Springfield, Missouri — The minivan leaves Springfield before the sun hits the limestone outcroppings of the Ozark Mountains, zipping past church-dotted roads and winding this way and that — deep, deep, deep into the hills. It has about a dozen boxes of Huggies and Cuties, sizes 4 and 5.
A handful of cars are already queued up when the van pulls into an otherwise empty shopping center — with a tiny, blink-and-you’ll-miss-it food pantry — in Forsyth, a town of about 2,500.
Kelly Brown unloads the boxes and keeps her eyes on all the cars. Most are seniors coming for food — “I don’t need diapers, yet!” — but then she spots a child. About a quarter of children in this region live in poverty, and their parents, most of whom are working, can’t cover the cost of diapers — about $100 a month. In the back of Angela Colley’s Ford Excursion is her 3-year-old daughter in a booster chair. Brown bounds up to Colley’s window.
“Do you need any diapers for your kiddos?” she asks, wearing a black T-shirt that reads, “This shirt doubles as a cloth diaper.”
Colley’s eyebrows shoot straight up. YesShe was surprised, she said. Brown quickly looks through their stores for a 74-pack of GoodNite pull-ups and stows it in Colley’s backseat. She gives the little girl a small pet cat.
Colley is visiting the food pantry to get food for her seven-member family. She said she didn’t know she could also get diapers for free. Her 3-year-old isn’t fully potty trained just yet, and affordable pull-ups have been nearly impossible to find since the pandemic began. When she can’t, she’s done what she must: slapped a maxi pad onto toddler panties and prayed it could keep her daughter comfortable for at least a couple hours.
Colley has five children — ages 18, 10, 9, 8 and 3 — and she remembers a time when three of them were in diapers at once, running through as many as 10 to 12 a day each. Although a pack of diapers will now last her daughter for the week she remembers how diapers helped her get to her knees.
Their family wasn’t always struggling financially. Colley’s husband lost his job as a truck driver due to a health condition during the Great Recession. The family was forced from their home and made homeless. Her children were still infants at the time. They could get food, clothes, and food stamps. But diapers were a different story. She started asking strangers for money so she could buy them.
“You cry — it’s very humbling to have to ask strangers for money for diapers,” Colley said.
Once, she gathered up all her silver jewelry, gifts from her family, and pawned it for $20 — enough to buy one big pack of Luvs. Another time, she found a $8 pack of diapers at a thrift shop, but all she had was $5 in change. She wept when she requested a $3 discount, but was denied. Later, she wrapped a towel around the child.
Diapers have rattled Colley’s conviction, sending her thoughts racing when her need was greatest: Are I really fit to be a mother? What if I don’t deserve these kids? What if I don’t deserve these children?
Research across the nation has shown that diaper need is more important than food insecurity and housing instability to postpartum depression. A landmark 2013 study in Pediatrics, a peer-reviewed medical journal, was the first to quantify the psychological trauma diaper need has on parents, some who reported leaving their children in soiled diapers for extended periods when they couldn’t find any, leading to urinary tract infections and diaper rash. Some parents skipped meals in order to pay for diapers. Mothers are the ones most affected.
“Because women are much more likely to be burdened by poverty … it becomes an issue that is not gender neutral,” said Megan Smith, the lead researcher in the Pediatrics study. “[Diaper need] was really just all-consuming for the mothers we talked to.”
The cost of diapers skyrocketed during the pandemic. about 14 percentAccording to a Nielsen survey, the average price of a pack is $9. Colley explained that a Family Dollar pack cost $9 months ago. Now it’s $11. It is now $11.
Colley can recall many instances when frustration over diapers turned into anger. The questions from others are almost always the same: Why did she have kids, if she couldn’t afford the diapers? Her family did OK when she had her older children and was OK again when she had her third child. But poverty is not an identity — it’s a state, one you can move in and out of.
This country is facing a silent struggle to provide diapers. Unlike with food and clothes, diapers cannot be rationed or modified — the option is a disposable diaper or a cloth one, an expense that doesn’t qualify for federal aid under most public assistance programs, including food stamps.
That’s where organizations like the Diaper Bank of the Ozarks step in.
