Elimination communication (EC) is a practice in which a caregiver uses timing, signals, cues, and intuition to address an
infant's need to eliminate waste. Caregivers try to recognize and respond to babies' bodily needs and enable them to urinate and defecate in an appropriate place (e.g. a toilet). Caregivers may use
diapers (nappies) as a back-up in case of "misses" some or all of the time, or not at all. EC emphasizes communication between the caregiver and child, helping them both become more attuned to the child's innate rhythms and control of urination and defecation. The term "elimination communication" was inspired by traditional practices of diaperless baby care in
less industrialized countries and
hunter-gatherer cultures. Some practitioners of EC begin soon after birth, the optimum window being zero to four months in terms of helping the baby get in tune with their elimination needs, although it can be started with babies of any age. The practice can be done full-time, part-time, or just occasionally.
Origins
Keeping babies clean and dry without diapers is standard practice in many cultures throughout the world. While this practice is only recently becoming known in industrialized societies, it remains the dominant method of baby
hygiene
Hygiene is a series of practices performed to preserve health.
According to the World Health Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases." Personal hygiene refer ...
in non-industrialized ones.
The terms ''elimination communication'' and ''natural infant hygiene'' were coined by Ingrid Bauer and are used interchangeably in her book, ''Diaper Free! The Gentle Wisdom of Natural Infant Hygiene'' (2001). Bauer had traveled to
India
India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
and
Africa
Africa is the world's second-largest and second-most populous continent, after Asia in both cases. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 6% of Earth's total surface area ...
, where she noticed that while most mothers carried their diaperless babies constantly, she saw no elimination "accidents" as would be expected in
industrialized countries where babies wear diapers almost continuously from birth. Subsequently, she raised her own children with minimal use of diapers, and eventually began to share her approach with other mothers and caregivers—initially through Internet-based parenting support groups and eventually through her book and website.
Prior publications introducing
Western
Western may refer to:
Places
*Western, Nebraska, a village in the US
*Western, New York, a town in the US
*Western Creek, Tasmania, a locality in Australia
*Western Junction, Tasmania, a locality in Australia
*Western world, countries that id ...
parents to this practice include the booklet ''Conscious Toilet Training'', by Laurie Boucke (1979), the book ''Trickle Treat: Diaperless Infant Toilet Training Method'', by Laurie Boucke (1991), a pamphlet entitled ''Elimination Timing'', by Natec (1994), and the more extensive ''Infant Potty Training: A Gentle and Primeval Method Adapted to Modern Living'', by Laurie Boucke (2000). Boucke was influenced by an Indian friend who taught her how mothers in India care for babies without diapers, and she adapted the method to fit her Western lifestyle. Boucke later co-produced an in-depth
DVD
The DVD (common abbreviation for Digital Video Disc or Digital Versatile Disc) is a digital optical disc data storage format. It was invented and developed in 1995 and first released on November 1, 1996, in Japan. The medium can store any kind ...
entitled ''Potty Whispering: The Gentle Practice of Infant Potty Training'' (2006) and co-authored articles for medical journals.
While the terms ''elimination communication'' and ''infant potty training'' have become synonymous, many caregivers who practice EC do not consider it to be a form of "training", ''per se''. "Nappyless technique" is a term some mothers in the
UK prefer to describe babies who use a
potty. EC is viewed primarily as a way to meet the baby's present needs and to enhance attachment and communication in general. In that sense, EC is often likened to
breastfeeding
Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...
. "Toilet mastery is, of course, an inevitable consequence", writes Bauer, "Yet it's no more the goal of Natural Infant Hygiene than weaning is the goal of breastfeeding" (2001, p. 217).
Today, one often hears the terms "natural infant hygiene", "infant potty training", "nappy-free", "infant pottying" and "elimination communication" used synonymously.
Benefits
According to ''The Diaper-Free Baby'' by Christine Gross-Loh, EC offers a wide range of advantages. Because EC lessens families' reliance on diapers, this helps reduce the environmental impact of discarding disposable diapers and/or washing cloth diapers, and saves families hundreds, if not thousands, of dollars in disposable diapers. EC babies are free from the problems of conventional diapering such as
diaper rash, diaper change battles, not being able to explore diapered parts of their bodies, vulnerability to
urinary tract infections
A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidne ...
, and potentially delayed or difficult potty training. Gross-Loh also reports that EC promotes a unique and wonderful bond between babies and caregivers.
["The Diaper-Free Baby" by Christine Gross Loh (Los Angeles: Regan, 2007)]
Parents report that the squat or "potty" position that they tend to use to hold their baby in order to go is very comfortable for the baby. The position aligns the
digestive tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
and supports relaxation, as well as contraction of the
pelvic floor
The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the lev ...
muscles, helping babies to release their urine or stool and simultaneously build control of the urinary and anal
sphincter
A sphincter is a circular muscle that normally maintains constriction of a natural body passage or orifice and which relaxes as required by normal physiological functioning. Sphincters are found in many animals. There are over 60 types in the h ...
muscles. This especially helps babies who are suffering from mild
constipation
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
. Many babies find defecating to be an unsettling process, especially as they transition to solid food. With EC, parents hold their infant in a supportive position as they defecate into the toilet or a suitable receptacle, offering loving emotional and physical support during this process.
