For the nearly 6 million children under the age of 3 years who are living in poor or low-income families, small things such as clean diapers can impact big things including health and well-being.
“Child well-being is a public good that benefits us all,” rightly states the Academic Pediatric Association Task Force on Childhood Poverty.1
Yet, when it comes to providing children from low-income families with access to diapers, a basic need as essential to well-being as food, shelter, medicine, and love, federal assistance programs fall short. Unlike other basic needs, such as food and heat, the federal government offers no provisions to help families acquire diapers. Federal antipoverty programs such as the Supplemental Nutrition Assistance Program do not cover diapers, often leaving low-income and poor families without the means to secure clean diapers, which can cost up to $100 per month per child.
This often-hidden consequence of poverty is known as "diaper need," and it impacts 1 in 3 families who are unable to buy an adequate supply of diapers for their children.2
A simple, achievable action step could make a tremendous difference in the lives of these children and their families: We should make sure that every child in America has enough diapers to stay clean, dry, and healthy.
Evidence of diaper need
This past year, the National Diaper Bank Network (NDBN), New Haven, Connecticut, joined with faculty at the Yale School of Medicine, New Haven, to conduct the first peer-reviewed study to quantify diaper need.3 Key findings included the following:
- Nearly 30% of low-income mothers reported they could not afford to change their children as frequently as they wished.
- One in 10 mothers reported stretching diapers, a practice associated with urinary tract infections and diaper dermatitis.
- More than 30% of respondents reported increased levels of maternal stress and depression as a result of diaper need. These mental health needs were even more pronounced in mothers who had trouble obtaining diapers than in mothers who reported food insecurity.
The good news is:
- An overwhelming majority (77%) of respondents reported a consistent relationship between their child and a pediatric provider.
Individuals working within organizations that provide diapers to low-income families have countless stories that illustrate the need. For example, a program director at a crisis nursery in Spokane, Washington, said recently, “We’ve had people come in with babies wrapped in a dish towel because they don’t have diapers.”4 Personally, I have encountered families resorting to cleaning out or drying soiled diapers and reusing them in order to meet their diaper needs.
A bigger problem
The lack of something as simple as a package of diapers can keep parents out of the workforce and place babies at enormous risk.
Most childcare providers require parents to supply disposable diapers for their children. A parent who cannot comply with this simple request cannot work or attend job training or other programs designed to help people improve their situation. Temporary Assistance for Needy Families ((TANF) often requires attendance at such programs, so parents who cannot attend risk loss of TANF benefits. Without childcare, children miss opportunities for early childhood education, and thus the achievement gap widens.
Fortunately, community-based diaper banks have sprouted around the country to help families obtain diapers. In addition to raising awareness of diaper need, the NDBN helps individuals and organizations start new diaper banks and promotes the growth of existing ones. Since its incorporation in 2011, the NDBN has distributed more than 60 million diapers from founding sponsor Huggies to diaper banks across the United States. In addition, the NDBN has linked more than 170 diaper banks in 42 states, all working together to address diaper need.
The NDBN’s mission is not to apply a Band-Aid to a problem but to provide a long-term solution to a chronic issue. Just as food banks are a reliable source of support for families in need, diaper banks provide a basic need for families in crisis.
However, there are not enough of these organizations or diapers to meet the needs of the 5.8 million US children aged younger than 3 years who live in poverty.
What you can do to help
As trusted advocates for children, pediatricians are in the ideal position to help raise awareness of diaper need among all members of their local communities regardless of their economic status. Doctors also can help quantify the scope and impact of diaper need on children and families. The first step is to recognize diaper need as a malady of early childhood poverty and to ask parents if they struggle to obtain diapers. Secondly, in many communities the opportunity exists to direct families to community resources—diaper banks, faith-based organizations, and social services agencies—that provide diapers. Thirdly, the pediatric community can partner and collaborate with diaper banks to replicate and expand the NDBN’s initial research.
Overall, the NDBN takes no position on whether the solution to diaper need should be a public or private program, or some combination thereof. We simply think that discussions about basic needs should include all basic needs, and who better to lead such discussions than pediatricians?
On an individual level, when a baby is obviously in distress, people are quick to ask, “Does she need a change?”
In America today, millions of babies and toddlers are less comfortable, less safe, and less likely to prosper in the long term because they are sitting in wet, soiled diapers.
They do need a change.
1. APA Task Force On Childhood Poverty. A Strategic Road-Map: Committed to Bringing the Voice of Pediatricians to the Most Important Problem Facing Children in the US Today. Available at: http://www.academicpeds.org/taskforces/pdfs/StrategicRoadMap_ver3.pdf. Published April 30, 2013. Accessed June 25, 2014.
2. Raver C, Letourneau N, Scott J, D’Agostino H. Huggies Every Little Bottom Study: diaper need in the U.S. and Canada. Available at: http://www.huggies.com/assets/en-US/huggies-2010-every-little-bottom-study.PDF . Published June 2010. Accessed June 25, 2014.
3. Smith MV, Kruse A, Weir A, Goldblum J. Diaper need and Its impact on child health, Pediatrics. 2013;132(2):253-259.
4. Rogers A. Need for clean diapers goes beyond preventing rash. Spokesman-Review. June 10, 2014. http://www.spokesman.com/stories/2014/jun/10/need-for-clean-diapers-goes-beyond-preventing-rash/. Accessed June 25, 2014.
RESOURCES FOR PEDIATRICIANS
For more information on diaper need and how to help resolve the diaper need crisis in your communities, go to www.nationaldiaperbanknetwork.org