Yes, all those things have to be purchased. They are not cheap. We have to get a nice little stock built up so that we can save some money during the school year. Not one of those it's taking over my house stockpiles, just enough so that I don't have to go to the store for the same thing repeatedly. Pull-ups are hard to stock up on because of the initial expense and the fact that the child is still growing but I know people that could use them in the near future.