Add diapers to the list of needs low-income families hope the state legislature and Governor Jerry Brown will fund this year. For the third time since 2014, the legislature is considering a bill that would cover some of the monthly cost.

Diapers cost $80 a month on average, but as much as $155 if bought at local corner stores, according to a 2017 report from the California Department of Social Services.

Assistance programs such as WIC (Women Infant and Children) SNAP (formerly known as food stamps) and Medi-Cal (California’s name for Medicaid, the federal insurance program for low-income people) don’t cover diapers. Some low-income parents find themselves choosing between diapers and other necessities such as utility bills and food, according to many sources including a brief on the topic prepared by the Obama Administration last year.

Cutting back on diapers can mean fewer diaper changes—and more diaper rashes and urinary tract infections for the baby.

“For some families the cost of diapers can be more than the cost of their electric bill,” said Assemblywoman Lorena Gonzalez Fletcher (D-San Diego) who has sponsored three bills in the past three years to help low-income parent afford diapers.

Gonzalez Fletcher recently introduced legislation (AB480) that would give participants in CALWorks (California’s welfare to work program) $30 per month to help cover the cost of diapers. The bill moves to the Senate in September, and if it passes the governor could sign the legislation into law as part of the state budget in October.

Last year Gonzalez Fletcher introduced a bill that would have dropped the sales tax on diapers and feminine hygiene products, saving parents of babies about $100 a year. But the bill was vetoed by the governor because it had no funding source.

A reintroduced version of the bill, funded by an increase in an excise tax on liquor, was killed in committee a few months ago.

“[The governor] has vetoed a diaper bill in the past. But we’d like to believe that the research showing long-term costs of infant suffering and toxic stress [especially to mothers] caused by unmet diaper need has also made it to his desk, and that he has had a change of mind on the topic,” said Jessica Bartholow, a policy advocate with the Western Center on Law and Poverty in Sacramento.

A 2013 study by researchers at Yale University that was published in the journal Pediatrics found that three in ten families struggle to afford diapers. They often make do by leaving babies in wet or soiled diapers, no diapers or toilet training them at about twelve months, which is months earlier than recommended.

The effect of having too few diapers can cascade well beyond a wet or soiled bottom. The study, which included data from interviews with 1,000 mothers, also found that low-income mothers who cannot afford diapers are more likely to report depression and anxiety. Megan Smith, an associate professor of psychiatry at the Yale School of Medicine and the lead author of the study, explained that “high levels of stress and depression in a parent can be associated with low achievement in school and mental health problems that can follow a child for a lifetime.”

Some, but certainly not all, low-income families are able to fill some of their diaper needs through the more than 300 diaper banks around the country. In many cities, families can call 211 to find out about diaper banks in their area, or other organizations that assist children in their area.

The diaper banks operate independently but are connected through the National Diaper Bank Network (NDBN), based in New Haven, Conn., whose executive director, Joanne Goldblum, was one of the authors of the Yale Pediatrics study. Diaper banks gave out 52 million diapers last year, said Alison Weir, Chief of Policy, Research, and Analysis at the NDBN. “We’re able to help a lot of families, but clearly there is a gap.”

Monica Chacon, the mother of a six-year-old and a three-year-old who lives in East Palo Alto, gets her diapers for her younger son, Joel, from a distribution partner of Help a Mother Out (HAMO), a
non profit that helps provide diapers to low income families in the Bay Area.

After the birth of her first son, Max, Chacon left her job in accounting at a surgery center. The family found diapers difficult to afford, along with all their other needs, on the $55,000 her husband earns each year as a high school maintenance worker.

Diaper and other costs soared when Joel, Chacon’s second son, was born with spinal muscular atrophy. Frequent infections required doses of antibiotics, increasing the number of diapers Joel needs. “But affording diapers was hard even when we just had Max,” said Chacon. “One time he cried, and my husband headed to change him until I stopped him and told him Max doesn’t get a diaper change if he’s only peed once.”

“It made me feel helpless that we had to stretch the diapers so we could also afford food,” she said.

Chacon said even tracking sales and using coupons made it hard to bring down the cost of diapers to affordable levels for her household. One day when Joel was about a year old, Chacon took Max to school and a teacher told her about about Baby Basics of the Peninsula, the HAMO partner and one of nineteen diaper banks in California. HAMO fields two programs: their Community Partners Program distributes diapers to families in need through social service programs such as family resource centers, parent support groups, homeless and foster children’s’ services and public health departments. The San Francisco Diaper Bank, their second program, is a partnership with the San Francisco Human Services Agency, and provides diapers to 1,400 CalWORKS families with children under three through diaper distribution centers around San Francisco. Lisa Truong, HAMO’s founding executive director, estimates that mothers of infants (0 to three months) need ten to twelve diapers per day, while toddlers need six to eight.

Congressman Keith Ellison (D- Minnesota) and Congresswoman Rosa DeLauro (D-Conn.), recently introduced (for the second time) the Hygiene Assistance for Families of Infants and Toddlers Act. The Act would make $25 million in federal grant funds available to states to create, administer and evaluate innovative programs that provide access to clean diapers. States would then have to share their ideas with the U.S. Secretary of Health and Human Services so that best practices could be modeled.

“The more we bring it forward, the less it seems like some crazy idea,” says Alison Weir of the National Diaper Bank Network.