Fixing a Leaky U.S. Social Safety Net: Diapers, Policy, and Low-Income Families

What Diapers Mean to Low-Income Mothers

Diapers were the first item many mothers bought after receiving aid or income, and most knew exactly how many days and hours their diaper supplies would last. Almost all mothers (93 percent) had completely run out of disposable diapers at least once. Forty-eight (69 percent) had borrowed diapers or diaper money from others, and fifty-five (79 percent) reported forgoing other basic necessities, including food, hygiene items, and medicine, to buy diapers. Mothers described cloth diapers as both cost and labor prohibitive and therefore not a feasible solution to their diaper need. The sixteen mothers (23 percent) who tried cloth diapering noted expensive start-up costs, lack of in-home washers and dryers, high per-load laundromat fees, and stigma associated with what others might not perceive as a “normal” diaper. Most who used cloth diapers reported that cloth was ultimately more expensive than disposables. They therefore devised diaper-stretching strategies, including using other household items such as paper towels and t-shirts to construct makeshift diapers, leaving used diapers on longer, and letting children go diaperless when not in public. A third of mothers described experiencing anxiety or depression related to diaper need, many emphasizing the stress of “living diaper to diaper.”

Half reported that diapers were the household expense they worried about most, even more than food or housing. Food shortages were less common due to mothers’ receipt of WIC and SNAP, access to food banks, and strategies for stretching limited food supplies. WIC and SNAP did not always cover all their families’ nutritional needs, and many mothers reported spending money out-of-pocket on food, especially infant formula. Compensatory tactics for managing diaper need, however, were limited relative to those devised for coping with food insecurity. Mothers justified going without food themselves or eating limited diets of low-cost foods such as tortillas and rice. Yet they could not rationalize depriving their young children of something necessary to perform a basic bodily function in a dignified and clean way. As Melissa, a thirty-two-year-old Asian mother of three, explained, “As long as you portion sizes and know how much your children eat, you know how much food you’re buying. But diapers, it’s uncontrollable because you don’t know how many times they’re going to pee or poop a day. If they’re sick and have diarrhea, they’re going to go through way more. I don’t worry as much about food because I can manage it with food stamps. I worry more about diapers because there’s no support, and they go like no tomorrow.” Mothers could also rely on more people in their social networks for food. As a fieldworker, Melissa could access fresh produce from work and knew family with fruit trees and gardens that produced excess. Respondents had fewer sources of in-kind diaper support and felt guilty asking for diaper money from friends and family experiencing similar financial constraints.

Family instability compounded the economic difficulties of diaper need. Single mothers were less likely to have an employed adult in the household and especially struggled to access diapers. Married and cohabiting mothers reported that they generally had more financial resources and could rely on another adult if diaper supplies ran low. Almost half (N = 21) of married and cohabiting respondents had an employed partner who contributed income to the household, which accords with research that many families experiencing diaper need include at least one working adult (Massengale et al. 2017). The time and money an additional live-in parent offered allowed partnered mothers to access diaper giveaways and be full-time caregivers at home where they could let children go without diapers. Although having a co-parent could mitigate diaper need, some mothers reported that husbands’ and boyfriends’ questioning about money spent on diapers exacerbated their diaper stress. Partnered mothers tended to purchase and change more diapers than fathers, some of whom, according to mothers, were unaware of diaper expenses, how many diapers children used, and the labor of managing limited diapers supplies.

Parental relationship dissolution also contributed to some mothers’ diaper need. Sonia, a thirty-three-year-old Latina mother of two, said, “I had never been without income. Her father and I separating dampened our situation. When he was around, he was helpful with her and diapers, but when we didn’t have [diapers] that was another detriment added to our fighting. We were breaking up, and I was worrying about the diapers.” Mothers noted that fathers struggled to provide diapers or diaper money due to unemployment, low wages, lost contact, incarceration, or death. Tracy, a twenty-five-year-old multiracial mother of three, explained, “I never thought I’d be a single mother needing help for diapers, but my son’s father was killed before [my son] was born. I just need more help. It’s hard to do the diapers and other stuff on your own.”

