Elimination Communication (EC): A Newfangled Idea?
I'll admit that when I first heard about Elimination Communication (EC), when I was still pregnant, I thought it was a bit backward. Trying to "force" babies to hold their pee and poop until they can go on the toilet?! Then my midwife explained to me that babies naturally hold their elimination needs for a short time anyway because they don't want to pee on themselves, just like all mammals. It's not about forcing them to hold it-- it's about providing them with the opportunity to eliminate somewhere other than a diaper. We afford our pets the same opportunity... why are we short changing our children?
When you read articles about EC in the media, it's often touted as a new "fad" that is only practiced among the obsessive elite. In fact, EC isn't new at all-- the practice has been around for hundreds of years and is still the norm in non-industrialized cultures, as well as parts of Asia, where you may see toddlers wearing split crotch pants to facilitate elimination any time, anywhere. The worldwide average age for potty training is 12 months, while in the United States the average is 35 months for girls and 39 months for boys! Even in the US back in 1957, the average potty trained age was 18 months. There is nothing "new" about the practice of EC; it has just fallen out of favor thanks to the convenience of modern diapers.
This belief that EC is a fad for the elite is equally unfounded. EC is a fantastic tool for families of limited financial means, as it not only saves money on diapers for each "catch" (the term used to describe the infant's pee or poop landing in an appropriate receptacle instead of a diaper), but also most EC'ed infants become fully potty trained earlier than the US average, potentially saving a year or more worth of diapers.
What is EC exactly?
When families ask me to explain what EC is, I often find myself describing what it is not. EC is not conventional American potty training; it's the opposite of diaper training. EC is not coercive; it is safe and gentle. EC is not teaching your baby to hold it; it's teaching your baby to let it go. EC is not all or nothing; many families do EC part time with cloth or disposable diapers as backup. And as described above, EC is not a new concept! EC is more about training the parents (to pay attention to timing and baby's cues) than it is about training babies. Note that children over 18 months typically do not respond as well to EC and will typically do better with non-coercive potty training methods.
Benefits of EC
I have touched on some of the benefits of EC above, but here is an extensive list of ways the EC could help your family:
- Breastfeeding: Assists caregivers with assessing output, which gives clues as to adequate milk intake; may explain some fussing at the breast-- breastfeeding parent may think baby is fussing because she is done when in fact she needs to eliminate.
- Health: Less diaper rash/irritation, reduced chemical exposure, lower risk of UTIs/constipation, better understanding of “unexplained” colic/fussiness
- Bonding: encourages communication between parent and child, and between older sibling and infant
- Environment: Less waste from disposables, less water/detergent used for cloth, less diaper production
- Money: $3000/yr conventional diapering, $1000/3 yrs cloth
- Potty training: Much easier down the line! Often occurs much sooner than in conventionally potty trained children.
- Fun: exciting when you get a “catch,” more opportunities to read/play/interract with your child, feel good doing something for their health… GREAT party trick!
For my family, the main reason for starting EC was that my daughter had extremely sensitive skin and had frequent diaper rashes. EC can be a great tool for dealing with this problem, as getting some air time on the bum is often the best thing for a persistent, painful diaper rash!
Getting Started: Observation
If you're still reading, hopefully it means that I've convinced you that EC isn't a crazy concept and that it could even be beneficial to your family. But where should you start? With a newborn, you may be able to jump right in with pottying between diaper changes and upon waking. With an older infant who is already diaper trained, some legwork needs to be done first. You'll need to first observe your infant in an effort to uncover her elimination timing and cues.
Undress your baby from the waist down, dress her in a fitted cloth diaper without a waterproof cover, or dress her in a prefold with a diaper belt (they're easy to make!). You can put her in some infant leg warmers if it's cold out. Then wait and watch. When she does eliminate, ask yourself: did she just nurse? just wake up? just get put down? just get left alone for a second? You are trying to determine patterns in her elimination habits. Also note how long she goes between pees or poops. Finally, note what your baby did just prior to eliminating: did she shudder? fuss? try to crawl away? look for you? grunt? These signs are called cues and will be used in conjunction with timing to figure out when your baby needs to eliminate.
During the observation period, you can also start making your own cue sound when your baby pees or poops. Most parents use a "pshhh" or "psss" noise. Make this sound every time you see your baby eliminating, so that she starts to associate the sound with the act of peeing or pooping.
Getting Started: Pottying
Now that you know your baby's timing and cues, you can start putting him or her on the potty. I use the term "potty" pretty loosely as the receptacles used by families for EC can include the adult toilet, a child potty, a special infant "top hat" potty, a large bowl (just make sure it doesn't make it back to the kitchen!), the bathroom sink, the tub, or a patch of grass. For a newborn, the traditional EC hold may be most practical, which involves holding baby facing out, back against your chest/stomach, and your hands under baby's knees (beautifully demonstrated by my daughter and her dolly below). Older babies can sit upright on a potty, or continue to use the traditional EC hold. Only rules are that baby should be comfortable and ideally have knees above hips, and you should be comfortable and have good posture! For more on postpartum posture and its importance, see this blog post.
When you think the timing is right (upon waking from a nap is a great time to try) or you notice your baby cueing a need for elimination, place her/hold her on the appropriate receptacle and make your cue sound. If baby fusses, give it a minute; remember that many babies fuss just before eliminating and this is a new experience for her. If you get a pee, go ahead and celebrate-- just make sure it's not over the top since young babies scare easily! If you're expecting a poop as well, note that most babies will pee first, take a break, and then poop. If nothing happens, don't continue making the cue sound more than a couple times as it will start to lose its meaning. Just put a clean diaper back on (or continue naked time if you're feeling bold) and try again in 10 minutes or so.
... is not linear! There will be "misses" (the term for when baby eliminates anywhere other than the appropriate receptacle of your choosing) and there will be messes. Try not to display frustration, as this can result in more resistance from your child. Have prefolds or absorbent towels at the ready for diaper free time, as well as a natural cleaning product. I like Meyer's Clean Day All Purpose Cleaner, diluted in a spray bottle. Prefolds just happen to perfectly fit in a Swiffer Sweeper, which can save your back. EC sometimes feels like two steps forward and one step back.
Potty pauses, during which you suddenly find yourself with more misses than catches, are common and often precede developmental milestones, teething, or illness, or coincide with a life stressor such as moving. The above picture is of my daughter around the time that she started walking; we had to think outside of (inside of?) the box to get her to stay put on the potty long enough to go! Potty strikes, during which baby completely regresses and may refuse the potty completely, can be incredibly frustrating. Trust that your baby knows what she is doing and do your best to make pottying fun again. My daughter went through a phase when she only wanted to pee in the grass "like a dog." Our neighbors were probably weirded out, but it worked. Support can be really nice to help you get through the tough phases. There are many EC groups on Facebook, Baby Center, and other forums. You can also feel free to contact me-- I've been there, I get it, I'm happy to help! Also don't forget that EC help is included as a service within my postpartum doula package. Most importantly, remember that the goal of EC is not dryness... the goal is communication and respecting your child's desire to eliminate somewhere other than on herself!