Criticisms
Conventional potty training advice is based on late 1990s research by
Thomas Berry Brazelton, who introduced the "readiness approach". He writes that "widespread acceptance of readiness and independent toileting have since been supported by clinical experience and resulted in agreement that a child should be ready to participate in toilet training at approximately 18 months of age and be trained completely by 2 or 3 years old." He argues that trying to toilet train before this age could be coercive and therefore psychologically damaging. Brazelton acknowledges that elimination communication is both possible and desirable, but he believes it is difficult to perform in Western society. In particular he cites a mother's return to work as an obstacle to elimination communication. He also argues that parents should not be made to feel guilty if they cannot communicate with their babies in this way. His neutrality on the subject has been questioned since he has worked as a consultant for
Procter & Gamble
The Procter & Gamble Company (P&G) is an American multinational consumer goods corporation headquartered in Cincinnati, Ohio, founded in 1837 by William Procter and James Gamble. It specializes in a wide range of personal health/consumer he ...
, manufacturer of
Pampers
Pampers is a brand of baby and toddler products marketed by Procter & Gamble.
History
In 1961, P&G researcher Victor Mills disliked changing the cloth diapers of his newborn grandchild. He assigned fellow researchers in P&G's Exploratory Divi ...
diapers, including appearing in a Pampers commercial.
Components
The main components of EC are
timing,
signals
In signal processing, a signal is a function that conveys information about a phenomenon. Any quantity that can vary over space or time can be used as a signal to share messages between observers. The ''IEEE Transactions on Signal Processing'' ...
,
cueing, and
intuition
Intuition is the ability to acquire knowledge without recourse to conscious reasoning. Different fields use the word "intuition" in very different ways, including but not limited to: direct access to unconscious knowledge; unconscious cognition; ...
.
Timing
Timing refers to identifying the infant's natural timing of elimination.
Newborns
An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used t ...
tend to
urinate
Urination, also known as micturition, is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, ...
every 10–20 minutes, sometimes very regularly, which makes timing extremely useful. Older babies may still be very regular, or may vary in timing based on when they have last eaten or slept. As infants get older, the time between eliminations will increase. By six months, it is not uncommon for babies to go an hour or more without urinating while awake (babies, like adults, rarely urinate during a deep sleep). Timing varies radically for
defecation, as some infants may have several
bowel movements
Defecation (or defaecation) follows digestion, and is a necessary process by which organisms eliminate a solid, semisolid, or liquid waste material known as feces from the digestive tract via the anus. The act has a variety of names ranging f ...
a day, while others may only have one every few days. Parents report that some babies as young as three months will appear to hold all their bowel movements until they are held in a particular
squat position, as long as this is offered regularly enough. Parents also offer the potty at various times according to routine, e.g. after a feed, after waking, just before bath or bed. In the West, infant potty training historically relied on timing as the main method of training.
Signals
Signals are the baby's way of informing a
caregiver
A caregiver or carer is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commo ...
of an elimination need. Some babies signal very clearly from the beginning, while others may have very subtle signals, or no signal at all. These signals vary widely from one infant to another. Examples include a certain facial expression, a particular cry, squirming, or a sudden unexplained fussiness, among others. Signals are most effectively observed if the baby is left without diapers for the first couple of weeks of starting elimination communication. Babies who are
nursing
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
will often start unlatching and relatching repeatedly as they feed when they need to eliminate. For defecation, many babies may grunt or pass gas as a signal. As babies get older their signals become more conscious and babies often point to, or look at, a caregiver or potty to indicate need. Older babies can learn a gesture or
baby sign for "
potty". Later they may learn a word as part of their early acquisition of language.
Cueing
Cueing consists of the caregiver making a particular sound or other cue when they provide the baby with an opportunity to eliminate. At first, the caregiver can make the cueing sound when the baby is eliminating to develop an association between the sound and the action. Once the association is established, the cue can be used to indicate to the baby that he or she is in an appropriate
potty place. This is especially useful for infants who may not recognize public toilets or unfamiliar receptacles as a "potty". Common sound cues include "psss psss" for urination and "hmm hmm" (grunting) for defecation. Older babies (late starters) may respond better to more word-like cues. Cues do not have to be auditory; the act of sitting on the potty itself or being held in position can serve as a cue, or the sign language sign for "toilet" can be a cue. The
American Sign Language sign for "toilet" involves forming a hand into the letter "T" (a fist with the thumb inserted between the first and middle fingers) and shaking the hand side to side from the wrist.
Intuition
Intuition refers to a caregiver's unprompted thought that the baby may need to eliminate. Although much intuition may simply be subconscious awareness of timing or signals, many parents who practice EC find it an extremely reliable component.{{citation needed, date=June 2014
See also
*
Attachment parenting
Attachment parenting (AP) is a parenting philosophy that proposes methods aiming to promote the attachment of parent and infant not only by maximal parental empathy and responsiveness but also by continuous bodily closeness and touch. The term ' ...
*
Baby-led potty training Baby-led potty training is a system for meeting babies' toileting needs. The main feature of the system is that care-givers 'hold babies out' or support them on a potty in order for them to void in an appropriate place outside their nappy. The metho ...
*
Dunstan Baby Language
Dunstan Baby Language is a theory about infantile vocal reflexes as signals, in humans. The theory is that across cultures and linguistic groups there are five sounds, each with a meaning, that are used by infants before the language acquisition ...
*
Infant potty training method
''Infant Potty Training: A Gentle and Primeval Method Adapted to Modern Living'' is a book about toilet training by Laurie Boucke. It is an expansion of ideas that were originally presented in a small self-published volume called ''Trickle Treat' ...
*
Open-crotch pants
*
Toilet training
Toilet training (also potty training or toilet learning) is the process of training someone, particularly a toddler or infant, to use the toilet for urination and defecation. Attitudes toward training in recent history have fluctuated substantial ...
References
Toilet training