Paternal diaper provision made some mothers more inclined to let fathers spend time with children, and fathers’ inability to provide diapers signaled lacking or waning commitments. Trinity, a forty-two-year-old Black mother of three, noted that “Even if you’re working, diapers are expensive. Her father helps, but not really. He’s not really around. I’ve been with him on and off for a long time. By the time we had the baby, I assumed from our conversations, and we had two miscarriages, that he wanted the baby. But once she came, he was just out, no diapers, no nothing.” Diaper transactions could be a barometer of co-parenting relationship quality, and diapers a currency used to negotiate fathers’ involvement. Marissa, a forty-year-old Latina mother of seven, explained how she and her youngest child’s father came to an agreement. “I get the milk, the formula, and he gets the diapers and the wipes. We both budget. Money for this stuff gets put aside first, and it means a lot that he always takes care of this one thing.” Although they had broken up shortly after their daughter’s birth, Marissa worked hard to maintain an amicable co-parenting relationship with the baby’s father, whom she believed proved his paternal commitments by ensuring adequate diapers.

When mothers could not rely on paternal diaper support, they were reluctant to ask others because they feared judgment about their childbearing choices and parenting abilities. Audra, thirty-two, white, and a mother of five, admitted feeling embarrassed. “It’s sad to need diapers. You don’t want to feel like you’re failing as a parent. I hate it when people say, ‘You knew what you were getting into having kids.’ People get food, but they judge you more when you struggle with diapers.” Likewise, Toni, a twenty-nine-year-old Latina mother of four, confided, “I will never ask my mom for diaper money again because she doesn’t get it. Neither does my sister. They look down on me about it. You feel so alone. It gets thrown in my face. I can’t live it down that I asked them for diapers.” Mothers speculated this was why no government program covered diapers. Ashley, a seventeen-year-old Latina mother of one, said, “I guess policy people think diapers are the main thing that’s a parent’s responsibility. If you ask for help because you can’t afford diapers, they think we’re not taking care of our kids, that we’re too lazy to get them.”

Natalie, twenty-nine, mixed race, and a mother of three, speculated that policymakers think, “They had a choice to have that child. There are all these other programs out there. They should be able to provide at least this one thing if they choose to have the baby. Nutrition, we’re not going to take that away. That’s definitely a necessity. People need housing, so we’ll help with that. But diapers, that parent can figure that out on their own.” Maria, thirty, Latina, and a mother of four, similarly surmised that policymakers wanted to discourage childbearing among poor families. “They likely think, ‘We’re not going to give you everything on a silver platter when you should be working and supporting these babies you’re making.’ We didn’t plan for another baby. Our daughter was already potty training. I was going back to school. My husband was working. I was on birth control. It failed us.” Assumptions that parents should live with the consequences of their choices, Maria elaborated, ignored the realities of low-income families’ constraints. Maria’s husband, a fieldworker, lost work hours due to extreme heat and wildfire smoke that ravaged Central California during the summer of 2018. Maria quit school because they could not afford childcare, and she lamented the struggles of trying to live responsibly on low wages and limited government aid that did not account for diapers.

Mothers’ stories pointed to the practical and symbolic significance of public support for diapers. Practically, WIC, SNAP, and housing assistance programs provide need-based aid to cover some, if not all, of families’ food and shelter requirements. Symbolically, they codify that food and housing are basic human needs to which all should have access regardless of ability to pay. The absence of any similar systematic policy for diapers combined with mothers’ struggles to provide them meant that diaper need was experienced as an acute parenting failure. Diapers are taken for granted as parents’ responsibility, but politically deemed a discretionary expense. This is misaligned with how mothers understood their infants’ specific basic needs, which for most came down to milk and diapers. Food stamps and WIC offered support for one. No comparable acknowledgment or assistance for the other meant that mothers struggled even more to access a necessity policy did not officially recognize their children have. Mothers astutely suspected that their diaper struggles were shaped by a work-based safety net that scrutinized work behaviors and stigmatized additional childbearing among poor families.