The welfare reform of the mid-1990s removed the cash assistance program that most low-income families relied upon and replaced it by Temporary Assistance for Needy Families. This program is now available to less than a quarter the low-income families. Shortly after, in the early 2000s, diaper banks — which collect diapers and distribute them to families in need for free — started popping up. The National Diaper Bank Network was established to support banks across the country in 2011. It was also created by Jill Bright, a former British nurse who discovered about diaper need at a conference. Bright brought the idea back to Springfield.
The bank began in a closet of a nonprofit with seven partner agencies. It distributed 50,000 diapers that first year. It exploded after that. Distribution doubled each year for the first two years. In 2021, it’s on track to distribute 1.2 million diapers through 105 partner agencies, covering one of the largest areas of any bank in the country — 50,000 square miles across 50 counties in the Ozarks — a region mostly made up of southern Missouri and northern Arkansas — into communities with only a couple hundred residents. It is the model for rural diaper banks distribution.
And yet, “it’s not good enough,” said Kelly Paparella, the bank’s assistant executive director who, along with Brown, represent the two paid staffers at the Diaper Bank of the Ozarks (both named Kelly). “We’re really looking at the gaps — who are the people who really need the services? — because we know that there’s inequities.”
However, the public and political will have not been there to address the problem. Banks like the one in Missouri continue their grassroots efforts to reach the most vulnerable areas of the state, even though they don’t have the resources to do so.
The Diaper Bank of the Ozarks conducted a study recently to determine how many diapers they could distribute to provide supplemental care for children with low incomes in their region. The number wasn’t the 1.2 million they’ll distribute this year, an all-time high — not even close.
It was 27 millions.
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After the distribution in Forsyth, the Kellys hop back into their van and chart a course into the mountains toward Branson, a tourist town about 30 minutes away, known for its profusion of theaters, motels and family-style amusements — mini-golf courses, zip lines, thematic museums.
Another food pantry is run by a Christian organization. The line of cars is already half-dozen deep when the van pulls in. This is long before distribution begins. They go car by car, asking if anyone needs diapers for their kids — or their grandkids. Meth addictionMany children lost their parents because of this. The Ozarks diaper banks helps about 20 percent of the elderly who care for grandchildren and are on fixed income.
Brown and Paparella meet Heather Reeves, a grandmother of three children under 3, who can’t afford diapers with the income she gets from her disability payments. She depends on the bank to buy diapers twice per month.
Sommer Guthrie’s boyfriend, Colby Ball and a couple of diapers are given to them by Sommer Guthrie. They stop by their 3-year-old every month. Ball works at LongHorn Steakhouse. She lives in a hotel with her roommate. Guthrie has tried to look for work, but the pay wouldn’t be enough to cover day care. When her son, then a baby, was born, she asked the staff at the food pantry if they had diapers. Surprised, they did. She’s been coming back consistently since.
The Kellys can see the relief on the faces of grandparents and parents when they give diapers to them. This is why they call this their calling.
“I found a role in my piece to be able to tackle poverty because I, too, was just completely dumbfounded [when I learned about diaper need],” Paparella said. “Everyone knows diapers are expensive. We joke about it: You’re pregnant and immediately the first thing was, ‘Oh wait ‘til you have to buy diapers.’”
Parents are often surprised to learn that assistance programs like WIC or food stamps, the supplemental program for low income women and children, can’t be used to purchase diapers. Both are nutritional assistance programs, and diapers don’t qualify because they are considered a hygiene product. Medicaid won’t cover them unless a doctor deems them “medically necessary” to treat a specific ailment like diaper rash, which can arise from parents not having enough diapers in the first place.
Only TANF provides cash assistance to low-income families. This could possibly be used for diapers. But TANF is difficult to apply or qualify for, and it’s increasingly shrinking — in Missouri, only about 9 percent of the state’s TANF funds are spent on cash assistance for families.
The poverty tax is another consideration. Bulk diapers are significantly cheaper per unit if purchased in bulk. However families will need to spend more upfront or join a big-box retailer such as Costco to get bulk discounts. Kelley Massengale, North Carolina’s researcher, stated that while a single diaper might cost $1.50, bulk can bring down the cost to as low as a quarter per unit.
The result of that inability to buy diapers in bulk shows up in just how much diapers soak up in a low-income family’s budget. According to an analysis, the poorest 20% of families spent almost 14 percent of their household income on diapers in 2014. analysis by the Center for Economic and Policy Research. The diapers consumed only 3 percent of the income for middle-income families.
