title: The challenges and realties of diaper area cleansing for parents.
abstract: OBJECTIVE
  To explore the complexities of diaper area cleansing reported by women participating in a randomized controlled trial designed to compare optimally formulated baby wipes (Johnson's Baby Skincare fragrance free wipe) with cotton wool and water.
  
  
  METHODS
  A mixed-method design incorporating quantitative and qualitative methods to explore maternal views and experiences of using baby wipes or cotton wool and water to cleanse their newborn's diaper area over an 8-week period.
  
  
  METHODS
  Participants were recruited from a large regional maternity hospital in Northern England.
  
  
  METHODS
  Participants included 280 women and their healthy term newborns; 252 provided 4-week data (90.0%) and 237 provided 8-week data (85.0%).
  
  
  METHODS
  Data from diaries and structured face-to-face interviews at 4 weeks and telephone interviews at 8 weeks were transcribed and thematically analyzed to identify themes. Quantitative data were compared between randomized groups using descriptive statistics and two-group tests, where appropriate.
  
  
  RESULTS
  Major themes identified highlighted the practical realities of diaper area cleansing, diaper area cleansing and everyday life, and living with the rhetoric that water is best. Baby wipes were perceived as more convenient efficient at cleansing. Some women using cotton wool and water did not cleanse skin after urination alone. Diaper changing was significantly more frequent in the baby wipes group at 4 weeks, but there was no significant difference between the groups at 8 weeks.
  
  
  CONCLUSIONS
  Women are faced with a complex environment regarding diaper area cleansing and need clear evidence-based advice and guidance on effective diaper area cleansing.
authors: School of Nursing Midwifery and Social Work, University of Manchester, Manchester, UK. christine.furber@manchester.ac.uk
authors: Christine
authors: C
authors: Furber
authors: Carol
authors: C
authors: Bedwell
authors: Malcolm
authors: M
authors: Campbell
authors: Michael
authors: M
authors: Cork
authors: Charlotte
authors: C
authors: Jones
authors: Lois
authors: L
authors: Rowland
authors: Tina
authors: T
authors: Lavender
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003902:Detergents; D003963:Diaper Rash / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006771:Hospitals, Maternity; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D009034:Mother-Child Relations; D010290:Parents; D018570:Risk Assessment; D017592:Skin Care / Q000379:methods*; D018709:Statistics, Nonparametric; D006113:United Kingdom; D014867:Water; D055815:Young Adult
chemical_list: D003902:Detergents; D014867:Water