A NUMBER of investigators have reported that fabrics can contain numerous residual bacteria after home laundering.4 One might expect this contamination to be appreciable in the case of diapers since the level of bacteria in human feces is 25% to 30% by dry weight.5 It is generally believed that the elimination of this contamination is beneficial in the management of diaper dermatitis.Since Koch first reported the germicidal activity of hypochlorites in 1881, chlorinereleasing compounds have been used extensively as disinfectants. At the present time, hypochlorite solutions are widely used in home laundering for bleaching fabrics such as diapers. Some physicians, however, have the impression that bleaching of diapers is contraindicated, feeling that bleached diapers are irritating to the skin of infants.6 To our knowledge, a controlled study to determine the effect of bleaching on the bacterial contamination of home-laundered diapers or on the infant's skin has not appeared in the literature. In view of the germicidal activity of sodium hypochlorite and the wide¬ spread use of this material as a household laundry bleach, the authors undertook the present study.
MethodsExperimental Design.-A group of 129 moth¬ ers with infants less than 10 months old was obtained. On a randomly selected basis, 68 of the mothers were given liquid hypochlorite bleach (Clorox, 5.25% sodium hypochlorite) and 61 were given a placebo bleach product (water colored with a yellow dye to match the color of the liquid hypochlorite bleach). Both products were packaged in paint bottles labeled with the same typical bleaching instructions.The mothers were instructed to use the as¬ signed bleach product each time they laun¬ dered diapers during the next four weeks. At the end of the fourth week the products pro¬ vided for bleaching were "crossed-over;" that is, the mothers who had been using the liquid hy¬ pochlorite bleach during weeks one through four were given the placebo bleach product to use during weeks five through eight and vice versa.To preclude the use of antibacterial products other than the test bleach, the mothers were supplied with a nonantibacterial laundry deter¬ gent, a nonantibacterial toilet soap, and a nonantibacterial baby powder. The laundry de¬ tergent was packaged in a plain box without brand identification; the toilet bar and baby powder were packaged in their usual market packages. The mothers were instructed to use these products exclusively during the eightweek test period. The use of skin creams, di¬ aper pail additives, fabric softeners, etc, was not permitted.At the start of the test, each mother was giv¬ en three dozen new diapers and instructed to use them exclusively during the first four weeks of the test. When the bleach products were "crossed-over" at the end of the fourth week, the original diapers were picked up and a new supply of diapers provided.A difference in odor between the hypochlor¬ ite bleach and the placebo bleach product could not be eliminated. Some women may have rec¬ ognized this; however, ca...
