For parents living in poverty, “diaper math” is a familiar and distressingly pressing daily calculation. Babies in the U.S. go through six to 10 disposable diapers a day, at an average cost of $70 to $80 a month. Name-brand diapers with high-end absorption sell for as much as a half a dollar each and can result in upwards of $120 a month in expenses.
One in every three American families cannot afford enough diapers to keep their infants and toddlers clean, dry and healthy, according to the National Diaper Bank Network. For many parents, that leads to wrenching choices: Diapers, food or rent?
The COVID-19 pandemic has exacerbated the situation, both by expanding unemployment rolls and by causing supply chain disruptions that have triggered higher prices for a multitude of products, including diapers. Diaper banks — community-funded programs that offer free diapers to low-income families — distributed 86% more diapers on average in 2020 than in 2019, according to the National Diaper Bank Network. In some locations, distribution increased by as much as 800%.
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Yet no federal program helps parents pay for this childhood essential. The government’s food assistance program does not cover diapers, nor do most state-level public aid programs.
California is the only state to directly fund diapers for families, but support is limited. CalWORKS, a financial assistance program for families with children, provides $30 a month to help families pay for diapers for kids under age 3. Federal policy shifts also may be in the works: Democratic lawmakers are pushing to include $200 million for diaper distribution in the massive budget reconciliation package.
Without adequate resources, low-income parents are left scrambling for ways to get the most use out of each diaper. This stressful undertaking is the subject of a recent article in American Sociological Review by Jennifer Randles, a professor of sociology at California State University-Fresno. In 2018, Randles conducted phone interviews with 70 mothers in California over nine months. She tried to recruit fathers as well, but only two men responded.
Randles spoke with KHN’s Jenny Gold about how the cost of diapers weighs on low-income moms, and the “inventive mothering” many low-income women adopt to shield their children from the harms of poverty. The conversation has been edited for length and clarity.
Q: How do diapers play into day-to-day anxieties for low-income mothers?
In my sample, half of the mothers told me that they worried more about diapers than they worried about food or housing.
I started to ask mothers, “Can you tell me how many diapers you have on hand right now?” Almost every one told me with exact specificity how many they had — five or seven or 12. And they knew exactly how long that number of diapers would last, based on how often their children defecated and urinated, if their kid was sick, if they had a diaper rash at the time. So just all the emotional and cognitive labor that goes into keeping such careful track of diaper supplies.
They were worrying and figuring out, “OK, I’m down to almost my last diaper. What do I do now? Do I go find some cans [to sell]? Do I go sell some things in my house? Who in my social network might have some extra cash right now?” I talked to moms who sell blood plasma just to get their infants diapers.
Q: What coping strategies stood out to you?
Those of us who study diapers often call them diaper-stretching strategies. One was leaving on a diaper a little bit longer than someone might otherwise leave it on and letting it get completely full. Some mothers figured out if they bought a (more expensive) diaper that held more and leaked less, they could leave the diaper on longer.
They would also do things like letting the baby go diaperless, especially when they were at home and felt like they wouldn’t be judged for letting their baby go without a diaper. And they used every household good you can imagine to make makeshift diapers. Mothers are using cloth, sheets and pillowcases. They’re using things that are disposable like paper towels with duct tape. They’re making diapers out their own period supplies or adult incontinence supplies when they can get a sample.
One of the questions I often get is, “Why don’t they just use cloth?” A lot of the mothers that I spoke with had tried cloth diapers and they found that they were very cost- and labor-prohibitive. If you pay for a full startup set of cloth diapers, you’re looking at anywhere from $500 to $1,000. And these moms never had that much money. Most of them didn’t have in-home washers and dryers. Some of them didn’t even have homes or consistent access to water, and it’s illegal in a lot of laundromats and public laundry facilities to wash your old diapers. So the same conditions that would prevent moms from being able to readily afford disposable diapers are the same conditions that keep them from being able to use cloth.
Q: You found that many women’s concept of being a good mother is wrapped up in diapering. Why is that?
Diapers and managing diapers was so fundamental to their identity as good moms. Most of the mothers in my sample went without their own food. They weren’t paying a cellphone bill or buying their own medicine or their own menstrual supplies, as a way of saving diaper money.
I talked to a lot of moms who said, when your baby is hungry, that’s horrible. Obviously, you do everything to prevent that. But there’s something about a diaper that covers this vulnerable part of a very young baby’s body, this very delicate skin. And being able to do something to meet this human need that we all have, and to maintain dignity and cleanliness.
A lot of the moms had been through the welfare system, and so they’re living in this constant fear (of losing their children). This is especially true among mothers of color, who are much more likely to get wrapped up in the child welfare system. People can’t necessarily see when your baby’s hungry. But people can see a saggy diaper. That’s going to be one of the things that tags you as a bad mom.
Q: Was your work on diapers influenced by your experience as a parent?
When I was doing these interviews, my daughter was about 2 or 3. So still in diapers. When my daughter peed during a diaper change, I thought, “Oh, I can just toss that one. Here, let me get another clean one.” That’s a really easy choice. For me. That’s a crisis for the mothers I interviewed. Many of them told me they have an anxiety attack with every diaper change.
Q: Do you see a clear policy solution to diaper stress?
What’s kind of ironic is how much physical, emotional and cognitive labor goes into managing something that society and lawmakers don’t even recognize. Diapers are still not really recognized as a basic need, as evidenced by the fact that they’re still taxed in 35 states.
I think what California is doing is an excellent start. And I think diaper banks are a fabulous type of community-based organization that are filling a huge need that is not being filled by safety net policies. So, public support for diaper banks.
