From NEW BEGINNINGS, Vol. 23 No. 6, November-December 2006, pp. 266-267
Editor's note: La Leche League is an organization about breastfeeding, and we don't take a position on how mothers should handle their babies' diapering or toileting needs. This article describes a way some mothers are choosing to work with their babies to help them use the potty (with a parent's help) at younger ages.
In recent years, most children in Western societies have begun the process of learning to use the toilet when they're toddlers. In many other areas of the world, elimination is dealt with differently. Some children are toilet-independent by the age of one. Rather than containing waste exclusively in diapers, parents watch the babies and help them to use a potty or toilet when they need to go. Thus, when the time comes for children to become completely toilet-independent, using a toilet is already such an accepted part of their lives that the transition is smooth.
This practice, known as "elimination communication," or EC, is becoming more widespread in Western societies as well. This article aims to share some basic information about elimination communication.
EC can be practiced with babies as well as with older children. Because EC is first and foremost about communication (not toilet training, which can sometimes imply a coercive or parent-led practice), it provides parents with another way to understand their children. Whether you have a newborn or a three-year-old, EC encourages parents to be sensitive and responsive to what children are trying to tell them.
At each stage during your child's early years, you will find there are ways to approach elimination and toileting that are compatible with general principles of gentle, responsive parenting.
For parents who fear that embarking on elimination communication with a newborn will be time-consuming, know that toileting can be done part-time -- even just once every few days or so. Some parents find it helpful to give it a try at times when the diaper would be off anyway, such as during a diaper change or before the bath.
The most important components of toilet learning at any stage, including the newborn period, are observation of your baby and getting in communication with your baby via the use of cues and signals.
Observing and becoming aware of timing and rhythms: You can begin simply by leaving your baby diaper-free, lying on an open cloth or disposable diaper in your arms, in a sling, or on some padding on the floor. Not fastening a diaper on your baby will make it easy for you to tell when he is eliminating. Take note of when he tends to go, keeping in mind that babies' patterns change often and quickly at this stage. Most young babies tend to release their bowels and bladder immediately after awakening from sleep, and during or right after nursing sessions. Newborns tend to go more frequently than older infants, which gives you more opportunity for observation.
Figuring Out Cues and Signals: With observation, you will probably start to notice that your baby makes certain faces, noises, or movements immediately prior to urinating or defecating. Your baby might start to fuss, squirm, and grimace when she feels a movement coming on. The more you observe her, the more you will be able to sense when she is about to go and be able to cue her right before or as she is having a bowel movement or urinating.
What is a "cue"? It's a sound you make that communicates to your baby that she is urinating. Your baby will start to associate it with the very sensation of elimination. The most common cue used worldwide is a shushing or soft hissing sound such as "pssss" or "shhh," made while holding your baby over a potty, bowl, or toilet. Be sure to continue to make the cue sound while she is urinating. Soon enough, your baby's imminent need to go, when combined with the cue sound and the pottying position, will signal to your baby that you're assisting her with her elimination need.
The most important thing to remember is to do this at a pace that feels right for you and your family. Some people keep their babies in diapers all the time and use EC only occasionally, others might just catch bowel movements and diaper their babies the rest of the time, while yet other families might try out a completely diaper-free lifestyle. There is no one right way to use elimination communication.
Once your baby is past three or four months old, toileting can become remarkably easy. In fact, some cultures begin toileting at this stage rather than at the newborn stage. Your baby's ability to hold her head up and even sit up means that she may be able to sit on a potty with your support. Her elimination patterns may be more predictable at this age as well. Again, the principles are the same as for newborns: observe your child, learn to read her signals just as you learn to tell when she is tired, overstimulated, or hungry, and then assist her with her biological need.
New signs and cues: Keep an eye out for new ways your baby may signal the need to urinate or defecate. Some of these signs at this age will include: grunting, grimacing, blowing raspberries, passing gas, an intent look, or sudden fussing or crying. To enhance communication further, this is an ideal time to introduce the American Sign Language sign for toilet. She may not repeat it back to you yet, but the foundations for mutual understanding will have been laid.
Babywearing helps: Many people who use EC with their infants also wear their babies on their bodies in a soft carrier. This is no coincidence. Babywearing can be a great aid in getting in rhythm with your baby. Babies tend not to release their bladders or bowels when being held close (although each child is unique and there are always exceptions to this). If they are comfortable and don't need to eliminate, they will remain in a state of quiet alertness. If they need to eliminate, they might squirm or otherwise let you know they want to be taken out of the sling.
Keeping baby close in this way provides a good chance for you to understand your baby's signals and rhythms. It also gives you an idea of when are good times to offer the potty to your baby.
Older Infancy, Toddlerhood, and Preschool Age
Many parents are advised by conventional toilet training experts to wait until their child is at least 18 months to two years old before even considering introducing the potty, and to do so only if their child meets certain checkpoints (for instance, can independently dress himself, can verbalize the need to go to the bathroom, or actually asks to use the toilet). This is said to initiate a "child-led" toilet training process.
However, a parent might observe that her child is interested in toileting at a much earlier stage when she won't necessarily meet all those checkpoints. EC encourages parents to be open to any window of opportunity you may see. A child-led toilet learning process essentially means being open to the fact that your child may want to begin using the toilet far earlier than most societal messages tell us.
If your child is starting out at an older age, EC principles still apply. Know that it may take some time for him to be aware of when he is urinating or defecating, but continue to communicate with him about this. Let him take the initiative as much as possible.
Bodily awareness: If your child has not used a toilet before, your initial approach will be very similar to that of parents of young babies. One good way to help him be aware of when he is urinating or defecating is to let him wear (preferably cloth) training pants or to have him eliminate without anything on at all.
Diaper-free time: Diaper-free time can be as long or as short as need be to meet your own family's needs. If you spend time apart from your child, if you have lots of carpet in the home, or if you are on the go a lot, you can make adjustments to accommodate your lifestyle. Many families find that it works well for them to have a brief period of diaper-free time every day. Being "diaper-free" can mean anything from having on a cloth training pant, a coverless cloth diaper, pint-sized underwear, or having nothing on at all. Above all, diaper-free time means being free of an exclusive reliance on diapers.
During diaper-free time, you can observe your child and cue him if you notice him eliminating. Having the diaper off will also allow him to notice the physical sensation of urinating or defecating and make the association between the sensation and the act. In the meantime, you can offer him the context he needs to put this all together by observing and verbalizing what is happening for him. A simple statement such as "You're peeing!" is sufficient.
Talk with your child about elimination: Toddlers can really express and act out their interest in pottying in a variety of ways. Play is a language children respond to, so join your child in the fun by putting his stuffed animals on the potty and cueing them, and so forth. Toddlers love routines. He may love being involved in all aspects of toileting -- wiping, flushing, and washing hands.
Elimination communication may appear at first glance to be merely about elimination. Once you embark upon this journey, however, you will realize it is a dance of communication between parent and child.
It's important to remember that EC is not about a result (toilet independence), but about the ongoing process of communication. It's not about having the first toilet-trained child in the neighborhood. It is about taking things moment by moment and learning to listen to your child and figure out what she is saying -- all valuable skills for the mother or father who wants to parent with empathy and respect.
Every family is wondrously unique. The range of experiences among families who use elimination communication reflects this variety.
Note: For photos of infant pottying positions, see www.diaperfreebaby.org.