Tuesday, September 07, 2010

The Pampers Dry Max Diaper Debacle Debunked: A Social Media Mess

Pampers Dry Max got an official pardon last week. The US Consumer Product Safety Commission announced it hasn't found any evidence the diapers caused chemical burns or an inordinate amount of diaper rashes. The Dry Max, the new and supposedly improved Cruisers, the most-tested diaper to ever hit tiny bottoms, one touted as thinner and more absorbent, with over 3 billion in circulation, stirred up the baby aisles in a big way this past spring months after a group of mothers started a Facebook page calling for Pampers to bring back the old Cruisers.

See my previous posts for my trip to Pampers and my take on the rash evidence, including the sensitive skin issue

The Pamper's pardon should come as a relief for parents worrying whether their diapering decisions set their children up for severe harm. Is there something about the Dry Max that promotes intense reactions? Is it dangerous? Are toxic gels somehow leaking into contact with my newborn's skin? Is it too absorbent? Too drying? How could I have done this to my baby? You can stop the second-guessing. As can the peeps over at Pampers and their parent conglomerate, Proctor and Gamble.

But for the rest of us, it's not welcome news, far from it. After investigating the Pampers evidence and Facebook events early this summer, I'd been worried it would come to this.

It means we need to consider how a small number of parents, not a health or medical professional in the lot, ignited a not insignificant health scare via the internet that generated over 11,000 Facebook fans, federal investigations in both the US and Canada, several lawsuits, and I'd argue, the further erosion of the relationship between parents and the parenting industry. We need to take a good hard look at how the social-media driven brouhaha happened and how it came to be that a few moms ignited a Facebook fury.

It pains me to declare this Dry Max to-do a social media mess. I don't like to have to challenge women acting in the supposed interest of their young children, moms who shared awful stories about babies and toddlers in pain. After my trip to Pampers, I exchanged several emails with Lisa Stone, one of the founders and 3 officers of the Pampers Bring Back the Old Cruisers Facebook page. She was nothing but friendly and eager to answer my repeated and pointed questions. Her genuine conviction and outrage came across in the exchanges. So it feels aggressive to question her actions and motives and those of the other moms. Moms who believed a company had harmed their children. Who can blame them? If I thought my baby had been injured as a result of corporate negligence, I'd be furious too.

But there were clues early on that the Facebook fuss wasn't just about diaper rashes, or for that matter, the new diaper as much as the old, beloved one. The women didn't name the group "Dry Max Causes Diaper Rash" or "Recall Dry Max". When I asked Lisa Stone about this, she confirmed that initially they were upset with a number of issues, including how Pampers had treated their complaints about the new diaper, both via telephone and online. Complaints ranging from leaks and fit to rashes (and that Pampers reported were significantly below what they'd expected). Rashes certainly were not the group's tantamount complaint, not in the first months. In fact, the women were particularly displeased by how Pampers sent out the new diapers in the old Cruisers boxes without alerting consumers of the change.

Check out the welcome on the group's home page:
Parents! Are you confused with the switch in cruisers? Are you having problems with the new Cruisers/Swaddlers? I have just created a fan page on facebook called "Pampers bring back the OLD CRUISERS". I got kind of fed up of seeing my posts lost amidst the "fun stuff on the Pampers fan page so it got me thinking...why not start our own fan page to bring back the old cruisers. Let's try and get as much support as we can. So Tell all your friends. It could serve to unite us in getting P & G to start taking us seriously. Please leave messages daily so that we can make a difference.
No mention of rashes let alone burns or toxic diapers. 

I wanted to publish some of Ms. Stone's comments back in early summer, but didn't feel quite right when I didn't have any data to discuss, except for the 11,000 plus fans and voluminous posts detailing red blisters, open wounds, screaming babies, etc . But I couldn't go through the thousands of pages and posts to track the debate back to the first days of the group's existence. So I relied on Ms. Stone for information about the history of the posts and to provide some text from targeted discussions (e.g., the first use of the term "chemical burn"). When I inquired about professional documentation of burns or parents with medical training whose children developed the severe rashes or burns, she emailed portions of the online discussions. I tried following up with some of these contacts, none of them doctors, one a nurse, another appeared to have some paramedic experience.

By the end of May, the red flags flying amidst a surging social media storm, certainly we could expect parenting professionals, especially the health experts, to weigh in on the possibility of a diaper creating severe diaper rashes, chemical burns even?

