Chelesa Presley is deeply familiar with the struggles of young families, first from her years as a social worker and now from running a nonprofit in one of Mississippi’s poorest regions. She’s used to the questions about car seats, nursing and colicky babies, but paying for diapers is always the chronic and most pressing worry.

“I see parents not putting anything on their babies because they don’t have diapers,” she said. “I’ve seen people use shopping bags with some rags in it. I’ve seen T-shirts. I’ve seen people keeping the diapers on longer than necessary, and the diapers sag down when the babies walk.”

As founder and executive director of Diaper Bank of the Delta, Presley is part of a grass-roots support network at the forefront of a crisis: Requests have doubled, tripled and even quadrupled at some locations, social services workers say, with diaper shortages and families lining up for hours in some communities. Meanwhile, the cash and in-kind donations that keep diaper banks afloat have slumped, and their mostly volunteer workforce has shriveled since the pandemic.

Diaper need is an often-overlooked measure of Americans’ economic reversals, said Joanne Samuel Goldblum, chief executive and founder of the National Diaper Bank Network. There are so many people “who do not have enough money to meet their basic needs, and what we’ve found is that diaper need is a window into poverty.”

Historically, most diaper bank clients live below the poverty line, a federal threshold capped at $26,500 a year for a family of four. One in 3 U.S. families could not afford diapers even before the coronavirus outbreak. But once the pandemic set in, and millions of Americans lost their jobs, the nation descended into a recession that disproportionately affected women and low-wage earners, leaving many to contend with eviction, debt and food insecurity. The initial round of federal stimulus kept 17 million people out of poverty, but millions remain vulnerable while waiting for additional relief.

“The people who lost their jobs first were retail and hospitality workers, which actually employs a lot of families that diaper banks serve and tend to be women,” said Audrey Symes, a volunteer at Good+Foundation in New York.

The pandemic also led to school closures and upended child-care arrangements, forcing guardians to leave jobs to tend to their preschoolers and adapt to remote learning. And families that lost access to publicly funded day care also lost access to the free diapers they typically provide.

In 2020, the National Diaper Bank Network distributed more than 100 million diapers to 220 diaper banks across the country, a 67 percent spike year-over-year. Most public aid programs don’t cover diapers, which run about $80 a month per child.

Presley says she opened Diaper Bank of the Delta in 2016, a year after she and 10 community volunteers spent Mother’s Day weekend camped outside the Clarksdale Walmart — the most central gathering place in the Mississippi town of 15,000 — to address the growing need they saw in their community. They collected $2,000 and three truckloads of diapers and wipes.

Over time, the nonprofit expanded its services and became a safe space for families trying to navigate poverty, Presley said. It has helped dozens of homeless women, many living in their cars, find housing, and aided clients in securing employment, GEDs, driver’s licenses and auto insurance. Her team also has worked with victims of domestic violence and trafficking.

In 2019, Presley’s group distributed 75,000 diapers to nearly 2,000 families on a $25,000 budget. Presley said she went into 2020 hoping to raise $35,000, but the pandemic shut off donations and moved the nonprofit to expand its service area far beyond north Mississippi: down by the coast near Biloxi, to Choctaw Indian communities, a homeless encampment in Jackson, students at Rust College in Holly Springs. It started mailing diapers to its most far-flung clients, though some of those packages have been snagged by U.S. Postal Service delays.

The nonprofit gave away 300,000 diapers in 2020, four times as many as the year before. Presley says she hasn’t taken a paycheck since March.

Corinne Cannon, who operates the Greater DC Diaper Bank in Washington, says her network also is severely stretched. That’s unlikely to change, even with the ongoing vaccine rollout that is expected to usher in new economic growth. Many of her diaper bank clients have been on its rolls since the last recession in 2009.

“Our families didn’t bounce. Our families hit,” Cannon said. “The families that we work with are going to be seeing the effects of this for five or six years.”

Pandemic stresses already fragile support system

The pandemic set off panic buying in March and April and put a strain on the supply chain. “It was hard for anyone to get diapers during 2020,” said Katherine Snider, executive director of the Good+Foundation, which operates diaper banks in New York and Los Angeles, concentrating on communities like Compton and East Harlem without easy access to large retailers.

“Those families rely on their local bodega for diapers, and they just weren’t on the shelves,” she said.

Cannon said diaper orders took as long as three months to arrive during the worst of the backlog. She says demand is up more than threefold since the pandemic: from more than 150,000 diapers a month to 550,000. The Greater DC Diaper Bank also serves upward of 25,000 families, compared with 10,000 before.

Melba Turner had been getting a monthly allotment for her two great-grandchildren from the Metropolitan Detroit Diaper Bank, allowing her to apply the savings to food and baby clothes. “The diapers and the wipes are very expensive,” Turner said. “It was a great help.” But it’s been months since she’s been able to get more. The child-care center that distributes them had to cut back because of the volume of new requests.

Most commercial child-care centers and babysitters require families to provide diapers, so a shortfall can make a difference in a parent’s ability to earn an income. Data collected by the Census Bureau shows that at least 10 million children have a family member who is unemployed or lacks paid work because of the pandemic, according to the Center on Budget and Policy Priorities.

Diaper need can have significant health implications, because keeping babies and toddlers in diapers too long — or washing and reusing disposable ones can lead to painful rashes, urinary tract infections and emergency room trips. A Yale University study found that it is a major indicator of maternal stress and depression, which can affect a child’s development and increase the likelihood of multigenerational poverty.

“An adequate supply of diapers may prove to be a tangible way of reducing parenting stress and increasing parenting sense of competency, enabling parents to be more sensitive with their children, and thereby improving parenting quality and overall child outcomes,” according to the 2013 research.

