How to Choose the Right Adult Diaper Size

Declan Davey

Written by Declan Davey on Thu Jun 03 2021.

Close up of measuring tape

Just like with any item of clothing, knowing how to choose the right adult diaper size is vital to ensure comfort and effectiveness. We want to make sure you get the information you need, so here’s a summary of what this guide will cover.

For help with sizing, don’t hesitate to get in touch. You can call the Carewell support team at (855) 855-1666 or contact us at

Key Takeaways:

  • Adult diapers are designed to bring comfort and dignity to those living with incontinence and are one of the top solutions recommended by health and wellness professionals.

  • Finding the right diaper size for your body shape is crucial to avoid leaks, rashes, and general discomfort.

  • You can browse adult diapers with tabs and pull-up diapers on the Carewell website, in sizes ranging from X-Small to 4X-Large.

  1. Why the right diaper size matters

  2. What happens if a diaper is too tight? 

  3. What happens if a diaper is too big? 

  4. Misconceptions about diaper sizes

  5. Features & types of adult diapers

  6. How do diaper sizes work?

Why the right diaper size matters

Selecting the right diaper size can be confusing, but it’s not just about comfort. If you or a loved one needs to wear diapers day-to-day, choosing an option too big or too small can cause an array of issues, both with diaper function and overall health. 

What happens if a diaper is too tight?

Tearing and breaks

Diapers that are too small are at risk of tearing. Usually, tears occur around the legs or waist, which leads to leakage. If the tear or break is severe enough, it may cut into the wearer’s skin, making the product unreliable and even dangerous for the wearer. If the tabs on your loved one’s diaper are tearing as you put it on, your product may be too small (or, you may be pulling the tab too tightly).

Allergic reactions

Overly tight-fitting diapers will sit too close to the skin, which may increase the chances of allergic skin reactions from any fragrances or dyes within the diaper material.

Top Tip: If you are prone to allergies or have sensitive skin, opt for a fragrance-free diaper. The incontinence products we supply at Carewell will be fragrance-free unless otherwise noted.

Ongoing skin problems

The most common issue with adult incontinence is the risk of diaper rash. Tight-fitting diapers can chafe and are likely to trap moisture and heat, which may irritate or damage skin. Unfortunately, diaper rash and sores are often a result of this avoidable issue.

Blood flow restriction

Wearing diapers that are too small can disrupt blood flow and cause significant discomfort, particularly for men. Restricted blood flow can lead to tingling, numbness, or muscle cramps. Continuing to use tight diaper sizes may result in nerve or tissue damage and other serious health complications. 

How to tell if a diaper is too small

A diaper that makes indentations around the legs or waist could be a sign that you need to go up a size. If you spot redness around the groin area, that could also indicate a product that’s too tight. That said, for diapers with tabs, you should check to see if you can make adjustments before changing size.

If you have to wear a tighter-fitting diaper in the short-term, it’s wise to use over-the-counter creams to avoid rashes and air out the affected areas regularly, which can help avoid moisture or bacteria build-up.

What happens if a diaper is too big?

Not discreet

The extra material from a diaper that’s too big has to go somewhere, and normally it’s around the buttocks. You may also find that the waist tends to sag, which leads to problems with diaper movement and can cause rustling sounds.


The biggest issue with wearing diapers that are too big is leakage. If a diaper isn’t secure around the leg opening, there is a high chance that fluids will leak out of the sides. For loved ones that are bed-bound, you may also experience leaks around the waistband. Even if the diaper has a high absorption feature, it’s only effective if the liquid doesn’t leak and is fully absorbed by the material.

Skin irritation

When extra material gathers in bunches, skin irritation or scratches can happen, especially around the waist. In addition, bunching around the legs can cause the material to pinch the skin, which may lead to chafing or sores. If you’re experiencing redness or rashes around the inner thigh, that’s also an indicator that you may be in a product that’s too large.

How to tell If a diaper Is loose

The most obvious sign that a diaper is too loose is when the diaper visibly protrudes from your clothes, or if you end up with a lot of bunched material around your legs or waist. A great fitting diaper with tabs will have the core resting against the body (if the core of the product is sagging, incontinence will not absorb and you will likely experience leaks). For tab-style products, the tabs should rest on the front of the hips – if you need to pull the tabs tightly and fasten them in the middle of the abdomen, they’re too loose. The best strategy to avoid this is to scale down a size or two, so you get a better diaper fit that can absorb liquids properly. 

One thing to know about larger diaper sizes…It’s important to note that a larger size does not mean a more absorbent product. The best way to prevent leaks is to choose the best size for your needs and to add booster pads if you’re looking for extra absorbency.

Tranquility TopLiner Booster Pads increase the absorbency of any protective underwear or tab-style diaper.

Misconceptions about diaper sizes

Before we move on to finding the right size of adult diapers and features to consider, there are two curious myths about diaper sizes that we want to bust.

1. Bigger is more absorbent.

Just because a diaper is larger, this doesn’t mean it has more absorbency. Like with women’s sanitary pads, there are a variety of absorbency levels. It’s good to remember that absorbency is a feature, not a size. In most cases, choosing a size that’s too big for you will actually cause leaks.

2. They are only used by men.

Adult diapers are used by both men and women, and most brands have both unisex and gender-specific diapers in their product line.

Types of adult diapers

Adult diaper features alter from brand to brand, but here are some of the basics to look out for:

Diaper or tab-style“briefs”

Briefs are one of the most common types of adult diapers. They have various features and functions to suit all types of incontinence, but the main one that sets them apart is having an opening at either side and tabs that fasten in the front.

