Forget diapers: Parents teaching newborns to use toilet with "elimination communication"

When a couple has a child, one of the many choices they have to make is to choose between cloth and disposable diapers. Now, some parents are introducing an option that’s been used in countries around the world — letting their child go without a diaper.

The method, known as elimination communication (EC), can begin as early as birth. Instead of letting their children do their business in their diapers, EC parents whisk their kids to the bathroom every time they get a signal from their child that suggests it’s time to go. Cues can include face scrunching and certain whines, but parents can encourage their children to go by using “sss” noises or soft grunts while plopping them over a toilet as they go. The idea is that babies will associate their parents’ noises with feeling relief, training the child go on command.

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EC not only can help fight that pesky diaper rash, it can also theoretically save money and eliminate unnecessary landfill waste. But, the ultimate goal of EC isn’t to let your child roam without diapers: It’s to foster a bond between parent and child. Dr. Alison Schonwald, medical director of developmental behavioral outreach at Boston Children’s Hospital, explained to Because parents are listening to their child and understanding their needs, they further their relationship, she said.

“The goal of EC is to have this tight communication and be in sync with your child,” said Schonwald, who wrote “The Pocket Idiot’s Guide to Potty Training Problems.”

It’s not a new concept despite recent coverage. Schonwald explained that in certain cultures where the child is always with a parent, EC is commonly practiced. A mother who is carrying her child on her back all day can sense if her baby needs some bathroom time. Since diapers aren’t available, she would simply take the child off her back, put the child over a hole or a pit and let them go.

Adriane Stare, owner of Caribou Baby in Brooklyn, N.Y., EC’ed her oldest son Damien and is currently training her son Loren, who is 4 months old. She holds meet ups for other EC parents at her store. Recently, the New York Times wrote a story about her and other EC parents, pointing out that parents at her gatherings “exchange tips like how to get a baby to urinate on the street between parked cars.” Stare claims that’s a misunderstanding.

“This is not a case where people are pottying kids between parked cars,” she countered. “That’s not at all what happens.”

In both her children’s cases, Stare said that she had them in diapers the entire time they were being trained. The only difference was, instead of having them go in their pants, she listened for their cues and gave the children the opportunity to use the toilet instead of having to walk around with a soggy diaper.

“Instead of changing a poopy diaper, offer your child a chance to go poopy in the toilet,” she elaborated. “It lets you dump your poop in the toilet. It’s not supposed to be in landfills.”

She said it is a misconception that parents employing EC live in houses littered with containers to catch a child’s accidents.

“Suggesting that you need to hold a baby over the bowl every two minutes — I’ve never seen a baby go every two minutes” she said.

This doesn’t mean EC has been a completely smooth ride for her. Stare said that Damien went through weeks or months were he refused to use the toilet and was put back in diapers. But, her and her husband stuck with it.

While EC isn’t a typical recommendation that pediatricians give to parents, the child-centered approach to toilet training is. Schonwald said that at an appropriate age, most doctors will suggest that parents listen to their child’s signals in order to help potty train.

In the U.S., children are usually potty trained between 3 and 4 years old, but Schonwald emphasized that EC isn’t potty training. While a potty trained child can go to the bathroom on their own, an EC child still needs their parents help. Stare said her son Damien was completely potty trained by 2, but she doesn’t know if EC had anything to do with his early development. And, there’s no evidence that EC kids are potty trained any faster than other children, but by Schonwald’s own admission, EC isn’t a well studied method.

The biggest challenge for EC parents is the need to constantly be with their child. Since Stare owns her own business, she can take her children to work, and she also has a caregiver who is willing to take her child to the restroom. For working parents who don’t have a caregiver who wants to practice EC or have to put their children in a daycare where they only allow disposable diapers, EC may not be an option. Still, Stare suggested that parents can try EC on the weekends — but also recognized that it may confuse the child.

“It goes back to the individual child,” Schonwald admitted. “For some kids, it might be just fine. For other kids, it may be very confusing. It’s very individual to the child and the family. When some people are introduced to the concept, it rings true and feels like a brilliant plan, but to other people it feels unsettling or uncomfortable.”

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