That reality, though, is hard to convey in southwest Missouri, where the concept of giving away diapers for free is often met with questions about why parents aren’t “just” doing cloth instead, or why the parents aren’t working, why they had a child if they couldn’t afford the diapers.
Laura Mowery, who heads one of the Ozark bank’s partner agencies, a mobile unit that carries diapers to rural towns, said the struggles low-income families endure have been oversimplified to the point that some people internalize beliefs about what families should be able to do. When her church first asked for diaper donations, she did it herself.
“I myself swept it under the rug because I thought, ‘I’m not buying diapers. If you want them, go to work,’” Mowery said. “But let’s say you do have a kid and you are working — you’re working every day — but you have to pay your rent, and your utilities. Where’s your food money? Where’s your diapers? People really need to understand there’s more than just, ‘Get a job’ for these parents.”
Two-thirds (33%) of diaper-need families are employed. Some of them can’t work because, without diapers, they can’t put their children in child care. Day cares typically change children’s diapers every two hours, and parents are expected to provide enough diapers up front to last the day. According to a 2017 study, 7 percent of North Carolina diaper bank recipients reported that they had to miss work due to diaper need. 15% of those parents said that diapers allowed them to return work or school, while 18% said they were able to send their children to child care.
The Ozarks diaper bank provides diapers to child care centers to have on hand in case a parent doesn’t have the necessary amount. Paparella said they realized parents weren’t changing their kids at home to ensure they could still go. One day care center would put a Sharpie mark on infants’ last diaper change of the day, and sometimes, that same diaper came back the next morning.
The bank’s cloth program, which Paparella leads and will talk about for hours if you get her started, also helps provide crucial services for parents. Cloth diapers can be reusable but cost from a few dollars to $30 per pack. Parents need about two dozen. The bank provides all cloth diapers for parents until their child is potty-trained, eliminating the need to pay high prices.
Paparella runs a class at the bank educating about the cost savings in the long run with cloth diapers and the best ways to wash them (you can’t use softener, for one). According to the bank, the 64 cloth diapers it distributed last year would have provided approximately 600,000. But cloth isn’t for everyone: Some laundry facilities and day cares won’t accept them, and they are difficult to transport on public transit if you don’t have a car or a washer and dryer at home.
The Ozarks Bank has worked hard to provide education and expand its reach with the resources it has. Paparella joined in 2017 to serve 15 counties. The bank served 30 counties the following year. Now, 65. Out here, where towns are far apart and most families still don’t know the diaper bank exists, their work is difficult. Most parents who visited Branson and Forsyth were surprised to learn that diapers could be purchased at the food pantries.
“Just like it takes a village to raise a child, it takes all of the collaborations of organizations and agencies in those communities to reach families,” Brown said. “Some of our partners travel four hours one-way to come get diapers, so we are dependent on them to carry out that mission in their community.”
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While research on diapers remains in its infancy, Massengale is helping to conduct an extensive nationwide study with the help 60 diaper banks (including the one in Ozarks), which will survey as many as 11,000.
The data could pave the road for more policy, showing that “whenever there is a diaper bank in a community, it’s helping to meet this basic human need for families,” Massengale said. “It’s also saving our health care system dollars, it’s providing access to early childhood education, it’s keeping families in the workforce.”
Currently, diaper needs are met with indifference and more and more families report being unable to provide enough food for their children. However, policy supporters claim that it protects children has seen a dramatic rise.
More states have passed laws restricting abortion in 2021 over the past year. than any other time in American history. After Texas, where a new law all but eliminates abortion access, Missouri’s patchwork of regulations is considered among the harshest in the country.
Many people specifically citeTheir inability to support their families financially is one reason they choose abortion. There is much less debate about what needs to be done to support families once a child is born.
Joanne Goldblum, the CEO of the National Diaper Bank Network — which now counts more than 225 members — estimates demand for diapers has grown 86 percent during the pandemic. Nationwide some diaper banks reported doubling their distribution; At one of the Ozark bank’s partner agencies in Ash Grove, a town of 1,400 a half hour outside Springfield, the number of families needing diapers has doubled, said Pattie Moulin, who runs the diaper pantry from the town’s United Methodist Presbyterian Church. Before March 2020 they were serving maybe 17 or 18 local families — now it’s 40.