Diaper briefs usually have either tabs or full side fastening.


Usually, tabs are placed around the sides to fit around the waist of the wearer. Briefs with tabs tend to give more flexibility in sizing, as you can loosen or tighten based on the individual.

Prevail Per-Fit 360 Incontinence Briefs promote dryness & skin health with 360 Breathable Zones.

Some adult diapers offer refastenable tabs for multiple adjustments. But cheaper products tend to have a “one and done” approach, which can make them less reliable if you need to change the fit.

Full side fastening

Full side fastening allows flexibility of fit around the legs. In essence, it’s a multiple tab approach (for cloth adult diapers) that fastens the entire side of the diaper.

Bariatric briefs

These have the same adjustable features but are catered to plus-sized individuals. This does affect the size, fit, and shape of the diaper with wider leg holes, and more expansion on the waist.

Tranquility bariatric briefs are heavy-duty and specially designed for plus sizes (4X-large).

Pull-up diapers

This is a more “traditional underwear” style and is better suited for those with full mobility. If you get the right size in pull-up diapers, they tend to be more reliable and feel more secure. If you get your size wrong, however, you’re likely to experience leakage and discomfort.

Sure Care Protective Underwear protects against heavy incontinence and feels just like regular underwear.


Brief diapers are made of different backing materials, depending on the type and absorbency. Some are made of cloth, while others are made of plastic. A cloth backing is more comfortable and ensures more discretion when worn. These are more breathable and provide added skin protection.

Typically, we would not recommend using a plastic-backed option. These lock the moisture and vapors from incontinence inside the product and often lead to skin irritation and even damage. Many cloth diapers have advanced polymers in the core, making them an ideal choice for either urine or bowel incontinence.

If you are experiencing bowel incontinence, it’s best to go with a tab-style or brief option rather than a pull-up. These tend to have a larger absorbent pad in the rear, whereas pull-ups only have absorbency in the core.

OPTIONAL READ: Traveling with Bowel Incontinence

Leg gathers

Some adult diapers have leg gathers, or “leg guards,” to provide a better fit and protect against leakage. These are strips of fabric around the legs that tend to be elastic and stretchy. They fit snugly against the skin, providing an additional barrier against incontinence leakage. 

Odor Guards and Advanced Polymers

Diapers with odor removal or fragrances can be ideal for those who want discretion while wearing their diaper all day. These are typically referred to as an “odor guard,” or “advanced odor guarding polymers.” Cloth-backed and breathable diapers tend to prevent bacterial growth as well, which protects against infections, such as thrush.

Note: With all chemicals and fragrances, there is a chance you could have a reaction. Diapers are worn close to sensitive skin areas, so please make sure to start with a trial wear or patch test before buying in bulk.

How do diaper sizes work?

Much like clothing, there’s a bit of math involved in diaper sizing. Different brands and features may fit differently, even if they have the same size. 

For example, extra absorbency and contouring might make your normal size feel slightly smaller. The best starting point is to get an accurate measurement of your size.

How to measure yourself for the right diaper size

The main measurements you need for most adult diaper sizes are:

  • Waist

  • Hip

But for some brands, features, and types you may also need:

  • Your leg measurement

  • Your weight

To take accurate measurements you should:

  1. Measure the width of your waist, just below the belly button.

  2. Measure the widest part of your hips.

  3. Measure your thigh, between your knee and pelvis.

Top Tip: Make sure you relax your muscles when measuring. It can move your waist and leg measurements by over an inch!

Most diaper manufacturers provide “brackets.” For example, a 34” – 38” waist size. If this is the case, use the highest number you measured and compare this to the diaper size guide you’re using.

What if you’re struggling to measure yourself?

If measuring yourself isn’t possible due to mobility issues or otherwise, the next best option is to try the product for yourself and see how it feels. Many of our products feature a height and weight chart, so selecting one of those products may be a good way to gauge your general size. 

Selecting the best diaper size for your body

The truth is, even with your body measurements, sometimes the differences in body shapes can lead to some discrepancies in size. If you have a larger belly or very thin legs, you may need to go up or down a size accordingly.  

If you’re struggling to find a great size for your body type, you can:

Choose your diaper size by weight. This can be useful if you experience leaks, despite wearing what should be the right size. Shop by weight to buy plus-size briefs, and you may find that the diaper absorbency is more effective.

Buy gender-specific diapers. Some brands offer gender-specific options with different measurements. These can be better at preventing leaks and providing comfort since it takes into consideration the physical differences between genders.

Add in “capacity.” If you need a larger size to fit your waist, but you have thinner legs and are experiencing leaks from the leg holes, you can always add in a booster pad for absorbency where you need it most. Booster pads can be placed anywhere in the diaper, so you can add some extra padding around the leg holes if needed. Listen to your body. If you’re experiencing tightness, rashes, or itching you likely want to go up a size, even if the sizing chart indicates that you’re in the right fit. If you’re leaking or are fastening tabs all the way over your belly, it’s best to go down a size.

Thanks for reading!

Struggles with diaper sizing are common because everyone is different. If you ever need help choosing the best incontinence protection for your needs, don’t hesitate to get in touch. You can call the Carewell support team at (800) 696-CARE or contact us at

SUGGESTED READ: 10 Best Adult Diapers for 2021 — Detailed Review

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Declan Davey
Declan Davey

Declan Davey is a health and wellness copywriter from London, UK. His background includes roles as a psychological therapist for Islington Memory Service, where he worked with family caregivers, and as a rehab assistant at Camden Neurology & Stroke Service.