Fewer nappies, fewer problems?

Raoul Furlano, how did you first become aware of the topic of babywearing?

It actually came about through a mother who came to see me during my surgery. During the examination, I noticed that her six-month-old baby wasn’t wearing a nappy. The mother explained to me that she practised «nappy-free parenting». I must admit: at the time, I knew very little about the subject. That surprised me, because as a gastroenterologist I have been dealing with digestion, excretion and continence for many years. That encounter sparked my curiosity and led me to look into the subject in greater depth.

What have you noticed in your work today?

My team and I treat children with congenital malformations as well as chronic and autoimmune diseases. At the same time, we see a surprisingly large number of children with chronic bowel disorders for which we cannot identify any organic cause. These include, for example, constipation or soiling. These functional disorders are increasingly occupying our attention in our day-to-day clinical practice. That is why I am interested in anything that could contribute to a better understanding or even to prevention.

«We see many children with chronic bowel disorders for which we cannot identify any organic cause.»

What exactly is meant by «holding back»?

When practising nappy-free care, carers pay attention to their baby’s cues and give them the opportunity to pass waste without a nappy. This is done, for example, over a potty, a washbasin or a toilet. In many parts of the world, this is nothing out of the ordinary. In Western industrialised countries, however, disposable nappies have been the norm for decades.

Why do you consider this topic to be of medical interest?

I am interested in the question of whether early experiences with excretion might have an impact on children’s development. Today, children often wear nappies for much longer than they did just a few generations ago. At the same time, we see many children with functional excretory disorders. We do not yet know whether there are any links here. However, I believe it is important to take this question seriously and investigate it scientifically.

In the film, you also touch upon the environmental aspect. Why?

Because disposable nappies generate enormous amounts of waste. At the same time, many emerging economies are adopting the consumption habits of industrialised nations. This raises not only a medical question but also an environmental one: are there any alternatives that could be beneficial for both children and the environment?

«I can well imagine that there are links between bowel problems and the way we handle nappies.»

You would like to carry out academic research into this topic in future. What do you have in mind?

I would be interested to know whether any differences emerge when children grow up with different nappy-changing practices from birth. One possibility would be a long-term study involving two groups: one group using conventional disposable nappies and another group who are potty-trained from the outset. This would allow us to investigate whether differences arise in terms of colic, constipation, soiling or the timing of toilet training. I can well imagine that there are correlations here. That is precisely why we should investigate them scientifically. However, this is still just a research idea, and the necessary funding must first be secured before it can be carried out.

That sounds like quite a labour-intensive project. What motivates you to pursue this idea?

We still know surprisingly little about this topic. That is precisely why it is worth remaining curious and questioning our existing habits. If, as a result, we gain a better understanding of how to prevent bowel disorders whilst at the same time conserving resources, we will have done something good for children, families and society.