In this article I will tell you how my two month old trained us to hold him over the toilet when he has to go to the bathroom. The technique is called Elimination Communication or Natural Infant Hygiene – the terms are interchangeable. It has made our life simpler, our house less stinky and our baby more content. I hope it can do these things for you too.
Elimination Communication is a straightforward way of managing your baby’s output without relying on diapers. It feels great to be free of diapers! Recently my husband and I went out to do an errand with our now three month old. I grabbed the diaper bag (just in case). “Do we even need that anymore?” he asked. Music to my ears.
If you are looking for a quick “how to” guide to starting Elimination Communication click here or scroll to the bottom. For our journey with Elimination Communication, read on:
Baby knows when he’s gotta go
In the first weeks after the birth of my son I diapered him in disposable diapers and cleaned him with disposable wipes. I was too busy learning to breastfeed and smelling the top of his head to give much critical thought to diapering.
I quickly learned what my baby looks like when he has to use the bathroom. He pops off my breast and begins to flail his arms and legs like a turtle while staring at the ceiling with a panicked look on his face.
I would watch him do this and say something like “you have to poop don’t you?” and he would poop 20 seconds later and I would laugh and change his diaper. This happened eight to ten times a day.
At first I took pictures of him doing his cute routine and sent it to my friends and family. After a while I began to feel silly, watching my baby poop into his diaper, taking it off, cleaning him up and definitely ruining any post-poop high he might have had.
Other reasons I wanted to ditch diapers
At the same time that I was thinking about how silly it was to watch him poop into his diaper and then change it, I was also thinking about horror stories from my parents’ generation of me and my friends being in diapers until we were four or five. That’s a long time and a lot of money. My mother tells me that by the time I was out of diapers she was spending $400 a month (in 90s money!) on diapers.
I also had an unshakeable feeling that I was being duped by the Pampers Mafia into forking over money for a product that was more about good marketing and less about normal baby physiology. Who says babies just poop and pee at random and need a diaper just in case? Each bathroom event seemed to be a big deal for my baby.
Also, the environment. I couldn’t bear the thought of some poor dolphin choking on my kid’s diaper. My kid was burning through ten plus diapers a day and each takes about 500 years to biodegrade.
My search for alternatives to diapers
While my son napped on me I gravitated to reading books on attachment parenting including the Sears’ Attachment Parenting, La Leche League’s The Womanly Art of Breastfeeding, and Tracy Gillett’s wonderful The Lost Art of Natural Parenting. There were murmurs of Elimination Communication in these pages but nothing that pumped me up enough or taught me enough to try it.
I bought Ingrid Bauer’s Diaper Free: The Gentle Wisdom of Natural Infant Hygiene because it was the only relevant book in the Kobo store on a day I was stuck under my sleeping baby with nothing but my Kobo handy. (I tried to get the ebook out of the library but there was an eight week wait… perhaps Ingrid was onto something? I wondered.)
Ingrid turned out to be a treat.
The wisdom of Ingrid Bauer
Ingrid tells it like it is. Diapers are a sham. Babies pee and poo at predictable intervals and cue their caregivers with body language to help them go to the bathroom in a specific potty place. Just like babies are born knowing how to eat, breathe, sleep, and snuggle, they are born knowing how to keep themselves clean.
I am pumped. I read on.
Ingrid opens with her story of how she figured out Natural Infant Hygiene (her preferred term) by trial and error with her three children. She diapered her first conventionally until he was two, the age at which books told her he would be able to control his bathroom sphincters. She then potty-trained him. It was unpleasant. She subsequently traveled to countries where babies go their whole lives without using diapers or soiling their parents. She had another baby. She did not diaper him but instead followed his cues and rhythms. They were diaper free by four weeks old.
She outlines a history of Western diapering practice that paints a picture of a world trying to fit babies to adult rhythms, schedules, and values rather than trying to figure out what babies tell us they need. She starts at the industrial revolution where there was an effort to make infant output run by an adult clock with harmful practices like soap suppositories at set times and strapping kids to potties for extended periods. These practices obviously resulted in psychological trauma.
By the 1950s paediatricians like Dr. Brazelton advised the opposite: “don’t rush potty-training” (he got a $$ cut from Pampers). The accepted wisdom became something like “babies pee and poo at random so thank God for these new absorbent disposable diapers that have come on the market.”
I imagine that to mothers of the 1950s, who were busy as stink with all their multitudes of babies, disposable diapers must have been a godsend because they took away the labour of managing your baby’s output. These mothers had little control over their reproduction: they didn’t breastfeed (they had the lowest rates of breastfeeding recorded in history) and they didn’t have The Pill. One of my mentors, the midwife Bridget Lynch, says, “the baby boom was a failure of breastfeeding.” (That juicy line deserves its own blog post.)
