What is Elimination Communication?

Elimination Communication (EC) is the practice of providing a baby with opportunities to eliminate into a potty instead of in a diaper. We can respond to a baby’s cues for elimination in much the same way as we respond to a baby’s cues for hunger or sleep. EC can start at birth.

The purpose of EC is not to “potty train,” but to cultivate responsiveness to a baby’s innate cues about elimination – to pay attention to her signals, to offer opportunities to eliminate at regular intervals, and to trust caregiver intuition.
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My EC Journey

Personally, EC has been a gift in my relationship with my daughter. It has opened another channel in which we can relate and interact. Just as I respond to my baby’s requests to nurse, I gently respond to and help foster her awareness of her own elimination needs.

We started with EC at four months. By 8 months, my daughter would usually tell me when she needed to urinate by rubbing her nose (this is a cue I learned from her; I did not teach it to her), crawling over and touching her potty, or squirming and crying while sleeping. Each time she used the potty, I sang a little song and make a cueing noise (“Ssssssss”). When she was younger and having several bowel movements each day, I would hold her against my abdomen and tense my muscles to bear down while making a soft grunting sound at each potty opportunity.

Before toddlerhood, our “catch” rate was 75% for pee and 90% for poo. She also requested the potty for passing gas and burping, which showed me that she has learned to relax her sphincter muscles while on the potty.

As a toddler approaching the end of her second year, my daughter wears underwear. She talks about going potty and poo-poo, often yelling out "Potty!" in the middle of play or other activities. She has an occasional pee accident, usually when I'm slow to pick up her cues. She still wears cloth diapers at night and pees in her sleep, though I am often able to catch a pee if she cries while sleeping and is not wet. I continue to maintain my focus on communication rather than expecting results, and it's working great for us.

Why not diapers?

By relying exclusively on diapers for infant elimination, we teach babies to ignore their elimination needs. We effectively train them to override their innate human (and mammalian) desire not to eliminate on themselves. In effect, we teach babies to eliminate into their clothing…and then we have to invest time, effort and – in some cases – heartache to teach them not to eliminate into their clothing!

What about the psychological and health aspects of EC?

I like to think of it this way: All babies are potty-trained. It’s just that some are trained to pee and poop into diapers and others can be given opportunities to eliminate outside of their clothing. EC done correctly does not introduce unhealthy pressure on the baby to conform to adult standards. It is simply about promoting a baby’s inborn awareness of elimination.

EC helps caregivers to reinforce the natural, good feelings that come with elimination, instead of responding to my baby’s elimination (and entire genital area) as “dirty,” as is often the case when changing diapers.

From a health perspective, EC can be useful in tracking stool consistency and urine output, significant in diagnosing food allergies and dehydration. The supported squat position in which babies are held before they can sit up on the potty by themselves is beneficial for bowel moments, since babies may need to strain more to poop in a horizontal position.

Are you truly diaper-free? What about out of the house?

For us, being diaper-free means being free from an exclusive reliance on diapers. Until around 20 months, we used waterproof training pants or diapers when out of the house, but we often spent several hours out and return wearing the same (dry) diaper. My daughter has peed in the bathrooms of homes of friends and relatives, fancy restaurants, grocery stores, airports, airplanes, and historical sites. Outdoors, she has peed on sand, grass, and concrete. In general, I try to give my daughter a chance to pee at transitional moments. For example, when she comes out of the carseat, I open the car door, take off her pants, and she will often go on the pavement (in cold weather, we take our potty along and sit in the car). In NYC, I wore her in a wrap when running errands, and the moment she came out of the wrap, I tried to give her a chance to go (one of the first things I do when I enter a new place is find the bathroom!).

Isn’t this just potty training the parents? Isn’t this too much pressure for a baby – and for parents? What about parents working outside the home?

Every baby is potty trained – either trained to go into a diaper or trained to go outside of a diaper. But EC is really not about training anyone. It is about creating a dynamic of trust and respect in a relationship, offering opportunities for elimination without pressure or coercion. Even if my daughter doesn’t “potty train” before her diapered peers, EC still will have been a wonderful asset to our relationship.

What working parents – and everyone – need to understand is that EC can be done part-time. Some EC is better than none at all, and can still be rewarding. EC is not about perfection, and it is not a zero sum game! There have been many times that I have diapered my daughter because I was overwhelmed with things to do and felt unable to devote my attention to EC.

Any loving caregiver, including grandparents and babysitters, can tune into a baby’s cues. Parents have the obvious advantage when it comes to deciphering the cues in the first place, since they usually spend the most time with a baby. But they can then teach the cues to others.

There are those who feel that EC imposes additional burdens on mothers at a time when women are still bearing the brunt of childcare duties while many are also working outside the home. A recent article in Slate magazine characterized EC-practicing moms as “mothers without a life.” A post on the mothering.commune message boards responded in a way that resonated with me:

“The article assumes that most mothers wouldn't benefit -- let alone enjoy -- the time and commitment necessary for EC (and AP). Sure, plenty moms have no desire to spend so much intimate time with their children…but for those of us who understand and feel drawn to a parenting style different from the mainstream, EC isn't much of a leap. Mainstream moms might see more movies, get more sleep and have an "easier" time with certain parenting duties, but I'd rather have a deeper connection to my son…I find my parenting style enjoyable, not a burden.”

 EC and Attachment Parenting

In my experience, EC is a natural part of my orientation toward responsive, attached parenting. It fits well with the main tenets of attachment parenting, especially babywearing and co-sleeping. The basic idea that a baby’s needs are paramount – whether it’s nursing on cue, child-led weaning, minimizing separations, or responding to elimination needs – is essentially an AP idea.

Critics of EC have suggested that it may push babies to become potty-trained before it is developmentally appropriate, which would contravene the AP-oriented approach of child-led potty learning. I agree that there could be cause for concern in foisting early potty-training on a child who has lost awareness of elimination as a result of diapering. However, true EC is about communication – not about pressuring anyone (child or parents!). EC is simply about maintaining the original awareness that the newborn possesses. This is why it is recommended to start EC before 4 months of age.

What else?

EC is a fun adventure. A sense of humor is an absolute necessity, along with a commitment not to take oneself too seriously. For me, EC is all about my baby and me connecting with each other on a fundamental level, while enjoying the journey.

Recommended Resources

• The Diaper-Free Baby, a fantastic new book on EC by Christine Gross-Loh!
  
  
• Diaper-Free! The Gentle Wisdom of Natural Infant Hygiene by Ingrid Bauer. Available through the EC Store.
  
  
• Learn more and join a Diaper-Free Baby group near you.
  
  
• Shop for EC equipment at the EC Store. My favorites: clear potties, fleece pad (for nighttime and pre-crawling).
  
  
• You’ll also want lots of pre-fold cloth diapers. A good source is www.diaperware.com.
  
  
• In addition to Diaper-Free Baby, another online community that supports the practice of EC is the Elimination Communication Yahoo group. I recommend joining this group and reading the archives if you have a specific question about EC. I haven’t been able to keep up with the daily traffic, but I posted once about preventing anal fissures while continuing to use EC and received several helpful suggestions.