Diaper banks underutilized for families in need


For families living in poverty, diaper banks can help keep their children clean and dry. Pediatricians could do more to assess their unmet need and step up referrals to these community resources.

A ready supply of clean diapers for an infant may seem like a basic need, but for some families, it’s an undreamed of luxury.

According to a new report, nearly half of families with infants and toddlers in the United States live within 200% of the federal poverty level and struggle to afford basic necessities such as diapers. The study,1 published in the American Journal of Public Health, investigates this unmet need and reveals that just 4% of children in these low-income households find relief through community diaper banks.

Diaper banks are available across the country to help families in need keep their infants clean and dry-in turn preventing problems including diaper rash and urinary tract infections. Although there are a host of diaper banks opened by clinicians, health systems, and community organizations, the new study reveals that there are many areas where families in need don’t have access to these resources. Kelley Massengale, PhD, MPH, of the National Diaper Bank Network in New Haven, Connecticut, led the study, and says the problem isn’t how much existing diaper banks are utilized but rather the amount of resources available.

Too much need, not enough support

“Existing diaper banks are not necessarily underutilized. Rather, the challenge is that not all communities have diaper banks,” Massengale says. “Within communities served by diaper banks, the percentage of met diaper need is much higher than when looking at a larger geographic area such as a state or the entire country. The diaper bank community has built an effective infrastructure across the country but at this time does not serve every community.”

Not only do diaper banks meet a basic need, Massengale says, but they also help engage families in other needed social support services. The problem with trying to do more comes down to funding, she says.

“Diaper banks are nonprofit organizations that rely on philanthropy and public charity. When we consider other unmet basic needs that low-income families may have-housing, food insecurity, trouble paying for utilities, transportation needs, health care, and other challenges-our country has federal policy programs that can address at least a portion of these needs,” she says. “There are no federal policy programs that address diaper need for all low-income families. Our society relies on a network of nonprofit organizations to address the public health concern of diaper need.”

For the study, Massengale and her research team polled 262 diaper banks supported by more than 3500 community organizations across the country. More than 52 million disposable diapers were distributed in 2016 and 74% of those diapers were donated. The remainder, she says, had to be purchased by community organizations. In addition to disposable diapers, diaper banks also distributed 4395 reusable diaper kits. It’s still not enough, however, according to the study, which revealed that just 300,000 of the 7 million children in need received diapers from these resources.

The study only investigated diaper banks and did not include other ways families might get the roughly 6 diapers their children need each day, but the fact remains that less than 16% of the families that need diapers can be served through existing diaper banks.

A call to action

Pediatricians can help, Massengale adds, by assessing for diaper needs and referring families in need to community resources where available. Each visit offers a pediatrician the opportunity to assess for unmet diaper needs and make referrals, she says.

“Research I have previously published documents that families receiving free products from a diaper bank report that their children are healthier and happier, and parents are less stressed,” Massangale says, adding that clinician awareness of local resources is key. “Before implementing diaper need screening in clinical practice, it is important to first know what resources exist in the community to address diaper need and what local procedures are for accessing them. Practitioners, especially those in communities without a diaper bank, are encouraged to increase awareness that diapers are a basic need for young children and that families’ needs for diapers are unmet.”

Lastly, pediatricians can help advocate for increased public health and philanthropic support for these programs.

“Diaper need is a public health concern that impacts infant health, parental stress, and families’ abilities to fully participate in society,” Massengale says. “We need federal, state, and local policies that address diaper need. It can take time to implement such policies. In the meantime, diaper banks need increased support so that they can continue serving their communities and grow to serve others.”


1. Massengale KEC, Comer LH, Austin AE, Goldblum JS. Diaper need met among low-income US children younger than 4 years in 2016. Am J Public Health. 2020;110(1):106-108.

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