Tens of thousands of low-income local families struggle to afford diapers, a little-known need not covered by federal assistance.

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When Slena Mackowski’s 11-year-old daughter, Mya, was a baby, diapers were the least of the Kirkland mom’s worries.

She was married then, living in a nice house, with a nice car, and she would buy big boxes of Huggies at Costco, barely aware of what it cost to keep her child dry and clean.

“It didn’t matter,” she said. “I’d never been in a situation where money was a worry.”

Where to get diapers and how to help

For information about obtaining diapers — or donating to help — contact WestSide Baby in Seattle at www.westsidebaby.org or Eastside Baby Corner in Issaquah at www.babycorner.org. The agencies especially need diapers in size 6, which fit 12- to 18-month-old toddlers. In addition to diapers, both agencies provide other basic necessities for children and families.

Now, however, two years after a difficult divorce, Mackowski, 39, is unemployed and living on public assistance while she cares for her second daughter, Myrya, 16 months. This time, she said, affording diapers is a constant struggle.

“It’s like being on a different planet, being on this side of the fence,” she said. “I get $420 a month and diapers cost $100. It’s impossible.”

Mackowski is among tens of thousands of low-income local parents coping with diaper need, an underrecognized consequence of poverty that experts say can result in unhealthy babies, family stress and maternal depression.

“It’s a national problem. Everyone believes someone else is helping,” said Nancy Woodland, executive director of WestSide Baby, a Seattle diaper bank that provides more than 1 million diapers a year to agencies that help parents like Mackowski make ends meet.

Diapers are a staple, with babies needing seven to 12 changes a day, at a cost of about $900 to $1,200 a year. But government-assistance programs — including Supplemental Nutrition Insurance Program (SNAP) and Women, Infants and Children (WIC) — won’t pay for them.

Without a prepurchased supply of diapers, parents can’t enroll children in day care — which often means they can’t work, added Renee Zimmerman, executive director of Eastside Baby Corner, another local bank based in Issaquah.

“Diapers become a huge barrier,” she said.

To avert the need, the two local agencies expect to provide about 2 million diapers to area families this year, funneling stacks of Huggies, Seventh Generation and other brands through dozens of area food banks and social-service agencies.

They get diapers as part of the National Diaper Bank Network (NDBN), which includes about 300 banks nationwide, including seven in Washington state. And they rely hugely on local donations.

The diapers are mostly disposables. Cloth diapers are available, but low-income families may find they’re not a realistic option. Laundromats and some apartment buildings ban diapers and other items soiled with human waste, said Joanne Goldblum, executive director of the Connecticut-based NDBN. And, even if diapers are allowed, the cost of using them is high.

Diaper need is predictably linked to poverty, the experts said. In King County, 11.5 percent of residents lived below the federal poverty level in 2013, a rate that jumped to 30 percent among households with children headed by women.

Although WestSide Baby has been in business for 15 years, and Eastside Baby Corner has existed for 25 years, there’s still too little awareness of the extent of the problem, the directors said.

“It’s sort of a silly thing to talk about. It evokes jokes immediately,” Woodland said. “But it requires a serious conversation about human waste.”

Research shows a shortage of diapers is anything but silly. About 30 percent of women in a 2013 study by Yale University researchers reported the problem, and about 8 percent of them reported “stretching” diapers, said Megan Smith, an assistant professor of psychiatry and child study at the Yale School of Medicine.

That means the women routinely kept diapers on babies longer than recommended, or emptied solids from soiled diapers and used them again. Woodland said she’s seen families resort to wrapping their babies in newspaper secured with rubber bands or fashioning diapers out of plastic bags and paper towels.

But stretching diapers can cause health problems, including urinary-tract infections and diaper dermatitis — severe diaper rash — in babies. And it also can make them miserable.

“Crying and screaming babies offer a level of stress that is difficult for families that are not struggling,” Woodland noted.

Along with the stress can come depression, according to the Yale study, published in the journal Pediatrics. Moms facing diaper need are more likely to suffer mental-health and behavioral problems, which can affect how they treat their babies.

“When you think of a mother not being able to soothe a crying child, it interferes with that attachment that the mother and child are forming,” Smith said. “It does not allow a mother to feel confident in her parenting abilities and really just increases that stress if a mother cannot soothe by providing a fresh diaper.”

Mackowski said her own experience proves that’s true. She had been a stay-at-home mom during a 10-year-marriage, with no higher education and no recent work experience.

Her divorce was unexpected and contentious, she said. Mackowski found herself with no job, no money and no home. She said that because she couldn’t provide a stable environment, her ex-husband was granted primary custody of their daughter.

Mackowski said she sought help from shelters and churches, and during a troubled time became pregnant. There was no question about keeping the baby, she said, although the future was frightening.

“Not being able to provide the basic necessities for my daughter made me question if I was even suitable to raise her, and if it was even fair to knowingly raise her in poverty as a single parent,” Mackowski said. “You have no idea what it truly feels like until you are a parent that cannot provide diapers for your very own baby.”

Now, Mackowski has found subsidized housing in a comfortable condominium, and she receives help from the federal Temporary Assistance for Needy Families (TANF). Caseworkers with Public Health — Seattle & King County visit regularly and bring up to 45 diapers a week.

“It’s a huge help,” she said.

Mackowski has enrolled at Bellevue College, where she plans to study business so that she can resume working in auto finance and operation, a job she held before her marriage. Myrya will be out of diapers soon, so that will be one less worry.

“It’s an awful feeling to have to worry about diapers,” Mackowski said. “I can’t wait until I’m a productive member of society again.”