The direct cash aid part of the social safety net has been all but dismantled in the last 25 years. California is pretty generous. But there are some states where just the cost of diapers alone would use almost half of the average state TANF (Temporary Assistance for Needy Families) benefit for a family of three. I think we really do have to address the fact that the value of cash aid buys so much less than it used to.
Q: Your body of work on marriage and families is fascinating and unusual. Is there a single animating question behind your research?
The common thread is: How do our safety net policies support low-income families’ parenting goals? And do they equalize the conditions of parenting? I think of it as a reproductive justice issue. The ability to have a child or to not have a child, and then to parent that child in conditions where the child’s basic needs are met.
We like to say that we’re child and family friendly. The diaper issue is just one of many, many issues where we don’t really put our money or our policies where our mouth is, in terms of supporting families and supporting children. I think my work is trying to get people to think more collectively about having a social responsibility to all families and to each other. No country, but especially the richest country on the planet, should have 1 in 3 very young children not having one of their basic needs met.
I interviewed one dad who was incarcerated because he wrote a bad check. And as he described it to me, he had a certain amount of money, and they needed both diapers and milk for the baby. And I’ll never forget, he said, “I didn’t make a good choice, but I made the right one.”
These are not fancy shoes. These are not name-brand clothes. This was a dad needing both milk and diapers. I don’t think it gets much more basic than that.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
13 diaper bag essentials for a day out with your baby
Diapers: Pampers Swaddlers
These diapers provide the best leak protection and comfort, available up to a Size 7. They are soft on your baby’s skin, highly absorbent and come with a wetness indicator, so you’ll easily know when it’s time for a new diaper.
Wipes: Pampers Sensitive Wipes
These wipes are a popular choice for both parents and hospitals. They are 20% thicker than other wipes, making them feel soft while remaining sturdy enough to handle tough messes. They are fragrance-free, hypoallergenic and made with 99% purified water.
Diaper cream: Aquaphor Baby Healing Ointment
Aquaphor is an effective multipurpose solution for your baby’s skincare needs. It helps relieve diaper rash and soothes irritated skin. Its skin-friendly gentle formula is free of dyes, preservatives and fragrances.
A 3-ounce tube is the perfect size for your diaper bag.
Disposal bags: Mom Easy Diaper Disposal Bags
These biodegradable poop bags are perfect for those inopportune moments when your baby has an extra-dirty diaper. They are high-quality, sturdy and easy to open. These bags conceal smells, in case you have to store dirty diapers or soiled clothes until you get a chance to dispose of them.
Baby blanket: Aden + Anais Swaddle Baby Blanket
These classic muslin blankets are soft and versatile. Their generous size and breathable fabric make for easy swaddling, but you can also use them as a blanket, a burp cloth, a pram cover or a nursing cover. They are built to last and maintain quality, no matter how many times they go through a wash.
Changing pad: Lil Fox Portable Diaper Changing Pad
If you want to make diaper duty a little easier, this waterproof portable changing pad can be unfolded with one hand and has pockets to store diaper essentials. It’s cushioned with a memory foam pillow to give your baby extra comfort during a change. You can find it in multiple patterns and colors.
Bib: Bumkins SuperBib
If you’re planning to give your toddler a snack or meal while you’re out, a washable bib keeps them a bit more clean. These lightweight, waterproof bibs from Bumkins have a helpful catch-all front pocket for solid snacks, and are available in a variety of lively patterns.
Formula dispenser: Tommee Tippee Travel Formula Dispensers
Save space in your diaper bag with these formula dispensers from Tommee Tippee, which fit snugly inside the bottle for easy, mess-free feeding prep. Each package includes six dispensers that hold enough formula for a 9-ounce bottle.
Extra clothes: Simple Joys by Carter’s Baby 2-Pack Sleep and Play
You never know when spills, spit-ups or a diaper blowout will require a change of clothing. Keep it simple and pack an extra sleeper or bodysuit, depending on the time of the year. These soft-but-durable cotton coveralls by Simple Joys by Carter’s come in a handy two-pack.
Snack cup: Brave Justice Kids Co. Snack Attack Container Cup
Healthy snacks are essential for growing tots. The Snack Attack collapsible silicone container with snap-on lid, has flexible flaps that lets your baby or toddler to grab a few snacks without spillage.
Sippy Cup: Munchkin Miracle 360 Trainer Cup
This sippy cup uses an innovative design that lets toddlers drink from all sides of the cup instead of a straw or a spout, helping to ease the transition from bottle to a drinking cup. With easy-to-grip curved handles and an easy-to-clean, spillproof design, it’s a great option for your diaper bag.
Sunscreen: Baby Bum Mineral Sunscreen Face Stick
Make sure to protect your baby’s sensitive skin from the sun. Consider a travel-friendly sunscreen with SPF 30 or higher, which is recommended for babies 6 months and older. The Baby Bum SPF 50 sunscreen stick is a lightweight, non-greasy mineral-based formula that’s free of fragrance and harsh chemicals. It’s easy to apply and tucks right into your bag.
Teething toy: Vulli’s Sophie La Girafe Soothing Teether
If your baby is teething, Sophie the Giraffe is an excellent toy that doubles as a teether.
Made of 100% natural rubber and food-grade paint, it’s perfectly safe for babies to chew on to soothe their sore gums
It's suitable for babies up to a year old.
Esha Saxena is a writer for BestReviews.
BestReviews is a product review company with a singular mission: to help simplify your purchasing decisions and save you time and money.