Diaper banks also are seeing huge spikes in demand for other hygiene products, especially for senior citizens. Michelle Old, founder of the Diaper Bank of North Carolina, said diaper distributions jumped 400 percent while those for menstrual and adult incontinence products swelled 800 percent and 2,000 percent, respectively.

How diaper banks seek to bridge the gap

Many diaper banks have come up with new distribution methods to cope with the sharp drop in volunteers and rise of homebound families, both groups avoiding in-person contact because of the coronavirus risk. Cannon said the Greater DC Diaper Bank would bring in 1,000 regular volunteers over the course of a year to help with diaper distribution. Since March, they’ve had 12.

Diaper banks have had to adapt to reach their clients. They have tapped mobile distributors, erected emergency diaper hubs at food pantries, and made use of drive-throughs, porch drop-offs and the U.S. Postal Service.

Diaper bank directors — who work in concert with churches, day cares and social services programs — say diapers can help social workers build trust with vulnerable families and, in some cases, incentivize clients to enroll in parenting and nutrition classes, or to sign up for WIC (Special Supplemental Nutrition Program for Women, Infants and Children) and SNAP (Supplemental Nutrition Assistance Program, also known as food stamps) screenings.

Over the summer, Mary Morrissette, a public health nurse in Alameda County, Calif., dropped by the home of a first-time mother she knew to be experiencing domestic abuse. She left diapers and children’s books from Help a Mother Out, a regional diaper bank, on the doorstep with notes of encouragement: Miss you and your baby. Can’t wait to see you again. Call me if you need me. Sending my love.

“I just think it’s nice for them to know that somebody cares and is willing to show up,” she said, “and the diapers are this perfect conduit.”

Dropping off diapers every two weeks was her only way of checking in, Morrissette said, and maintaining that connection was vital. The mom, with help from the county’s mental health team, has since moved away with the baby and is taking early-childhood education classes.

Veronica Claybrone, executive director of the Metropolitan Detroit Diaper Bank, said she dislikes the incentivization model because she thinks it’s rooted in judgment — akin to the reproach she senses when public officials ask her why people have children if they’re poor. While acknowledging the importance of wraparound services for families, she said the focus should be on filling an essential need, not on why that need exists.

“We have girls not going to school because they don’t have the supplies to stay in school while they’re menstruating, and we have people with babies who don’t have what they need to stay clean and dry,” Claybrone said. “I just don’t like the fact that diapers are used to incentivize people to do stuff. The babies need them, and the parents might not want to do anything, but they still deserve diapers.”

Such groups also get pushback for not using cloth diapers. That’s mainly because child-care centers only accept disposables. Cloth diapers are also prohibited at laundromats and laundry rooms in apartment complexes.

Plus, parents should be able to decide what kind of diapers to use, said Lisa Truong, founder and executive director of Help a Mother Out. “I’m not rich, but I had the capacity. I could go to Target and I could buy whatever diaper brand I wanted,” she said. “I’m not going to ask a mom who’s living in a cramped, one-room apartment with laundry services to use cloth diapers.”

But Kelly Paparella, program director for Diaper Bank of the Ozarks, which serves 59 counties in Missouri, Arkansas, Kansas and Oklahoma, contends that cloth is more economical and environmentally friendly. Though the bank mostly distributes disposables, Paparella said, its cloth diaper loan program gave away 64 kits, each containing 24 cloth diapers, last year, saving 615,000 disposables. It also offers a virtual class on the proper way to hand-wash cloth diapers.

A public problem without a public solution

Antonette Smith in Westchester County, N.Y., receives 50 diapers a month from the local diaper bank for her 11-month-old son. She lost her job in March, just after returning from maternity leave. She’s now a full-time student, studying nutrition at Lehman College in the Bronx.

She wants lawmakers to do more to help regular people. “These are the future of the country and whatever ways we can do to assist them at a tender age, I’m sure they can grow up and serve the country.”

No federal aid or welfare program covers diapers — not WIC, SNAP or cash assistance. States can distribute Temporary Assistance for Needy Families (TANF) funds for that purpose, but that’s a fixed pot of money that legislators decide how to distribute.

That’s what led to the formation of the National Diaper Bank Network in 2010, Samuel Goldblum said. The Connecticut-based nonprofit relies heavily on funding and in-kind donations from Kimberly-Clark, the owner of Huggies and U by Kotex. Huggies provides the network with 20 million diapers a year and has donated $1.25 million since 2011. “We knew immediately we wanted to be a small part in the fight to end diaper need,” said Robert Raines, the general manager for Huggies North America, and “help raise awareness of this important public health issue.”

But most advocates say diaper banks need a more sustainable model, one that is less reliant on corporate giving, individual donations and the time-sucking process of grant writing, as evidenced in a year when volunteer and smaller donor aid dried up. There needs to be some government funding, they say.

Help a Mother Out, which got its start in 2009 as a scrappy group of moms with extra diapers to share in California’s Bay Area, was the first in the country to receive public funds, Truong said. The 2015 partnership with the city and county of San Francisco allocated state funding for diapers.

Phillip Vander Klay, the National Diaper Bank Network’s director of policy and government affairs, has lobbied Congress to include diaper funding in stimulus aid since the beginning of the pandemic, without success. Earlier in February, Sens. Chris Murphy (D-Conn.) and Joni Ernst (R-Iowa) introduced the COVID-19 Diaper Assistance Act to devote $200 million through the Social Services Block Grant program for families struggling to afford diapers during the pandemic. A bipartisan bill previously failed in the chamber.

“There just hasn’t been any support from the federal government on this,” Vander Klay said. “I don’t know how much longer our member diaper banks will be able to meet those needs. Eventually, donor fatigue will set in.”