Saturday, January 9, 2010

Elimination Communication

I recently read a book by Christine Gross-Loh about elimination communication. The title is called The Diaper-Free Baby. In my quest to learn about cloth diapers, I stumbled upon a small group of people in the US who practice this concept of toilet training. Since I worked in a typical day care setting potty training, I dismissed the practice and didn't actually read anything about it until going to my public library I found this book.

The book is well written and explains at every stage of infancy how you can train your child to use a toilet. I'm not going to go into a lot of detail about the process because I'm sure you can read the book or find another one of the subject at your local library. I'll just give a brief overview so that you will understand what I am talking about.

The idea behind elimination communication is to teach your child how to use a toilet instead of allowing your child to mess in a diaper. Diapers in this method of potty training are used as a way to catch "misses" or missed opportunities to take your child to the bathroom. You can attempt to catch as many opportunities to use the toilet as you can or you can decide to use the method only part of the time, meaning maybe for bowel movements only or when you are changing a diaper.

In order to teach or communicate with your infant about elimination needs, there are four main components: timing, cueing, signals, or intuition. Timing is knowing when your child needs to go to the bathroom. For example, in the morning when they first wake up, before bathing, after or during feeding, or after a diaper change. Cueing is using sounds "pssst", words "go pee pee", or ASL "signing toilet" to let your child know that it is okay to eliminate. It's sort of like Pavlov's dogs or teaching your dog to ring a bell in order to go outside. Every time they eliminate you make the sound, words, or sign so that the baby associates that with going to the toilet. Signals is your child's way of communicating their need to go to the bathroom. This could be fussiness, using ASL, making the sounds, popping on and off the breast, making "the face", etc that is appropriate for their age. Intuition is the thought that the baby has to go. Some ECers refer to things like "phantom pees" where they think the child needs to go.

Other facets to EC is giving your child time away from their diaper or using cloth diapers without a cover. This allows the caregiver to learn what signals the baby uses when eliminating and to practice cueing. Also not praising a child when using the toilet is common because it is considered to be like eating or sleeping. They also practice a no pressure approach. You don't have to get your child out of diapers by a certain age and if there are times when progress is slow then you accommodate the child without frustration.

Practitioners say that EC is very common world wide especially in underdeveloped countries where diapers are not easy to come by. They also say that 50 percent of children world wide are out of diapers by age one where in the US the common age for girls is 2.5 and for boys 3 years of age.

I like the concept of EC, but I also can see where it can be a problem. Many opponents say that children really aren't equipped to manage those bathroom muscles until age 18 months. They feel that it can frustrate a child or parent by trying too toilet train to early.

What I like about EC is that if you see your child going, take them to the bathroom no matter what age they are at. There is no point in waiting for them to finish in their diaper. I also like the idea that it helps with detaching from diapers. Many of the children I worked with get very upset about their diapers not being put on them. Peer pressure helps, but some children are so emotional attached to the diaper like a security blanket. This is because at age 2 they are experiencing the same kind of brain development and independence that teenagers do. It's a lot easier to introduce the toilet as being a normal part of elimination at a much earlier age.

I also like the idea of being able to know when they actually go to the bathroom. Just like adults know about the time of day they will have a bowel movement, children will also develop set schedules for bowel movements and peeing. This helps in over all potty training. I used this concept with older children who had difficulty communicating when they needed to use the potty. I had one child who would use the toilet after waking up from nap and then before I would leave for the day about 3:30pm I would take her to the bathroom again. If I didn't make this time commitment, there would inevitably be a pee pee accident.

I'm a little opposed to the idea of cueing. I don't like the idea of training my child to pee or poop on command. I would rather use the idea of timing or having the child communicate to me when they need to go. Intuition seems odd to me as well.

Also proponents begin the process when the child is born before they can even hold themselves upright to pee.

What I plan on doing is waiting til my son is 3 months old or so when he is able to hold up his head and sit upright. Then I will buy him a little potty. I probably will look for those moments when I can tell that he's going and place him on the potty or I will place him on the potty after a diaper change, when waking up, after eating, and before bath and sleep time. The rest of the time he can stay in diapers. The idea is for him to get used to the potty and not be inhibited by it later. I have no expectation that he will be potty trained nor do I want to spend all my time trying to "catch" moments of elimination.

I believe getting children on a schedule is important. I'm not a big proponent of having the schedule of feedings, wakefulness, sleeping to be regulated by the child. This is largely because children will not be consistent and not develop a good schedule on their own without guidance. This leaves many parents pulling out their hair. Children like structure and knowing their boundaries. It develops a sense of trust and consistency where children can flourish. I know hospitals say to have child-lead breast feeding and ECers use child-lead toileting, but I'm not into that. I just like the concept of knowing when he needs to go and not having him become scared to use the toilet.


  1. I like the idea of this... but I don't see it working for me. I used to think I was patient, but its something I struggle with now lol. We did pull out the potty early though and let her get used to it and use it when she wanted. I caught some earlier on, but nowhere near what ECers do.

    As for schedules... Eh.. It really depends on the kid and family. We do schedule somethings. I think bed/naptimes are important after the newborn stage (you know when they start to lump it together more). Solid feedings too... but breastfeeding on a schedule can cause issues. Doable? Sometimes... but not something I'd recommend at all.

  2. A friend of mine suggested breast feeding on a schedule because babies tend to fall asleep not completely full and wake up wanting to feed more. He suggested keeping the baby awake to feed and awake for a little while afterwards. In this way you can get the baby to sleep and wake up completely hungry. He suggested feeding every 2.5 hours with 15 minutes of awake time for the baby.

    But we'll see. Someone told me about book on schedules. I'll have to see if I can find it.

  3. Wow. Never heard that... but w/ Kalila we couldn't keep her awake for anything if she was ready for sleep.. and getting her to sleep was really easy.

    But what that will do (word of warning) is mess with your supply if you're not careful (esp in the beginning). The more you nurse the more you make, and feeding on demand sets up how much your baby needs so your body can regulate itself. Also if the baby does not get enough hindmilk they can get a hindmilk/formilk imbalance.. not fun and you'll see it in the dipes.. green and mucusy. On top of that (lol) at certain points babies have growth spurts and they will want (and need) to nurse more no matter what you do...

    So if you decide on scheduleing just be careful to watch out for that stuff. Like I said before, I know some people do it. Is just not recommended.


I love to read your thoughts. Thanks for sharing!