When Welfare and Work Are Not Enough

Most mothers received government aid, including WIC, food stamps, housing assistance, and TANF. Of these, only TANF could be used to purchase diapers. All forms of assistance could potentially offset household expenses, but combined benefits were not enough to cover diapers. Solange, a twenty-four-year-old Black mother of five, described how difficult it was to qualify for cash aid, how little it covered, and how rarely case managers asked about diapers. “I still have to get everything these children need, and being low income, it isn’t the easiest to survive. There’s this very old saying, ‘If you have clothes on your back, food in your mouth, and the lights on, you’re okay.’ But nobody cares about the other stuff, like does your baby have diapers? People think that people like me are ungrateful because we need more resources. . . . They’re like, ‘You get WIC? You get this service? You should be able to afford everything.’ But no one cares about diapers.”

Some mothers’ requests to welfare case managers for diapers were met with condescension. One told Aisha, a twenty-year-old Black mother of one, “You have cash aid. Why is it so hard for you to get diapers?” Aisha responded, “You have to pay rent, and food stamps don’t cover everything. You have to figure it out on your own. People act like we don’t want to get her diapers, or we just like spending money. But it just doesn’t always work in our favor.” Others echoed concerns that cash aid was not enough for diapers along with other household basics.

Respondents specifically challenged stereotypical assumptions that poor mothers do not effectively budget public aid. Brenda, twenty-five, Asian, and a mother of three, said, “If you get any government assistance and you need more because it’s not enough, people wonder where are you putting your money? They just think, ‘You’re buying other things, you’re not buying for your kid.’ I do whatever needs to be done for my kid, and my kids come first. But cash aid, it’s never enough for the gas, the bills, keeping the lights on. They think it’s not enough for the diapers because we screw it up. But it’s not enough because it’s not enough.”

Mothers explained how benefit levels did not account fully for basic living expenses and that the problem was not mismanagement of lavish government handouts. Indeed, in all fifty states, TANF benefits are not enough to pay utilities and rent for a modest two-bedroom apartment, and no state benefit is above 60 percent of the poverty line (Safawi and Reyes 2021).

The falling value of TANF combined with purchasing restrictions on other forms of aid forced mothers into a perpetual bind when it came to work, welfare, and diapers. Many mothers could not afford to work due to prohibitively high childcare costs, and employment did not always pay enough to cover diapers. Although working mothers generally had higher combined monthly income and aid, many of the twenty-four employed mothers described how work reduced the time children’s diapering could be managed privately at home, thereby increasing the need for disposable diapers. Although family diaper costs varied depending on how many children wore diapers and diaper brand and size, employed mothers were more likely than stay-at-home mothers to report monthly diaper costs higher than the sample mean of $66 per month.

Employed mothers relied on center-, family-, or nonfamilial home-based childcare to work. Childcare facilities require that infants’ disposable diapers be changed for each urination or defecation or at least every two hours otherwise; cloth diapers are not accepted by many care providers due to hygiene guidelines for preventing fecal contamination. Centers that receive Child Care Development Block Grants are not required to provide diapers, and many funds do not fully cover salaries, facilities, and program mandates. Therefore, most parents, even those who receive childcare grants, must provide diapers. Mothers reported that a full day of center-based care could require six to eight diapers, sometimes twice the number they would have used at home. Thus a full-time employed mother could expect her diaper costs to double, and five mothers had missed work at least once because they had had too few disposables required for daycare.

Employed respondents who used family or home-based childcare described tacit agreements that providing disposable diapers was a condition of leaving their children in the care of others not able or willing to manage cloth diapers or leave children diaperless. Employed mothers were also more likely to describe time pressures associated with work, commuting, and readying children for school and childcare, which further increased their need for disposables. Natalie, a twenty-nine-year-old multiracial mother of three, noted, “I’m always in a rush on the way to work, a tight schedule, getting the kids and baby ready, making sure I have enough clean diapers.” The demands and costs of employment could ultimately contribute to mothers’ diaper challenges and restrict their diaper need coping strategies. Even low-wage work could earn just enough to cut the value of mothers’ cash aid or cause them to lose eligibility entirely. In California in 2019, a family of four could earn monthly gross income up to $3,970 before losing WIC benefits. Yet a similarly sized family could earn only $1,724 before losing a portion of TANF, the only form of public assistance that can buy diapers.