The collision of those two things — a rise in poverty while abortion access shrinks — incites a complicated question about American ideology: Does the sanctity of life end after those first cries if, in practice, the United States fails to support children once they are out of the womb? Rural areas are where abortion is decried and aid is essential, it becomes even more complicated.
“We’re very pro-life [in this region],” Paparella said. “You want to protect the unborn baby, but we need to protect the baby that’s born afterwards.”
Colley, the mom of five, is religious and doesn’t support abortion, but she can understand why someone would get one.
“You just gotta understand how hard it is for people to raise children in this world these days with no support,” she said. “If we’re making anti-abortion laws, we need to support the children that are here more.”
Despite a handful of bills being introduced to help diaper banks, there has been little concrete action at the federal government to address diaper need. It’s low-hanging fruit, advocates argue, that could help significantly reduce diaper need in the country. Most banks, such as the one in Ozarks, run almost entirely by volunteers. They are managed by a few paid employees with a budget of around two hundred thousand dollars per year.
Nevertheless, the need is not decreasing or new. It’s a window into poverty, Goldblum said.
“I know that diapers are not the answer to ending homelessness, but sometimes diapers can be the difference for one family,” she said. “I think that’s what’s powerful about this — we are talking about basic human dignity. We’re not talking about complicated issues.”
There were moments during the pandemic that diaper need suddenly rose to national prominence. Major publications published stories about the event. cost of diapers rising; About big-box retailers running out of supplies; About a father stealing a box for his kidsHis parents rallied support and reacted with anger to the police’s actions. It’s the kind of moment-in-time focus that also happened after the Great Recession, when President Barack Obama called for ending diaper need.
Two bipartisan bills were presented this year, which was the first time Republicans had cosponsored legislation.
Republican Sen. Joni Ernst and Democratic Sen. Chris Murphy cosponsored a bill that would provide $200,000,000 in aid to diaper banks in response to the pandemic. Republican Senator Kevin Cramer and Sen. Tammy Duckworth, a Democrat introduced companion legislation in Senate to the End Diaper Need Act. This is a bill that Rosa DeLauro (Rep. Barbara Lee) have been pushing in this House for years. It would provide ongoing aid to diaper banks — $200 million a year through 2025 — as well as qualify diapers for use with a health savings account, and allow Medicaid recipients to receive diapers for older children with a medical necessity.
All potential watershed moments, and then — nothing. The bills remain in the record, unmoving. Perhaps there’s still not enough bipartisan support, or political will, or too many other priorities.
“This should be a lay-up,” said Audrey Symes, a volunteer lobbyist for the National Diaper Bank Network. “Why is it not happening? It’s not that expensive.”
This reality has been confronted repeatedly by Goldblum in the 20 years since she founded a diaper bank in New Haven (Connecticut), one of the first banks in the country. After two decades of advocacy, there have been a few legislators who are willing to fight for the cause. There have been a few bills proposed, some movement in some state, but nothing else. She is often still explaining diaper needs to people for first time.
“Legislators tend to think about the big picture and the truth is nobody very much thinks about the little things,” Goldblum said. “But something as small as a diaper — I’ve had people say, ‘This to me can make the difference between being able to make ends meet at the end of the month.’”
Goldblum and the diaper bank lobbyists have advocated for legislation that does away with diapers in food stamps and WIC. They argue that these are food assistance programs that already suffer from inadequate funding. They don’t want to see families weighing whether to use the money to feed or diaper their child. Instead, they want to see individual set-asides (the proposed legislation would be paid through the existing Social Services Block Grant).
Previous attempts at doing this have been ridiculed. DeLauro, a Connecticut Democrat and the first federal bill addressing diaper needs, was introduced in 2011. It proposed that diapers be distributed by the federal government through child care centers. Conservative radio talk show host Rush Limbaugh lambasted DeLauro’s proposal as an example of “nanny-state” legislation that “gives a new meaning to the term ‘pampering the poor.’” Limbaugh argued the bill also left out parents whose kids were not in day care.
Lee, the Democrat from California, has tried a couple different directions, proposing removing sales tax on diapers — something 10 states now do, including California — sending grants to diaper banks and allowing parents to pay for diapers using pre-tax dollars in health savings accounts.