Ah, no. Not at all.

Not much from The Parenting Industry, those folks who toil to inform parents, educate parents, advise parents. Where were they?

They were virtually silent on the mounting Facebook-facilitated virtual fisticuffs. Of course the controversy reached parenting websites and message boards, but the coverage was brief, limited to the basic story, especially upon news of the lawsuits. Sure a couple other industries were interested, mildly. Business outlets discussed the financial aspects and the lawsuits, the Wall Street Journal, Bloomberg to name a few. Several PR sites weighed in, mainly to critique Pamper's response, especially the use of mommy bloggers. Friends and readers saw the story on the televised nightly news and morning shows, but again, only perfunctory reporting.

The American Academy of Pediatrics? Nothing. Silence. A spokesperson informed me they don't make statements about particular products unless a recall is issued.

WebMD? Ari Brown, a pediatrician posted a brief piece on the Dry Max on his blog at the site. He personally saw only one case of "contact dermatitis", that is diaper rash, on a Dry Max-wearing baby.  He cautioned that bad rashes happen, especially to babies with sensitive skin.  His tone suggested he dismissed the Dry Max claims. But he didn't really question the possibility of a diaper causing extreme rashes let alone chemical burns.  Didn't really dispell the claim altogether.  If only more doctors would have spoken up. 

What about other pediatricians? Most of my pediatrician contacts hadn't really heard or known much about it. As my one pediatrician friends remarked, she wouldn't know about it until the journal article came across her desk. But an academic study on the Dry Max would not appear this time - though I suspect some researchers are now writing up grant proposals to study the Dry Max as a social media phenomenon and/or marketing/PR dilemna.  So I guess I can't entirely blame these individual physicians for not speaking out, that is, if they hadn't even known about the claims. But if they'd heard more about it early on they certainly would have been better informed and better prepared to answer questions from parents.

Maybe most of the parenting industry believed it was a big to-do about nothing. Maybe pediatricians agreed with the moms who reminded us on message boards and on playgrounds that some diapers give some kids rashes. One kid can't wear Pampers. The other one can't wear Huggies. Rashes happen and they can look real bad real fast.

True, the story lost traction. Media attention spiked in May and the early part of June then died until last week's verdict from the CPSC. I suppose someone could argue the experts did the right thing by ignoring claims. It's just exaggerated reports of regular diaper rash, why give it credence? If they thought the claims ridiculous than they should have said so. They should have stood up. It's not like they had to bash the Facebook moms. Someone could have written about the different types of rashes, their severity, the unlikehood of a link between diapers and chemical burns. Questioned the Facebook history/timeline. Told us just how dang bad a rash can look, hurt, etc.

This time parenting experts did not help parents decide whether they should throw out all the Dry Max they'd just purchased. Or whether they should be worried about their newborn who'd been wearing them. Or call the pediatrician first thing in the morning. When even unlikely claims or threats gain traction, the experts need to respond. Misinformation has the half-life of permanent marker on your white silk draperies.

From the beginning no one from the media (and please correct me if I missed an article somewhere), except Trevor Butterworth at Forbes.com, hardly the arena for child health discussions, dared challenge the veracity of the claims about the diaper (Social Nutworking).

No one, save Butterworth, dared suggest the possibility of it as an example of social media gone amok. And that's too bad because there were red flags early on.

And so that's why it's up to us to be more skeptical. We gotta be our own detectives now. For every health claim we have to consider the sources, the circumstances involved. It wasn't so difficult this time. Could the Dry Max have been causing an inordinate amount or inordinately severe rashes? Of course, but diaper rash is extremely common. Could people without health backgrounds notice severe diaper rashes? Maybe. Could they distinguish an unusually severe diaper rash from a severe one? Doubtful. How about a severe one from a chemical burn. Doubtful. Did we hear from any medical professionals confirming the chemical burns. No reports. Did we hear any alerts from any health agencies? No. But then again, we learned like nada from the professionals here. 

This time it was just diaper rash. Thank goodness for that. A common event. Something we know about. Most of us parents have seen diaper rash. Diapers and diaper rashes are hardly abstract, complicated phenomenon.

Next time the threat might be more serious. Something with an unpronounceable name, something most of us know nothing about. Maybe it'll be a threat less easily and readily falsified. Say a food additive, a drug, a new vaccine, a medical procedure - suspected of causing birth defects, leukemia, attention deficit disorder, childhood depression, infertility. Something that takes years, decades, millions of dollars to investigate with more severe consequences.