Back to Ingrid. She gives a list of times babies are more likely to pee including just after waking up and at the end of a feed. They pee more frequently when they are very young (every 15-30 minutes in the first few months) and less frequently as they age (once an hour around six months). They do not pee or poo when they sleep.
Ingrid emphasizes that babies don’t WANT to go in their diaper and soil their nest – they want you to help them go in a safe, clean place.
We train them into diapers.
Ingrid has a theory that we are setting our kids up for a more challenging relationship with the nerves around their pelvis if we ask them to ignore feelings there for the first two, three, four, five years of their life and then reawaken these nerves with “training.” Could we trace some sexual fetishes to diaper training and then toilet training? Constipation? Illnesses of the pelvis in adulthood? Her theory is not impossible to me.
Ingrid explains that the barriers people have to practising Natural Infant Hygiene are actually barriers to success in other parts of their life: fear of failure, fear of being messy, fear of being weird, fear of losing control. To throw yourself into Natural Infant Hygiene is to take up a parenting model where you treat your baby with trust rather than control. Ingrid writes:
Letting go of control can be one of the scariest, and most freeing things we ever do. To support the gentle practice of Natural Infant Hygiene, we are challenged to let go of control through transforming our reactions. We learn to give up our preconceived ideas about parentings, our cultural definition of convenience, and the illusion that we are separate from our babies. We experience what it means to trust our child and ourselves, and let go of the outcome of our actions.Ingrid Bauer, Diaper Free: The Gentle Wisdom of Natural Infant Hygiene
I give Elimination Communication a try
I have a year of mat leave to play with Elimination Communication. Plus it’s either I try Elimination Communication or I change one million diapers. Plus I like Ingrid’s bit about feeling free to be weird and trusting your baby. I certainly don’t know much about babies beyond a few weeks old so it seems smart to me to let my baby lead the way and tell me what he needs.
I approach Elimination Communication as a fun experiment: if it works, great. If it doesn’t, cool. Same way I approached my home birth (which of course didn’t go as planned — a post for another time!) My primary goal is to get better at listening to my son and responding to what he’s telling me. Getting poop in the toilet is bonus.
The next time my son does his turtle flail I take him to the bathroom. I take off his pants and diaper and hold him over the sink in a squat with my hands under his thighs and his back against my belly. He looks at me in the mirror and furrows his eyebrows. A poop sails out of his butt and into the sink. (For those who don’t know what baby poop looks like, imagine the smell and colour of a little squirt of banana smoothie.) His face breaks out into a giant relieved grin. I rinse his bum with a little water and get him dressed.
I feel like I have discovered fire.
That night I feel bold. I bring him into bed with me with no diaper on. He sleeps on my chest. I am awoken three times by a little turtle wiggle. I carry him to the bathroom and he pees and poos in his sleep without waking. We pad back to bed and he nurses for about ten seconds and then falls back asleep on my chest. I wonder if my child wakes at night to pee rather than eat like the books say?
I wake in the morning to a smiling baby in a dry bed. Is this real life?
Day to day EC
We have continued to practice Elimination Communication since our kid was seven weeks old. He is now 12 weeks old. It is a little messy and very fun. Reading his cues involves a whole new level of living in the moment with him which I’m enjoying.
The best gear for Elimination Communication changes over time
I used to think that if I had a certain kind of easy tear-off diaper I would be more successful at helping my child potty. I now know that the right gear will not make or break your EC adventure and you can just work with what you have to get started. The key is just hanging out with your baby and listening to what they have to say.
We have four Canadian-made Applecheeks cloth diaper inserts and two cloth diaper covers. I chose the Applecheeks brand because they were available at my local mom store the day I went shopping. These four diaper inserts are usually enough to cover my misses throughout the day but just in case they aren’t I have a couple of stiff cotton baby blankets I can fold up and use instead. We rarely need these.
Lately I’ve been enjoying just hanging out with our diaper free baby on a waterproof soaker pad like the kind you give birth on. My big soakers were hand-me-downs from my awesome midwife Tracy Franklin. They are haaandy: absorbent on top and waterproof on the bottom.
Canadian company Komfi Baby makes soaker pads that are especially designed for Elimination Communication and are the right size and weight for sleeping on with your baby. Plus they are much cuter. Mom if you are looking for a Christmas gift for me… 😉
Other than Komfi Baby most clothing does not seem to be made with Elimination Communication in mind because it is hard to take off every 15 minutes! We’ve settled on hand-me-down bottom-zip onesies during the day because they enable quick access when we’re out and about. At night we just wear a simple sweatshirt with no diaper. We’ll likely ditch the sweatshirt once it warms up.
