Infant Potty Training

(Originally published in the Boston Parents' Paper)

by Sarabeth Matilsky

Babies can't use the toilet until they're at least 18 months, right? Not true, say a growing number of parents and experts. They practice a technique known as “elimination communication,” or “EC,” to help their babies (as young as newborn) eliminate in a potty or other receptacle.

“Babies are, at birth, able to communicate their need to eliminate,” says Rachel Milgroom, mother of two and co-founder of Diaper Free Baby, a locally based non-profit dedicated to educating parents about the benefits of EC. “In our society, babies are generally diaper-trained because we as parents haven't been taught to recognize our babies' signals.”

EC is common in non-industrialized parts of the world where diapers simply don't exist. Emily Davidson, a developmental behavioral pediatrician at Children's Hospital, has done EC with her two-year-old daughter for over a year. “As a resident, I read some cross-cultural stuff about people in Africa and China associating a cue sound with holding the baby in a squat to go. I thought it was interesting that what we did here would be so different from what they did there.”

Susan Donohoe, mother of two, conventionally trained her oldest daughter. “We started toilet training at two and a half, but it took six months and there were LOTS of accidents.” Donohoe began EC when her youngest was six months. “I changed her cloth diaper once an hour and offered the potty with cuing sounds.” Donohoe's daughter would often pee at that time. And although she was usually wet in between changes, she was reliably dry by 18 months, a fairly common age for an EC child to graduate to independent pottying.
 
Carrie West, of Worcester, first heard about EC from a friend. “I thought she was crazy. It seemed so counter-culture. But after I thought about it, I realized that it's such a natural thing to do.” West notes that her two year old son was motivated to potty train himself within six weeks of seeing his baby sister use the potty.

Janet Levatin, a pediatrician with a private practice in Brookline, says “As long as you're loving and gentle, I think it's probably a good idea.” Levatin's son is now grown, but she says, “If I had it to do over, I would try [EC]. When I introduced toilet training, he didn't want anything to do with it, and he was over three before he was pooping in the potty.” She adds, “It's very difficult to introduce something new at two or three.”

Kimball DiCero, Child Development Program Director at Isis Maternity, says, “As long as there's no pressure, I think it can be a real extension of communication between parent and child. It's the expectations that I worry about. There's room for parents to feel disappointed in both themselves and/or the baby, if there's missed cues.”

Carrie West says that, at its best, EC is “a reminder that we don’t need more gadgets and experts to raise healthy children. They are born ready to communicate with us and we have the tools that we need to respond to them, if only we had the confidence to tune in and listen.”

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SIDEBAR
How Does Elimination Communication Work?

EC involves a combination of learning baby's unique signals (much as a parent learns to tell when Baby is hungry), and intuition. Some babies learn to use simple sign language when they're older, or mimic a “cue” sound when they have to go. Some babies wear diapers full-time, or part time, or just when out of the house.

Emily Davidson, MD, notes that babies of all ages and developmental stages can learn to associate eliminating with potty use if they're given chances to use the potty when they're most likely to go (shortly after a meal or first thing in the morning, for example). This “timing” technique is also a component of EC.

For more information:
www.diaperfreebaby.org
Diaper Free! by Ingrid Bauer
Infant Potty Training, by Laurie Bouke