Unfortunately we parents are not as patient as we used to be having suffered through the vaccine-autism scare and its gradual, costly debunking. Living with the still-present anxieties over bisphenol-a and phthalates - the final verdict years if not decades away. These exaggerated threats, false alarms of varying degree, they take their psychological toll. Doesn't take a Ph.D. in psychology to know it. Hopefully we'll still be able to recognize the true threat when it comes our way, that is, if we aren't busy worrying about whether we should buy Dry Max diapers, infant formula, organic produce, or the BPA-free lunch bag.

15 comments:

TherExtras said...

I've got to admit that I am not in the least passionate about this diaper kerfuffle. But I applaud your tenacity in running-it-to-ground, Polly. You make excellent points (in purple font).

"For every health claim we have to consider the sources, the circumstances involved." And yet a sizable portion of the population does not question the source of news information. How can we hold accountable a HUGE & massively rich (read powerful) industry? (Rhetorical question.)

Barbara

JoyMama said...

Makes me think of the quote attributed to Mark Twain: "A lie can travel halfway round the world while the truth is putting on its shoes."

Perhaps social-media simply magnifies that which has been with us all along?

Polly Palumbo, Ph.D. said...

JoyMama, yes! Funny, I was trying to remember that quote as I was writing the post - nearly used it!! And you're right, nothing new about rumors and half-truths. But now so many more people have their own personal pulpits and megaphones, myself included!

Barbara, love it - yes I feel like I've run this diaper aground too. Yet, it's the kind of thing social psychologists just love to dissect - the spread of misinformation over social networks, the accuracy of social judgement, the role of experts in persuasion, motivations, peer pressure - almost makes me want to get my own research proposal together.

Polly Palumbo, Ph.D. said...

And Barbara I am so going to borrow "kerfuffle" today - my children will love it. Of course their current fave is "lallygagging" - of which they do plenty...

TherExtras said...

Giving 'kerfuffle' credit to JoyMama. She has expanded my vocabulary more than anyone else in my blog-life. You can count on her for the most astute quotations, too.

I had lots of 'science' karma yesterday - with your post and a couple of others. On this post, I was poo-pooed for bashing the journal (source) of a really bad article. http://daisymayfattypants.blogspot.com/2010/09/on-anti-vaxers-science-and-sticks-of.html

If social media and news media are questionable sources of information, does that not make 'scientific' journals just that much more responsible for what they publish?

Barbara

Jamie said...

I don't normally comment on your blog - although I really like it when I get a chance to read it - but I wanted to say, as a pediatrician, it is incredibly hard to comment on what the media reports these days without being completely attacked by one's patients. A lot of people called my office when the media reported a "problem" with Pampers Drymax - I told them all in no uncertain terms that this was not something I had seen nor was I concerned since any brand of diapers can some times seemingly contribute to an irritant rash - of course, with every rash that I see, I can not reliably state that it is the diaper that is the problem but sometimes if the rash doesn't improve with traditional barrier techniques and more frequent changing, I suggest trying a different brand. I also told many moms that some times what one considers to be a "severe" rash is not as bad as one might think. And finally, I asked most moms if they were using Drymax and if so did they have any problems with rashes. None did.

Anyhow, these days pediatrics is a service industry - people often walk into an office demanding antibiotics or a custom vaccine schedule (if they are getting their child vaccinated in the first place) or specific lab tests sent to specific labs to test for certain infections or diseases that may or may not have any evidence in support of their existence. Very few physicians have enough time in the day to see enough patients to cover their overhead much less make a decent salary unless they are a self-appointed expert who has sold their soul to someone to speak on behalf of whatever special interest group that is paying them. So many pediatricians do not even have time to address these social media gone amok situations - and there are certainly a lot of them (you nicely name a few in your post, but add in chronic lyme, pvcs causing cancer, and just about every psychiatric diagnosis out there - and you know there are more).

Sadly, it's just too darn exhausting to address them all day - especially when you can even quote the evidence and that still doesn't matter (thank you Jenny McCarthy and Barbara Loe Fisher). So maybe you could go a little easier on us. I know I'm trying my best and reading as much as I possibly can (which is why I sometimes don't even know what the media is reporting because I don't have time to watch the news).

Thank you for writing about the evidence from a mom and PhD's perspective. It's inspiring and useful to a mom and MD like me.