She said some of her fellow members of Congress have laughed at the idea, “They said, ‘OK Barbara, diapers? Why diapers?’” Lee said. It’s the same people who passionately decry abortion, and yet diapers has not been able to drum up the same attention, she said.
DeLauro is an expert on this road. This year, legislation to expand the child tax credit to the poorest families, something she’s been championing for decades with little bipartisan support until quite recently, finally passed. Parents have reported using the funds — up to $360 a month for the youngest children — for diapers.
But the child tax credit expansion is currently just for a year, and, besides, it’s not a targeted solution to diaper need, she said.
“People feel it’s not a front-burner issue,” DeLauro said. “With the child tax credit, it wasn’t opposition, but it was indifference. That may be the case here.”
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Kelly Paparella receives a call from Branson.
A mom in her cloth diaper program, Desiree Abbott, has just been to the doctor with her 10-month-old son and learned he’s allergic to coconut oil, the replacement for diaper rash cream that Paparella suggests parents use with cloth diapers. (It’s one of the main ingredients in most creams, and it’s better for the diapers). She doesn’t have any disposable diapers for the baby.
Abbott lives in a hotel room with Steven Bryant, her husband, and their 2-year-old son.
“So, the address, we’re gonna text it to you, OK?” Paparella tells her from outside the food pantry. “You can just click it and get on over here, and you guys can get some food and diapers today.”
Abbott is only 25, but Bryant, 26 has faced more adversity than most people in their lifetime.
She worked three jobs and took care of her grandfather, who was sick, when her eldest child was born. She was only a teenager. Her uncle eventually adopted her son. Abbott was seven-weeks pregnant with her youngest child when doctors discovered an infection in her left ear bone. This resulted in partial facial paralysis. As she underwent treatment, she showed up to her job at McDonald’s with a picc line in her arm.
“I can’t not provide for my kids,” Abbott said. Because her middle son was battling severe pneumonia, she missed work and lost her job as a housekeeper.
They tried cloth diapers to save some money, and now even that isn’t quite working
Before Abbott arrives, Paparella prepares herself. Kelly Brown is told by Paparella that she and Abbott happen to be in Branson the same day. But her job is tricky — she isn’t just distributing diapers. Sometimes, she’s acting as the connective tissue and different forms of aid. Paparella wants to help parents be self-sufficient, and some of that means keeping them accountable, making sure they are reaching out for all the help that’s available to them. Building trust is key.
She immediately recognizes Abbott when her car pulls up in front of the line outside the pantry. A big, black stroller is strapped to the top of her red Nissan. The two boys are sitting in the back, wearing matching tie dye shorts and tank tops.
After volunteers have packed the back seat of the car to the roof with diapers, wipes, and other necessities Bryant takes the boys to a nearby park where Paparella discusses with Abbott.
They have two nights to stay in their hotel and then have to move on. Some people have suggested she leave the kids at Isabel’s House in Springfield, an emergency services shelter. Abbott is concerned that it could cost her custody. It could signal she isn’t fit to care for them.
Paparella also urges Abbott to leave the kids at Isabel’s House. It won’t put her custody in jeopardy, she tells her.
“To put myself in your shoes,” Paparella tells her, gently, “I would understand completely, because when I first learned about that, I was like, ‘Oh my goodness, how do you build trust with somebody to allow your kids to be staying with them?’ When you meet the staff and when you see what’s going on in there, they want and encourage you to want to come all the time. That’s why I want you guys to move to Springfield.”
Paparella tried to encourage them to move from rural Missouri to where the aid is concentrated and where they can be reached. She wants Abbott to be connected to every resource available, because “one thing I understand, in everything that you’ve ever said is, this is your life,” Paparella tells her, motioning with her index finger at Abbott’s family in the distance.
Abbott and Bryant’s lives are so clearly built around their children. It’s purposeful: Bryant didn’t grow up with his dad, and being a father felt like a calling for him long before he became one. He carried the positive pregnancy test in his pocket when he and Abbott discovered they were pregnant with their first child. On his left bicep is a tattoo that reads “Ohana.” Family.
When they’ve had diapers, things are OK, they can provide. When they haven’t, they’ve fallen into periods of severe depression.
It’s so upsetting, Bryant struggles to find the words to describe it. “It’s emotional,” Abbott says. “At that point, it makes me think, maybe my kids are better with someone else.”
Their diapers are a symbol for who they are as parents. Without them, who would they be without them?