Mothers in households with an employed adult also underscored the stresses of working poverty. Patricia, a twenty-nine-year-old Latina mother of three, described how her husband’s low-wage job was not enough for diapers, yet made it harder to ask for diaper support:

I’m embarrassed to ask people for help because they’ll say, “Your husband works so you should be able to afford diapers.” But no, there’s more I have to pay for. I think it’s even more of a problem because a lot of the working class, we don’t get a lot of extras. I barely get WIC, barely any financial support. It took my husband getting deducted in hours for us to get food stamps back. It’s harder because everything has to come out of his paycheck, and we literally have to pinch and dime every single thing for the diapers.

Employed mothers emphasized the strains of living paycheck to paycheck and questioned how even working two-parent families could not afford essentials. Yazmin, twenty-eight, Latina, and a mother of three, described how working mothers’ diaper need seemed invisible and unjustified. “My husband and I have full-time jobs, but we’re in debt, don’t qualify for anything, and rely just on our income. I’m working. He’s working. There should be no reason why she shouldn’t have diapers.” That married, full-time employed parents struggled to get diapers challenged assumptions that “doing everything right,” in Yazmin’s words, prevented diaper need.

Other employed and married mothers asked how they could play by the rules of a welfare system that promotes work and responsibility yet still not afford diapers given the high cost of living and raising children. Alexis, a twenty-three-year-old Asian mother of two, earned $1,000 a month at Wal-Mart; her husband earned slightly more doing seasonal farm work. “They used to say it takes a village to raise a child. Now that means it takes a village to fund a child, like paying for diapers. I work, go to school. He works. If you do get a job, you get cut off from everything. I could never be a stay-at-home mom because now it takes two working. Even when parents have jobs, on minimum wage, you work hard, and with taxes you still you don’t make enough for diapers.” Employed mothers like Yazmin and Alexis faced stigma when asking for diaper assistance because people assumed that a dual-earner household should make enough to cover all bills. Yet, much like welfare, low-wage work was rarely enough to meet families’ diaper needs.

Mothers receiving welfare found that benefit levels were too low to pay for diapers not covered by other safety net programs, and employed mothers’ low wages, inconsistent work hours, and added childcare costs meant that income did not necessarily prevent diaper need. The third group—the ten mothers who neither were employed nor received TANF—were particularly hard-pressed to afford or access diapers given their disconnection from both the labor market and the cash aid safety net. Like those in the Kristin Seefeldt and Heather Sandstrom (2015) study, disconnected mothers in this study relied on a patchwork set of coping strategies to get diapers, including informal side jobs like housekeeping, living with family or friends, and asking for diapers or diaper money from others. The shared difficulties of managing diaper need among mothers who were welfare recipients, employed mothers, and disconnected mothers point to fundamental problems of the incomplete transition to a work-based safety net (Danziger et al. 2016). Without a guarantee of living-wage employment or sufficient cash aid benefits, basic needs not covered by in-kind aid programs will often go unmet. Almost all of the more than three hundred diaper banks in the United States have been founded since 1990s welfare reform; they have become an increasingly important part of the community-based safety net of organizations that provide in-kind goods to help families meet needs unmet by government policies and programs (Allard 2009). With mixed success, mothers turned to diaper distribution services to fill diaper gaps.

Setbacks and Successes of Seeking Diaper Support

Mothers sought various sources of diaper support, including family service agencies, churches, and diaper pantries. Two in three mothers had accessed or tried to use diaper assistance services at least once, and half of these reported negative experiences. The half who had positive experiences spoke specifically about respectful, accommodating, and empathic staff. Alas, numerous challenges prevented respondents from utilizing in-kind diaper aid.

Mothers spent significant time and energy tracking when diaper distributions were scheduled, arranging for how to get there, and ensuring they had the proper documentation or proof of need, which often included the physical presence of children. Gina, a sixteen-year-old Latina mother of one, could not receive diapers from a church pantry without an adult guardian and government-issued form of identification. Because her mother’s work hours conflicted with diaper distribution times, Gina rarely received diapers. Other mothers worried about pantries running out of their children’s sizes before they could get there. Jackie, a thirty-five-year-old multiracial mother of three, was nearing the end of her diaper supply because the organization from which she received diapers ran out of the larger sizes her son wore. As many mothers reported, smaller diaper sizes (newborn, 1, and 2) were in greater supply, but demand for 3s, 4s, and 5s was higher. Jackie said, “Many places have smaller sizes because they’re more supportive toward the newer babies versus the older ones.” The standard weight range for size 2 diapers is twelve to eighteen pounds, the typical infant growing out of size 2 at six months. Mothers struggled to get the right diaper sizes given that seventy-six of the ninety-one diapered children of mothers in the sample were six months or older. The average age of children who wore diapers was 16.2 months (median = twelve months), though only two mothers ever received disposable training pants for toddlers. Some mothers described not receiving diaper assistance because their children had been deemed too old and ready for toilet training. Yet only ten diapered children were thirty-six months or older, the average age at which children in the United States finalize toilet training (Thaman and Eichenfield 2014). No child needing diapers was older than four years, and one of the only two diapered four-year-olds had been diagnosed as medically incontinent due to health issues.

