the existence of a problem in the same blog post as the level of analysis we are bringing to bear just wasn't working. So what was conceived as a three-part series will now be four, although I promise we'll have the third installment - the teardown and diaper analysis - up sometime Wednesday. [Update: Part 3 is now online.]

Three ways Pampers' assessments minimize the problem

Pampers' defense against claims that diaper rashes have become a bigger problem with the introduction of Dry Max rely on internal documentation collected by the company and now shared, presumably in full, with the Consumer Product Safety Commission for the government's investigation. There are, however, some significant problems with their defense.

1. Diapers versus consumers

Until about a week ago, Pampers claimed they had received two complaints for every million diapers sold. This figure was presented as a "normal" level of complaints.

A million diapers is a lot of diapers. But let's not confuse diapers with consumers. We encouraged Casey, a reader we'll introduce you to later in this post, to estimate how many Dry Max diapers she used before discontinuing them; she tallied up an estimate of 360 diapers, including the period when she did hourly changes to try to address the problem. Based on the report of Alexis, whose story we'll also share, we'd assume she used one full package before switching brands. 100, 150 diapers.

Here comes a little guesswork - it could be off by a little or a lot, but is used to make a point independent of the actual figures.

If Pampers began introducing Dry Max diapers into the disposable diaper stream about a year ago, and admits to having done it since last August, we might assume that that date was the point when they were selling Dry Max diapers almost exclusively. Let's also estimate that the average child (averaging newborns to toddlers) uses somewhere around 150 diapers a month. That means a parent whose child was not suffering from a debilitating diaper rash - the level that would cause them to discontinue use of the diaper and switch to another brand - would have bought an average of 150 diapers a month for nine months, or 1350 diapers, while a parent whose child did have such a reaction, and discontinued use, did it after purchasing somewhere between 100 (a reasonable average number of diapers in a single package) and 400 diapers.

See what we're driving at? The implication of a figure like "two complaints for every million diapers sold" is that the ratio of satisfaction to dissatisfaction is 1:500,000. But if you consider that during this period satisfied customers are likely to have purchased far more diapers than those whose children suffered significant harm - in our example, anywhere from 3.5 times to nearly 14 times as many - you get a very different picture of the impact. That's because the reported number of incidents is the same, but the total pool had been wildly exaggerated.

If you go to a restaurant 14 times and I go once, and I complain about the service, the restaurant manager could conclude that everything is fine because only one out of every fifteen meals served resulted in a service complaint. If this occurrence were scaled up, however, he'd be a fool to think that this record makes him a shoe-in for the local "Best Restaurant" poll.

(And don't forget [thanks, Sarah!] that treating complaints as an indicator of the extent of any product safety problem disregards anyone (everyone) whose child experienced an unusually serious rash but did not call to complain. How many consumers a single complainant represents is an open question in product safety circles, and varies depending on the circumstances, but the answer is certainly not "one." Through research, surveying, and mathematical modeling, companies that wish to know such things are able to develop reasonable estimates.)

2. Inconsistent numbers

Two weeks ago, Pampers was stating they had had "no increase" in complaints of rashes than with their previous designs, and cited a rate of two complaints for every million diapers sold as proof. Here is one of several references made to that figure:

The Consumer Product Safety Commission said last week it is probing reports about babies and toddlers suffering severe diaper rashes and blisters from the new, thinner diapers. P&G responded that the claims were "completely false" and that it has received fewer than two complaints about rashes for every million Pampers sold. [Link]

Jodi Allen, president of Pampers' North American division, who has been making the rounds and engaging consumers directly on the question of Dry Max rashes, repeated this figure in an interview with Advertising Age:

At any given time, 250,000 U.S. babies have diaper rash, Ms. Allen said. But P&G has gotten only two reports for every million among the 2 billion Dry Max diapers it’s sold so far. While it’s not dispatching teams to every home that reports a rash, P&G is doing extensive follow-up calls when it gets complaints and inviting some parents to visit a pediatrician on the company’s dime to explore the problems. [Link]

A few days ago, however, spokesperson Bryan McCleary began using a different figure. We noticed it first in an article published by the French wire service AFP:

"Two billion Drymax have been sold," said McCleary. "America has voted with their purchases.