Polly Palumbo, Ph.D. said...

Welcome Dr. Jamie and thanks for reminding us of all the expectations and demands we heap onto pediatricians! It's always good to hear from someone in the field too. I'm always amazed that we require our kid and baby docs to be both medical doctors and psychologists,and of course, up to date on the latest controversy! No easy feat. When I was criticizing those who didn't speak out, I had in mind those folks who make a living doing so. Er, maybe the same "experts" who've sold their souls?

Don't be a stranger!

JRM said...

Thanks, Polly. And if ever you need another pediatrician contact, I'm more than happy to contribute.

Polly Palumbo, Ph.D. said...

Oh absolutely! Are you on call 24/7. Just kidding...

Anonymous said...

There were massive resources mobilized on part of the manufacturer to both minimize perceived impact, ridicule/discredit critics and cover up any ill effects. Given the established practice of unannounced re-formulations of the product prior to the uproar created in online communities, why is anyone assuming that reformulation did not also happen AFTER it came to light that there were potentially serious concerns with the new product? While I very much agree that the veracity of ANY source of information must be questioned, a question that needs to come up in the course of this is 'cui bono'? Who benefits? And by how much?


A very small-scale experiment with limited means and miniscule sample size -- but interesting to consider nevertheless:

http://www.zrecommends.com/detail/final-results-of-our-pampers-dry-max-testing/

Sarah said...

Hi....just wanted to say I've been reading your blog on and off for a while. I LOVE this last post and think it really sums up modern parenting in so many ways. I'm a PhD scientist too (of the brain development variety) and *just* starting out in this social media world - now I'm at home with two kids I need something to focus my day!! I'll be following your blog! Nice to 'meet' you.

Polly Palumbo, Ph.D. said...

Welcome, Sarah! Great to hear from a mom with a Ph.D., and the brain knowledge an extra cherry on top. Please drop by again and let us (me) know what you think and of course, if there's some topic out there waiting to be debunked, let me know.

Polly Palumbo, Ph.D. said...

Mr./Ms. Anonymous, howdy. Of course it's quite possible the manufacturer reformulated their product. But let's not forget the stated primary reason they stuck the new dippies in the old boxes was because it takes a long time to change over the production lines (not an uncommon practice in the manufacturing realm) so do we really think they could have reformulated so readily?

Who benefits? If we're talking about moola to be made we must throw in the class-action attorneys for sure. Guess we can't add any politicians as the fervor fortunately never made it to Washington, unlike a few other suspect substances.

And yes, I am very familiar with zrecommends, whose founder wore bm-soaked diapers on his forearm and relied upon the skin-grading expertise of his young daughter.

JRM said...

Polly, I am so glad you addressed Anonymous' comment. While Anonymous recognizes the limitations of a study with an N of one and one's child as the "expert" nose and eyes doing the analysis, he or she STILL references a completely useless "study" as if to say it matters even at all that someone decided the way to test whether or not drymax is a problem is to put your child's stool on your arms - and to even blend it with your child's urine to see if this causes irritation when wrapped with different diapers!!!!

Seriously? The fact that anyone would even do that is bizarre. The more disturbing fact is that someone would think that this would be a way to determine whether or not drymax is a problem!

When did so many people sitting on their computers become such conspiracy theorists? When did people start to believe that by doing an entirely uncontrolled experiment at home with numerous variables and confounders and an impossibly small sample size (if you can even call it that) that they could then determine whether or not the "big bad industry" covered up what the moms and dads know?????

Do we even teach science in school anymore? Are our egos so great that we are all self-professed experts of everything? It is really so depressing and sad that anyone can use a bunch of words that make what amounts to a middle schooler's science project sound like a valid statistical analysis. Clearly, Z had at least one person fooled.

Your reply was far more gracious than mine. If only I could be as patient!

Polly Palumbo, Ph.D. said...

Thanks so much, JRM! Well said! Amen! You know I started this endeavor because I'd become exasperated by the lack of respect given scientific evidence and rationality and just plain common sense in the parenting information industry. So while I'm on the soap box/pulpit (apparently not enough caffeine earlier but now I'm well-primed) I'll suggest you take a look at zrecommends. The site's gotten positive notice (and recommendations) by the main stream media - dumb-founding considering the urine-soaked self-experimentation saga. As for science class, I wish we could just make it more exciting, maybe even change the name altogether, any suggestions?