The number of diapers mothers received varied widely. Some received as few as five, whereas others received full bulk-sized boxes with 120 to 150 diapers that would last a month. Most reported receiving in the range of thirty-five to fifty per month, which aligns with recommendations for what families typically need. Most pantries allocated diapers per child, but some distributed by household. This was a problem for Christine, a fifty-three-year-old Black grandmother of three children in diapers. Three toddlers needed triple the diapers, and Christine was forced to choose the one size that would best fit all of them, ages one, two, and three.

Mothers who did not live near organizations that distributed diapers had difficulty with transportation, especially when diapers were available only during narrow time windows on specific days. One of the two mothers living in rural areas reported that traveling to the closest diaper distribution would require three bus changes and several hours of transit time just to receive thirty diapers. Many mothers shared stories of traveling across town via circuitous bus routes with numerous young children in tow, only to arrive at diaper pantries that had already run out. Although Aisha was aware of a family resource center that gave out diapers, she noted,

You have to buy a bus pass, make it all the way downtown, and they usually want you to bring the baby to verify you have a kid. They ask for a lot just to get what you need. I don’t blame them. A lot of people scam the system, but most people need help. After all that, you only get fifteen, twenty diapers. That would be gone in less than a week. It’s pretty embarrassing to ask for diapers for your own kid because it comes with questions like, “You’re not taking care of your kid?” And the last thing we want in our life is [Child Protective Services] when a lot of us have been in the foster care system before.

Like Aisha, many mothers of color feared that asking for diaper support would trigger accusations of negligent parenting that could lead to involvement with the child welfare system. Several had experiences with child removal based on citations of unfit living conditions, including lack of diapers. Mothers often did not know whom to trust and questioned whether agency staff or case workers would see their efforts to get more diapers as good mothering or as evidence of potential neglect. They feared that requests for diapers would cause child welfare agencies to conflate the conditions of poverty with parental unfitness.

The sixty-one respondents (87 percent) who identified as mothers of color were more likely to report racialized stress, stigma, surveillance, and social exclusion associated with diaper need and seeking diaper assistance. Overall, White mothers in the sample were somewhat less economically disadvantaged; all but one had at least a high school diploma, and they had higher combined household income and aid ($1,093 monthly). Likely in an effort to deflect racialized welfare queen stereotypes of having additional children to collect more public aid, mothers of color were more likely to emphasize that they used aid frugally and were responsible parents. Mothers of color, especially Black mothers, described being attuned to public perceptions of their children’s diapers and fears of involvement with the child welfare system on the basis of inappropriate or too few diapers. Mothers of color were also more likely to report avoiding public spaces, including diaper distributions. Undocumented immigrants or those with undocumented family members were also reluctant to seek diaper support from agencies they feared might disclose their status and risk their deportation. Several expressed concern that diaper pantries might be immigration enforcement checkpoints. Although no such cases were known, immigrant mothers’ fears kept some from seeking diaper aid.

Another obstacle was that many organizations distributed diapers only as an incentive for watching or attending parenting classes. Through a family support agency, Ramona, twenty-one, Latina, and a mother of one, earned “mommy money” she could spend on diapers. Staff treated her respectfully, she said, and “didn’t make you feel absolute crazy because you don’t have enough diapers for your kids.” Yet once she started picking up more work hours as a restaurant server, she found it harder to travel when the required classes on managing money and parenting were available. Mary, a twenty-eight-year-old Latina mother of three, was especially irritated that a church from which she received diapers made single mothers watch and discuss a half-hour video about the importance of fathers’ involvement. Jessica, thirty-seven, White, and a mother of five, was able to get diapers every three months if she watched a twenty-minute video about how to prevent choking hazards and safely secure car seats. The diaper supplies they provided were generous, enough for two weeks, but the church would not provide diapers to children older than two years, the age at which staff believed children should be toilet trained.

