Being a mother is difficult—from childbirth to child care, women often bear the principal burden to provide basic necessities for their children. This becomes all the more challenging for poor women, who piece together their income with support from government social safety nets. Yet, one of the most basic necessities for mothers and their babies –diapers– are not covered by federal assistance programs. As these programs face spending cuts and the imposition of onerous work requirements—from the Trump Administration’s proposal to cut federal spending for Medicaid to House Republicans planning to cut SNAP benefits in the farm bill (Supplemental Assistance for Needy Families, also known as food stamps)—poor mothers must spend more money on food and housing, leaving even less available to pay for diapers.

More women lived in poverty than men in 2016 (more than 16 million women compared to nearly 11 million men), and 35.6 percent of families headed by single mothers were poor in 2016. The percentage of female-headed families in poverty is higher among Black women (38.8 percent) and Latinas (40.8 percent).

After these poor mothers pay for housing, transportation, and food—at an average monthly cost of $2,810 for a single mother and two children—they have little left over, even for basic necessities like diapers.

Diapers are very expensive, and they are not allowable expenses under federal assistance programs. A child usually needs between six to eight diapers daily, at a monthly cost of $70 to $80, or about $960 annually for disposable diapers. The cost can be higher for poor mothers, who are generally unable to purchase diapers in bulk to reduce the cost, lacking the storage and higher immediate resources needed to buy large quantities. Thus, in 2014, families in the lowest income quintile spent almost 14 percent of their pretax income on diapers. For a single mother working full time at the federal minimum wage of $7.25 per hour, diapering one infant will require more than 6 percent of her annual gross pay.

All this means that low-income mothers can be forced to go without enough diapers for their young children.

A 2013 study found that 27.5 percent of women reported times when they did not have enough diapers for their child. Latina women were significantly associated with a greater diaper need—that is, more frequent shortages—than African American or White women. To cope, poor families improvise to make the diapers they do have stretch further, changing diapers less often or attempting to clean and reuse disposable diapers. These practices can create health consequences, including urinary tract infections and skin rashes, with a cascade of negative effects as medical costs mount and parents miss work to care for their sick child. Diaper need is obviously a considerable cause of stress for families, compounded by the possibility that it will prevent families from using daycare centers, which often require parents to provide a diaper supply for children as a condition of admittance.

Despite the serious consequences of a lack of diapers, most government assistance programs do not allow recipients to apply benefits to diapers.

WIC (the Special Supplemental Nutrition Program for Women, Infants and Children), SNAP, and Medicaid do not cover diapers, and Temporary Assistance for Needy Families (TANF) is rarely generous enough to cover the cost of diapers after other basic needs. Further, few families in poverty—only 26 percent in 2013—are covered by the welfare program.

Federal level efforts to mend this gap have stalled.

The Diaper Investment and Aid to Promote Economic Recovery (DIAPER) Act, for instance, was introduced by Representative Rosa DeLauro (D-CT) in 2011 and would have amended the Child Care and Development Block Grants to require that state funds in the program cover diapers and diapering supplies. More recently, The Hygiene Assistance for Families of Infants and Toddlers Act of 2017, introduced by Representative Keith Ellison (D-MN), aims to expand TANF to allow states to create their own diaper-distribution program through federal grant funds, but it has not advanced. Taking the lead in local efforts, San Francisco implemented a similar program in 2015 that seems promising.

One study of a community-based diaper bank in California has shown that supplying families with diapers in efforts like these increases the health, social, and economic outcomes of affected families.

The positive effects of the diaper bank program included improved parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to spend money on other basic needs, such as utilities and medical care.

But until we can expand federal assistance to include diapers, many poor mothers and their children will suffer. Federal policies can fix this problem and improve outcomes for young children and their families by expanding SNAP, WIC, or TANF benefits to include diapers as allowable expenses. The Trump administration has not proposed such changes.  So for now, parents in poverty must hope for the expansion of efforts such as the community-based diaper bank in California.