Diaper Need: The Impacts of the Inability to Afford Diapers for Families in California

As pandemic-era relief programs end, more and more families report an inability to afford basic needs such as food, housing, utilities, childcare, and healthcare according to Stanford’s RAPID survey. Asian, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander, experienced the greatest rate of material hardship among California parents, followed by Latinx and Black families, while White families were the least likely to report experiencing material hardship. Households at or below 400% of the federal poverty level were also more likely to experience material hardship.

Diaper access and affordability are essential components of a child’s basic needs. Without consistent diaper changes, babies run the risk of infection, diaper rashes, urinary tract infections, and other significant health problems that may require medical attention. Despite this necessity, nearly one in two families across the U.S. with babies or toddlers cannot afford to buy enough diapers to ensure their child stays dry and clean. This represents a sharp increase from previous years, where one in three families reported being unable to afford enough diapers for their children.

The inability to access a sufficient supply of diapers to change a child as often as needed is called diaper need. Diaper need is a silent crisis. Many families and caregivers, especially those from communities of color who are more closely scrutinized by our child welfare system, fear being reported as negligent for not being able to provide their baby or toddler with an adequate number of diapers.

On average, monthly diaper costs range from $70 to $100. The monthly expense of diapers often forces families to choose between their child’s health and other needs. Families experiencing diaper need are often forced to cut back on essential spending for food and utilities. Diaper need also risks pushing families into poverty in other ways, too. Medical costs associated with diaper need can create additional financial strain on families. Moreover, in nearly a quarter of households reporting diaper need, parents say they have had to miss work because they did not have an adequate supply of diapers required to drop their child off at a childcare facility.

Diaper need is not just associated with financial and economic hardship. It can also negatively affect parental mental health. Studies show that parents experiencing diaper need were at increased risks for post-partum stress and other mental health issues. This can create a negative feedback loop, damaging the parent-child relationship and putting children at a greater risk for developing social, emotional, and behavioral problems.

For California families with infants and toddlers experiencing diaper need, diaper banks have been a critical support. Diaper banks allow these families to access diapers at no additional cost. California’s 18 National Diaper Bank Network members distribute approximately 72 million diapers annually, helping almost 120,000 infants and toddlers every month. Recently, California was awarded $1.2 million through the Department of Health and Human Services’ Pilot Diaper Distribution Program, which will be distributed to diaper banks across the state to improve diaper access among California families with infants and toddlers. Diaper banks are a critical part of the infrastructure needed to tackle diaper need, but they also represent a limited solution. In addition to federal funding, California is one of the few states to fund a diaper distribution program, supporting broader access to diapers for families. In 2017, the state legislature passed Assembly Bill 480 (AB 480) to support families experiencing diaper need. AB 480 provides California families with children three years old or younger in a CalWORKs, Welfare-to-Work family with a $30 monthly supplement to pay for diapers.

Since 2017, state efforts to further support families experiencing diaper need have been few and far between. Recently, the federal government has tried to fill the gap where existing safety net services have fallen short to support families experiencing diaper need. In September 2022, the Department of Health and Human Services (HHS), through the Administration for Children and Families (ACF), launched the first of its kind federally funded diaper distribution program for families experiencing diaper need called the Diaper Distribution Demonstration and Research Pilot program. The pilot program awarded $8 million in funding to Community Service Block Grant state associations and tribes to provide diapers and diapering supplies to families in need through the pilot program. In May 2023, HHS announced an additional $8.2 million in federal funding to expand the pilot program to serve families with infants and toddlers in seven new states and territories, including California.

As a state Medicaid policy leader, California could pursue another avenue to improve diaper access through Medi-Cal, following the leads of Connecticut and Tennessee. Tennessee is poised to become the first state to allow Medicaid to cover the cost of diapers. If approved by the federal government, Tennessee’s Medicaid program, TennCare, will cover diapers for the first two years of a child’s life beginning in 2024. Meanwhile, Connecticut lawmakers are considering including diapers in Medicaid coverage. A proposal for studying the new benefit is currently making its way through the Connecticut state legislature.

California has over 687,000 infants and toddlers who qualify for Medi-Cal. Without adequate support from the state, many parents are left on their own to find ways to meet their children’s basic needs. Access to clean diapers is an essential basic need for all infants and toddlers. While there is no one-size-fits-all approach for addressing diaper need, potential solutions for California to consider include increasing the CalWORKs diaper benefit and expanding eligibility to include a greater number of families, providing a diaper supplement to childcare providers, and creating a Medi-Cal benefit. By improving diaper access, California can help bolster the economic security of families and their infants and toddlers across the state.