Shame also prevented mothers from seeking diaper assistance. Jamie, a thirty-eight-year-old White mother of one, said about using a pantry, “You have to provide a lot of information about why you need the diapers that people wouldn’t share if you weren’t in that situation. It’s humiliating and humbling. Some of them are understanding. Some are just judgmental. If you stutter, they think you’re on drugs, and they look at you, like, ‘What’s wrong with you?’ Like you can’t provide, or that my baby’s dad can’t provide.” Mothers emphasized that some were quick to pass judgment when they sought diapers, but less willing to seek understanding of why they needed them. Faith, forty-three and multiracial, was the guardian of four young children of her best friend who had died of cancer, including three-month-old twins. Recently diagnosed with lung and cervical cancer and undergoing radiation and chemotherapy treatments, Faith once tried to get diapers from a national charity. The woman she spoke to asked Faith whether she had a car, implying that if Faith had any asset of value, she should sell it before seeking free diapers. “I took off my wig, ‘I’m going through chemotherapy. . . . I don’t have time [to sell my car] when I have to raise these four babies.’ I shouldn’t have to explain why they should help me. It’s humiliating because I’m used to doing things on my own. It’s hard to explain why you need diapers to a stranger. They’re just looking at you like, ‘Why don’t you get a job?’ I’m not asking you to give me money. I just need some diapers.” Faith later got diapers from a compassionate church group that knew her situation and offered a big box of diapers monthly until the twins were toilet trained.

Half of the mothers who had received diaper aid reported positive experiences like Faith’s with the church group. Sonia, a thirty-three-year-old Latina mother of two, described it as “one thing in my life I knew I could count on, which gave me a sense of peace. If I run out or have a problem, I can go over there and ask and probably get another set of diapers.” Mothers stressed the value of developing relationships with staff who knew and treated them with knowing respect, not anonymous indifference. These relationships were helpful when the staff’s knowledge of a family’s situation resulted in more diapers beyond the allotted amount in emergencies. Trinity, forty-two, Black, and a mother of three, was grateful for the six packs of diapers she received each month through a municipal diaper bank that served all TANF recipients in her city.

You can only get diapers as long as you qualify, so that’s the stipulation. If something ever happens where I’m not able to get aid, cash aid for her, because I don’t get it for me, just for her, then I’m not going to be able to get them. It’s easy. I just show up with my government-issued EBT [electronic benefit transfer] card and say, “I’m here for diapers.” They just give them to you. At first I was embarrassed to go get them, but I had to work through that, and I put in my share of time. I’ve worked and paid taxes my whole life. I’m just in a unique situation right now. I don’t know what I would do without this program.

Trinity felt more justified in accessing diapers as a tax-supported service because she saw it as a benefit earned through work rather than a stigmatizing charitable handout.

The six mothers who received CalWORKS (TANF) diaper vouchers had mostly positive experiences. Although the voucher’s $30 value did not cover all diaper costs, it filled many of the gaps. Unfortunately, three of the six mothers lost eligibility within three months. Molly, a thirty-one-year-old Black mother of two, received the voucher for two months before her household income barely surpassed the $2,100 eligibility limit for a family of four. Before that, she strategically shopped at a supermarket that offered a $20 gift card if a customer spent $100. Molly converted $70 cash into $50 worth of diapers and spent the rest on groceries and other household items, including tampons and toilet paper. Receiving the diaper voucher as a cashable check gave her a sense of agency to spend the extra benefit based on her family’s needs. Aurelia, twenty-five, Latina, and a mother of three, received the voucher for two months before sustaining life-threatening injuries in a car accident. After she could no longer fulfill the requirements of her work plan, she became ineligible for the voucher. During the two prior months, the $30 voucher was enough to stretch diaper supplies until she received her next aid check. Offering cash aid for diapers as a work support reduced the stigma and shame of receiving it but also meant that mothers who desperately needed it did not qualify.