"We saw a big increase in sales, a big increase in consumer acceptance... they will be appearing in other Pampers markets soon."

He said complaints about the diapers were not above normal levels of one per five million sold. [Link]

McCleary repeats it again in an interview with Business Week:

P&G spokesman Bryan McCleary said in an interview that the company has found no evidence that the diapers cause rashes or burns and that P&G has received one rash complaint for every 5 million Dry Max diapers sold -- about 400 complaints so far. [Link]

Those figures differ by a factor of ten, folks. In other words, for every ten complaints Pampers admitted to in articles published on May 10 and May 13, they are now admitting to one. Meanwhile, the estimate of Dry Max diapers sold (two billion) has not been altered.

So... what happened between May 13 and May 15 that could possibly cause a company to scale back its own internal estimates of harm by a factor of ten, never publicly correcting or referring to the discrepancy and pushing forward with their new numbers as though nothing had changed?

Oh yeah.

3. Numbers versus severity

Inconsistent statistics and misleading expressions of them are certainly frustrating, but even they are not the biggest problem with Pampers' public analysis of what is happening in homes that use Pampers Dry Max. The elephant in the room is the reason why the parents who are angry with Pampers are as angry as they are, and it is probably a contributing factor in why, if a product engineering problem existed, it might not be fixed in the product testing phase. It is also something so blindingly obvious it is very strange to us that no major news organization has yet made mention of it.

Pampers has publicly relied exclusively on the number of diaper rashes that are occurring, without considering their severity. They have stated that they have not received complaints or calls at a more frequent rate than with the old diapers. Even if we are willing to suspend our disbelief and accept these numbers (see #2, above), it does not follow that a similar number of diaper rashes, of much greater severity, would not represent a product defect, a problem that needs to be addressed, or a significant hardship for infants and their families.

We suspect that Pampers does not even collect information regarding the severity of diaper rashes, as doing so would be a complex undertaking and create potential product liability issues. If this is true, it means that Pampers has no data regarding how severe diaper rashes from Dry Max diapers are compared with their old diapers or with competing brands, and they have given no indication that they believe such knowledge would be beneficial or would affect their belief in their product's quality. Which is ridiculous.

Two tales of Dry Max rashes

As in the case with Carter's tagless clothing, it looks to us like we're dealing here with an irritant that causes contact dermatitis in some but not others; that the non-universality of effect causes some reasonable people with good intentions to question its reality; and that the "diaper rash" it produces is likely to be so severe that it is the worst the child has ever experienced and, in many cases, the worst the parent has ever seen.

To illustrate what appears to be happening, we'd like to share two stories with you. Like so many consumer accounts of unusual diaper rashes experienced with Pampers Dry Max, in both of these cases parents were using reformulated products that were not labeled as having been changed - and, in fact, were sold in packaging still advertising product features (such as a mesh liner) that were no longer present.

ZRecs reader Alexis and her then sixteen-month-old daughter had their first encounter with Pampers Dry Max over a year ago, in March 2009. Here is Alexis' story:

[My daughter's daycare] called my husband on a Friday saying that she had broken out in a horrible diaper rash and that we should come and get her from school. She had an awful red, bumpy, rough diaper area and swollen redness from her belly button to the small of her back. Part of the rash was a really bad yeast rash but the other part looked how your skin looks after you skin your knee. It was very painful and she screamed every time I used a wipe or even a cloth diaper rinsed with warm water on her bottom.

The pediatrician's office was closed but we called the on-call doctor who said it sounded like an allergic reaction. I was confused because she had not eaten anything different, no new lotions or creams, nothing. And she had no rash in the morning when I changed her.

We had just opened a new box of diapers and brought them to the daycare that morning. They were the same brand of diapers we'd been using since day 1 - Pampers. Upon closer inspection I found that the mesh liner that we had come to love with Pampers (and is why we paid so much money for the darn things) had been removed. Also, the new diapers were as stiff as a board and she leaked out of every single one out of the box, before we had realized this is what caused the reaction.

Alexis' daughter recovered fairly quickly; they went to their pediatrician, who prescribed multiple oatmeal baths, Benadryl, and three different topical creams. But it seemed clear to Alexis, and seems reasonably clear to us, that her daughter had a sensitivity to the new diaper that she did not have to the old version. In our view, even parents whose kids haven't reacted to Pampers Dry Max should be able to accept that.

