The blog of the Urban Institute
December 17, 2021

Home Visiting Programs Can Help Ensure Families Have the Diapers Their Babies Need

One-third of American families don’t have the diapers they need to keep babies clean, dry, and healthy. With diapers costing roughly $1,000 a year, many families struggle to afford (PDF) this necessity—especially families with multiple children in diapers and families with low incomes.

Some diapers are more affordable than others, but access to more-affordable diapers is not equitable. Many families facing transportation challenges, and those who have to rely on higher-priced convenience stores rather than big-box stores pay top dollar for diapers.

Nonprofit diaper banks collect and distribute diapers to families, but studies have found that local diaper banks are only able to reach a small share of families in need. Home visiting programs can help fill that gap. These programs provide education and parenting support to families facing a range of challenges.

For the first time—because of pandemic relief funds allocated to the federal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program—home visiting programs can now use MIECHV funds to purchase diapering supplies for eligible families and deliver donated diapers to families in coordination with local diaper banks. By partnering with local diaper banks, home visiting programs can reduce diaper need among the families they serve and improve family engagement with home visitors. 

Diaper need has detrimental effects on children and their parents

Federal assistance programs aren’t enough to help families access affordable diapers. Families in the Supplemental Nutrition Assistance Program and the Special Supplemental Nutrition Program for Women, Infants, and Children aren’t allowed to use those benefits to buy diapers. 

Temporary Assistance for Needy Families (TANF) provides limited cash benefits that could be used for diapers, but families also use this money to pay for rent, clothes, and other necessities. And only 23 percent of families living below the federal poverty level receive TANF. Infants and toddlers enrolled in Early Head Start have access to diapers during the day at their child care providers, but fewer than 1 in 10 eligible children are in these programs.

Many families must sacrifice other basic needs to pay for diapering supplies. Some families report “stretching” diapers, extending the time between diaper changes to make supplies last. Stretching diapers can lead to diaper rash, urinary tract infections, and other skin conditions.

When families run low on diapers, they may need to make the difficult choice of not sending children to child care because programs require parents to send in disposable diapering supplies. As a result, children may miss out on early learning opportunities, and parents may have to miss work or school to care for their children.

Research indicates that mothers who cannot afford a sufficient supply of diapers are more likely to experience maternal depression, poor mental health, and parenting stress. They may also face judgment from others, which can be compounded by pervasive biases about the parenting of families with lower incomes. 

Home visiting programs can partner with local diaper banks to alleviate diaper need

As state leaders consider ways to spend available MIECHV funding to support families most affected by the pandemic, stories from the field highlight the importance of community partnerships between home visiting programs and diaper banks to both address families’ urgent needs and support the home visiting workforce.

We spoke with home visiting program leaders and staff to learn more about the importance of these partnerships. Alyson Jacobson, the home visiting program director of the Prince George’s Child Resource Center in Maryland, told us, “Bringing a pack of diapers to a home builds trust because it sends a message that I see you, I see your need. There's nothing wrong with asking for help or getting help from the community. And that really adds a layer of trust within the home visiting relationship.”

The home visitors we interviewed agreed. Providing diapers to families addresses an immediate problem and helps engage parents, so the time home visitors spend with parents can be focused on working toward family goals. Providing diapers also reduces home visitors’ stress, makes them feel like they are making an immediate difference, and improves staff retention. 

Jacobson added, “The diaper bank has been absolutely amazing during COVID, really working with their partners in making it easier for us to get the diapers out to families that need them. There was such a big need with families that lost jobs, lost income, couldn’t work because they were getting sick. And having diapers being delivered to their home was a godsend.” 

Diaper need is an underrecognized issue affecting many American families. State home visiting administrators and local program leaders can tackle this issue by leveraging available federal funds and local partnerships to ensure more families have access to the diapers they need.


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Sandra Tramiel (l to r), public health nurse, Improving Pregnancy Outcomes Program, gives client Roseanda Hersey a kiss after presenting her with a package of diapers on her last full day of home visits on Tuesday, December 2, 2014 in Oakland, Calif. (Photo By Lea Suzuki/The San Francisco Chronicle via Getty Images)

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