Saturday September 24th 2022

Nappy-free babies? Elimination Communication is the key

Trendy toilet training or practical parenting?

When four-month-old Liam feels the urge to go, his mother is one step ahead of him. She simply pops him on the potty, where he makes a deposit in a matter of seconds. The difference between Liam and other babies his age is that he’s virtually nappy-free – and likely to be fully toilet-trained by nine months to a year.

Impossible? Not according to supporters of elimination communication (EC), a small – but growing – movement that’s gaining popularity among modern moms in Europe and the United States.

EC is based on the principle that caregivers use timing, signals and “gut instinct” to determine when a baby needs to urinate or perform a bowel movement. Also known as natural infant hygiene, it is similar to “toilet practices” in traditional societies, which do not use nappies.

The terms EC and natural infant hygiene were coined by author Ingrid Bauer (Diaper Free! The Gentle Wisdom of Natural Infant Hygiene, 2001) following her travels to India and Africa, where she witnessed mothers carrying their nappy-free babies all day, with no “elimination” accidents. She applied her observations to her own parenting and claimed that EC was a natural, normal process that could be successfully practised by anyone.

EC is started between birth and six months, with experts cautioning that training begun after six months is likely to be more difficult, as babies have lost their natural ability to “signal” and will be more inclined to use their nappies for elimination.

A lifestyle – not a training tool

Fans of EC are often people who prefer “natural” parenting methods such as breastfeeding, co-sleeping and baby-wearing. The limited use of nappies – particularly disposables – is seen by environmentally-aware parents as an important stand against pollution.

A British television show recently highlighted the movement as a slightly “whacky” alternative to potty training, with some parents allowing their children to deposit bowel movements on the kitchen floor.

EC parents, however, deny that babies are left to their own devices or allowed to run (or crawl!) wild, arguing that this gentle, effective communication method results in better hygiene, a healthier environment and far less money wasted on expensive packs of disposables.

American anthropologist Meredith F. Small, author of Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent (1999), says that EC is a fancy term for “paying attention”. We should, she says, pick up a baby’s elimination cues in the same way that we recognise hunger, tiredness or emotional signals.

Dr Small says the idea of EC is nothing new – parents in parts of China, India and Kenya dress their babies in normal pants or allow them to run about naked from the waist down. When they signal a desire to “go”, they are held or squatted over a designated area immediately.

The difference between babies in these cultures and western society is that traditional parenting promotes strong bonding, while modern methods encourage independence. Traditional practices such as baby-wearing, for example, encourage caregiver and child to interact more intimately, meaning a mother can easily tell when a baby is squirming or feels warmer – possible signs that he needs the toilet.

The use of nappies is also so culturally entrenched in western society, that parents don’t really see any alternative to investing in disposables or towelling cloths for a good two to three years, she says.

So how does it work?

Zara, 31, mom to five-month-old Joshua, says she and her husband Mike have been successfully practising EC with their son since he was a few weeks old.

“Babies have an awareness of their elimination needs until five or six months, at which point they stop signalling if they have learned that their signals are ignored, and the place to go is their nappy,” she explains.

“But babies that are held over a potty when they need to urinate or have a bowel movement learn to connect this with its function and so a pattern is set. While early toilet independence is a positive outcome, it’s not the goal. The purpose is to meet their hygiene needs in the present moment.”

Zara had never heard of EC before discovering it on the internet. “I’d just assumed that I’d use cloth nappies and do toilet-training later. But after reading other people’s stories, I thought I’d give it a try.

“The first time I held Josh over a bowl, he did a wee within thirty seconds – so after that I was hooked! My husband was interested and once he saw the proof, he thought it was great too.”

Zara says there are essentially three ways to learn when a baby needs to use the toilet :

l  Involuntary physical signals such as going still, getting louder, bobbing on and off the breast and kicking legs madly while lying on the back. Bowel movements are often quite obvious to parents and generally easiest to get in the potty or toilet. Baby sign language (signing) can also be used to communicate.

  • Timing – usually when baby wakes in the morning, after naps, 10 – 20 minutes after a feed, before or after a bath.
  • Intuition – mothers get “a feeling” that baby needs to go. This occurs as a thought or, if you are holding her, your lap might feel warm before a wee.

This two-way communication process involves baby “signalling” and parent responding by giving opportunities and cueing the baby by holding her over a toilet, bowl or potty – usually making a “ssss” sound or running a tap.

Parents can choose to do EC full-time – aiming to get all wee and bowel movements in the potty day and night – or part-time, which involves only the mornings or afternoons, or only using timings. The part-time option often suits working mothers.

Zara says parents may also put cloth nappies on their babies and them remove them as needed, put a nappy under them while sitting or have no nappy at all. Cloth is obviously preferable to disposables, as the latter tend to keep baby dry, thus inhibiting his sense of being wet or uncomfortable.

Joshua and the potty

“I started doing EC with Josh at four weeks,” says Zara. “I began by holding him over a bowl first thing in the morning, when he woke up. To learn his signals, I stopped using a cover over his cloth nappies, so it was immediately clear when he had done a wee.”

If he eliminated in his nappy, Zara recorded what he had been doing immediately beforehand and also changed his nappy quickly to stop him getting used to the feeling of being wet.

“To learn his timings, I recorded his feeds and sleeps. Intuition just comes the more you do EC as well – you just ‘know’ when they need to go.”

Generally, the family feels EC has been successful. Teething, social disruptions and developmental stages can result in babies not signalling, but the whole process is a learning curve, she says.

Zara says people have been quite supportive – particularly the older generation, who all started similar potty-training techniques much earlier than modern parents do today.

The benefits

“The most important reason for me is that I don’t want Josh to sit in his poo or wee,” Zara says. “I am taking care of his hygiene needs. He might not be able to verbally communicate his needs, but in the same way that he can’t verbalise his hunger or comfort needs, I learn to read his signals and meet those needs.”

EC parents say that is much easier to keep babies aware of their elimination signals at a young age than forcing them to re-learn it at toddler stage – the usual age for potty-training.

The physical benefits include no nappy rash and learning to “release” rather than “hold it in”. Emotionally, say parents, it provides the same sense of bonding as breastfeeding does.

The financial pay-offs are obvious, while the environmental impact of nappies is greatly reduced.

The drawbacks

It does require commitment and may inconvenience working parents or those who would prefer to simply slap on a disposable and be done with it.

Visiting family or travelling can also put a halt on the process, while criticism and peer pressure could result in parents shying away from trying something radically different.

Many people may only hear of EC – or decide to do it – after six months. This is more difficult than starting with a young baby. However, says Zara, the basic principles of offering opportunities on the potty and learning to work with timings are the best techniques to employ at this age, as the other signals are likely to be lost after the age of six months.

Want to give it a go?

Zara has a simple tip for parents keen to venture into the world of EC.

Regardless of age, a good way to start off is to hold your baby over the toilet, potty or bowl as soon as she wakes up in the morning.

Monitor what happens and then take it from there, deciding what would work best in your family situation. A part-time approach would be suitable for first-timers – you could do the morning potty routine and then try again after a nap or just before bed.

With commitment and a little women’s intuition, you may be buying your last pack of nappies sooner than you think.

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© Beth Cooper, 2010