But compared with many consumer stories about these diapers, Alexis and her daughter were pretty lucky. After reading our initial warning about Pampers Dry Max, reader Casey wrote in. We have read and received many accounts which share many of the characteristics of Casey's, but hers offers a couple of insights you won't see in some: A frank admission of how difficult it can be to identify a problem when you are using a product you have learned to trust; and how guilty a parent can feel after realizing that their child's suffering could have been avoided "if only" they had put the pieces together sooner.

We have been Pampers users since Kael, my 4.5 year old, was born. Even when we used cloth during the day, we used Pampers at night. I say this, because when we were doing what we thought was "trying everything" to get rid of the rash, we did not switch diapers for a very long time. I assumed Pampers were the diapers, and because of our previous experiences with them, I never once assumed it could be the diapers that were causing the problems.

Somewhere around November 2009, Asa, my younger son (now almost 3), started developing a diaper rash. It's not unusual for him to get an occasional rash. He has sensitive skin, and so we were prepared. We tried all our usual tricks. We used Butt Paste, Aquaphor, Vasaline, Desitin, A&D. We started changing him hourly all day long. For a 2.5 year old, this is a big waste of diapers, but it was worth it to get rid of the rash that no paste could cure.

After using the different types of diaper creams for weeks, I decided it wasn't working. Because he had been sensitive to dairy when he was younger, I decided to work on dietary issues. I limited his fruit intake thinking that maybe his poop was too acidic or sugary. (I know it makes almost no sense now.) I eliminated milk, cheese, and yogurt from his diet. I did this in early December. I remember because it was the holiday season and crazy to try to control what he was eating with all our get-togethers.

In December, we went to my parents' house for Christmas and spent 10 days with them. At some point in early December, the rash started moving down the backs of his legs. During the time we were there, my mom was really appalled by Asa's rash. This was when I decided to start doing very frequent changes.

Also, looking back on Facebook, I found the post from my friend that first caused me to suspect the diapers would be the issue. It was posted January 31.

On January 31, I was reading my Facebook updates and a friend of mine made an offhand comment about how Pampers had a new diaper that was causing rashes.

Apparently pampers has reformulated their diapers to be 20% less material and still as absorbent, but they put them in the old boxes without notice and these new materials can cause serious diaper rashes to babies. hmm, glad I use huggies ;-)

We were really surprised, because none of the boxes of diapers had indicated anything new or different with the diapers. We switched immediately. We noticed a small improvement in the rash. Instead of red, raised, and cracking, it was no longer cracking open.

At this point, I made our first doctor's appointment. We went in, explained our situation to the doctor. He glanced at the rash, said it didn't look like any sort of typical diaper rash but assumed it was a yeast/fungus rash. He recommended an over-the-counter antifungal. We used it for a week with no results. Then I contacted a friend of mine who is a nurse practitioner that specializes in dermatological issues. She recommended that we try some hydrocortizone cream on a small spot. She said that if it was inflamed that would help it. It did. We used it for quite some time, but every time we stopped using it, the rash returned. We finally made an appointment with our family doctor. She diagnosed it as a type of contact dermatitis. She prescribed a stronger steroid and a compounded diaper cream made only at our pharmacy. Finally, after using those for about a month, we are to the point that Asa only has one small red spot on his leg.

I do have to say that looking back I cannot believe how long it took us to put things together. This has been a very long, drawn out issue for us. :(

Think a diaper rash is a diaper rash is a diaper rash? Tell that to Casey.

Tomorrow: Dissection and analysis (we swear)

That's it for today. For those who have been waiting patiently for us to tell you what we think might be wrong with Dry Max diapers, you don't need to be patient for much longer. We'll publish our diaper dissection and analysis of possible causes of rashes by tomorrow at noon. Thanks for reading, and please feel free to comment below with your thoughts. [Update: Here it is!]

Move on to Part 3 of this series, in which we dissect pre- and post-Dry Max diapers and discuss potential sources of irritation. Or jump back to Part 1, in which we discuss the history of disposable diapering and Pampers' role in it.

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