Diapers are a basic need for children in the United States, as essential to their health and well-being as food, shelter and a parent’s love. Unlike other necessities such as food and heat, diapers are not recognized as a basic need by the federal government, and so no provision is made to help families acquire diapers. Federal anti-poverty programs such as Food Stamps (now called the Supplemental Nutrition Assistance Program or SNAP) do not cover diapers, leaving poor families without the means to properly diaper their children.
Families from a range of incomes struggle to afford diapers, including both families who fall below the federal guideline of poverty ($22,350 for a family of four) and families with incomes above the federal poverty guideline but who are still considered low-income. Research suggests that families earning twice the federal poverty guideline still struggle to meet their basic needs, making the poverty level figures cited in this plan a very conservative estimate of the universe of people struggling to meet their diaper needs.
Families unable to afford diapers are forced to choose between a range of undesirable alternatives that can severely impact the health and well-being of both the child and the rest of the household. According to a study by Ravers and Letourneau, 34% of families surveyed had cut back on basics such as food, utilities or child care in order to purchase diapers for their children. Other families reported leaving their children in soiled diapers for a longer period of time than they otherwise would have. Some families even resort to cleaning out or drying soiled diapers and reusing them in order to meet their diaper needs.
The lack of diapers also limits families’ child care options. Most licensed child care programs do not accept children who are not sent with an adequate supply of disposable diapers and do not accept alternatives such as cloth diapers. When parents run out of diapers, they are forced to withdraw their children from child care, hindering their ability to work or attend school.
Twenty-two percent of all children under five years of age in the United States live in poverty, ranging as high as 34% in Mississippi to 12% in Maryland. In the U.S. territory of Puerto Rico, as many as 57% of children under five live in poverty. This poverty is most pronounced in households headed by single mothers, where 54% of children under five live in poverty, compared to only 27% of children under of five in single father households and 10% of children under five in households with two married parents.
In absolute terms, 4.4 million children under five live in poverty, of which roughly 2.6 million are children who wear diapers (0-36 months). At a rate of six diapers per day per child, diaper wearing children in poverty in the United States require more than 5.8 billion diapers annually to keep them clean, dry and healthy.
An inadequate supply of diapers can have severe repercussions for the health and economic and emotional well-being of the child, parent and rest of the household. Most immediately, an inadequate supply of diapers forces many parents to leave their child in a soiled diaper longer than is appropriate, which frequently leads to diaper rash, and may cause staph infections and urinary tract infections. Uncomfortable babies also experience irritability, prolonged crying and poor sleep. These consequences, in turn, erode mother-child attachment and may lead to lower levels of self-esteem and even depression for parents who are not able to provide the diapers their children need. In many cases, these outcomes result in neglect and abuse of the child.
The inability to enroll children in child care due to lack of diapers threatens parents’ economic and educational opportunities. Without proper child care, parents cannot work to support their families and cannot attend the schooling that will help them provide a firmer economic base for their family.
Moreover, the unplanned removal of the child from child care when diapers run out may itself cause harm to the child’s well-being. Adams and Rohacek report that instability in child care arrangements has been linked to a range of negative outcomes in children, including problems with relationship attachment, social competence, behavior, cognitive ability, language development, school adjustment and overall well-being.
In cases where parents cut back on other expenses to afford diapers, families suffer due to a lack of other necessities. Cutting back on clothing, heat or prescription drugs can negatively affect family members’ health and emotional well-being.
 U.S. Census Bureau, American Community Survey 2005-2009.
 Laura Frame, Parent-Child Relationships in Conditions of Urban Poverty: Protection, Care, and Neglect of Infants and Toddlers, Center for Social Service Research, School of Social Work, U.C. Berkeley, 2001, p.4.
 Gina Adams and Monica Rohacek, Child Care Instability: Definitions, Context, and Policy Implications, Urban Institute, 2010, p.6.