If you can get your hands on any wool baby clothes, hold tight! Wool is the gold standard for baby clothing fabric: wicks away all drool, pee, spit up, and milk in the blink of an eye. No more cold and wet cotton clothes!
I also experimented with adorable baby legwarmers but he was always peeing on them.
Running errands and elimination communication
Errands are easy with EC once you get a car potty! When I do errands I usually come home with a happy, dry baby if I follow my routine:
- Potty my baby in the toilet before we leave the house,
- Potty in The Mini Potty in the car when we arrive to our destination (not a paid link, just a great potty!),
- Put my baby in the sling for shopping,
- Potty in the store bathroom every 15 minutes or when he gets wiggley in the sling,
- Potty in the car before we leave, and
- Potty in the toilet and once we get home.
“That is a lot of work!” you might think. I say, “Put in the work now to save the work later.”
Also it’s not actually that much work once you change your expectations and it’s truly less work than changing a bunch of diapers.
Unexpected benefits of Elimination Communication
It is a fun bonding activity for the whole family
My amazing husband got the hang of it quickly – when you are exclusively breastfeeding like us it is great when you can find things for your partner to do with your baby. My mom, dad, and sister can all identify when baby’s gotta go and my mom even keeps a potty in her car.
It has made bedtime sooo easy
I used to think that my baby nursed until he got sleepy and then had to be bounced around in the sling while he cried until he fell asleep.
After this nurse-cry-bounce circus I would lay down and try to ooze my body out of the sling without waking him up. This routine took about an hour and he would wake up 2-3 hours later.
I now know that he has to pee 5-10 times in the hour before bed and I need to just nurse him and potty him and wait for him to finish his pre-bed pees. Once his bladder is empty and his diaper is dry he zonks out for 4-6 hours.
In retrospect I was probably bouncing him around until he got out all his bedtime pees and he was sleeping unhappily in a wet diaper.
Bedtime is a breeze now!
It has made me a more confident mom
I spent ten or so days naked with my baby in front of the fireplace (December in Canada) just figuring out the nuances of his bathroom cues. By the end I was less covered in pee and poo than I expected and way more in tune with my baby and his needs.
Trusting my baby to lead the way and tell me what he needs is a very cool feeling. It let me stop parenting from a place of fear and control and start parenting from a place of love and trust, which has been great for my confidence as a new mom.
Before we go… a historical perspective
Most resources on Elimination Communication tout it as an ancient practice. While it may have been practised in low resource settings for a long time, Elimination Communication in its current form seems to appear in North America first in 1979 with the publication of Conscious Toilet Training by Laurie Boucke. A few women like Boucke and Bauer have worked tirelessly to popularize the approach with publications, DVDs, and articles in medical journals. I am thankful!
I sense the practice is gaining popularity as I talk to other moms and search for resources. Elimination Communication was praised in a recent volume of Pediatrics by two physicians who practised it at home with their third child: “We strongly feel that this underrecognized approach to toilet training could be beneficial to US families in terms of child health, convenience, and expense.” http://pediatrics.aappublications.org/content/140/1/e20170398
- Hang out with your baby. Holding or wearing your baby is ideal because you can feel his little “I gotta pee!” dance.
- Notice when he starts to wiggle more than usual. Remember the “I gotta pee!” dance you did as a kid when you had to go? He does it too!
- Take off his bottoms and hold him in a squat against your belly over the sink or sitting between your legs on the toilet.
- Give it a minute or so.
- Relax! This is supposed to be fun. He can sense when you’re being pushy or anxious.
- As he pees say “sss” or as he poos say “caca” so he has word association with each bathroom event.
- Rinse his bum off with a little water and go back to snuggling.
Thank you for reading my article about our journey with Elimination Communication. Are you wondering anything else about Elimination Communication? Do you have experience with EC? Share in the comments please!
Bauer, Ingrid. Diaper Free: The Gentle Wisdom of Natural Infant Hygiene. Penguin: New York, 2001.
Bender JM, She RC. “Elimination Communication: Diaper-Free in America.” Pediatrics Jul 2017; 140:1. http://pediatrics.aappublications.org/content/140/1/e20170398
Boucke, Laurie. Infant Potty Training: A Gentle and Primeval Method Adapted to Modern Living. White-Boucke Publishing, 2008.
Sears W, Sear M. The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. Word Alive, 2001.
Wiessinger D, West D, Pitman T. The Womanly Art of Breastfeeding. Completely Revised and Updated 8th Edition. La Leche League. Ballantine, 2010.