An Alternative to Diapers

We stopped using cloth diapers when Gabe was just under 10 months old. Diapering and un-diapering had begun to almost always result in tears as he tried his best to wiggle away and I tried my best to keep him from wiggling away. He learned to get out of his diaper. It was getting hot outside. His poop was not the sweet smelling breast milk poop that it once was.   I am convinced he was not actually ingesting any of the table food he played with during meal times, but he might have been eating some of the sand and dirt he put in his mouth all day. I was getting a little tired of doing diaper laundry every two or three days. He was peeing very little at night and would squirm all over the bed when he needed to go. This is it, I thought, Gabe is wearing underwear or nothing and these diapers are going in a box for the next baby!

Elimination Communication (EC). That’s a complicated sounding phrase for a very simple concept. Elimination refers to peeing and pooping. Communication refers to an active awareness that a parent has of her baby’s elimination needs. By expecting a child to eliminate in a diaper all the time, the parent trains the child to lose awareness of his bodily functions. The parent of a fully diapered child has a passive awareness of her child’s elimination needs. In contrast, a parent practicing EC helps her baby to retain his bodily awareness by helping him to eliminate in an appropriate place outside his clothing. Parents who do EC believe that babies have an innate desire not to poop and pee on themselves. They argue, no other mammal sits in poop and pee so what makes us think our babies want to? Many parents use cloth diapers as back-up for young infants. As the baby gets older, it is common to gradually switch over to underwear. Each family develops a unique style of EC that works for them. Just Google ‘elimination communication’ and you will find an array of how-to websites, discussion forums, and even online EC supply stores.  Families who practice EC are extending the philosophy of attachment parenting to their babies’ elimination needs by actively responding to needs as they arise instead of passively letting their children eliminate in a diaper to be changed later.

So how exactly does one know when a baby needs to pee or poop? Use the same method you use to figure out when your baby is hungry or tired. Babies communicate in their own ways and they usually develop routines. Gabe has always had a sleeping and nursing routine that has gradually changed over time. Elimination works the same way. I knew about EC before Gabe was born but I thought EC meant not ever using diapers at all because the EC websites and books used the phrase ‘diaper free’. I found out later that ‘diaper free’ just means freedom from diaper dependence. It’s not a rule prohibiting diaper use. At about 2 months old, Gabe finally convinced me that EC makes more sense than diaper dependence.  Next baby, I will start from birth.

Gabe has had a fairly consistent routine for the past month or so, and he is now 11 months old. He pees every 20 to 30 minutes for about two hours after waking up in the morning. After that, he pees about every hour until he takes a nap. Then he pees when he wakes up from his nap. Again, he pees about every hour or two until he takes nap number two. He pees upon waking and then pees every 2 or 3 hours until bedtime. He pees once or twice at night.  I take him pee when I get up to go myself. We also ‘diaper’ the bed with some cotton prefold diapers so that if he does pee in the bed, it’s not on the sheets. He poops every 2 to 3 days, almost always before noon.  This is the sort of communication a primary caregiver has with an EC’ed infant. I’d be willing to bet most parents can detail their children’s eating and sleeping routines the same way I just detailed my son’s elimination routine. EC doesn’t require extra-sensory perception or running your child to the toilet every 10 minutes. All that is needed is the same parental intuition that you use to know when your child is hungry or tired.

So how exactly does one take a baby to the potty?  Parents practicing EC usually use a cue word, such as ‘psss’at each ‘pottytunity’ so that the baby forms an association between the cue word and elimination. A newborn can be held over a toilet, bowl, diaper, or other appropriate place to eliminate. Newborns go a lot and I have gathered that most EC families keep a cloth diaper on as back-up during this stage. When I started EC with Gabe at 2 months, I held him over a bowl while I was waiting for the little potty I ordered to arrive. I took him potty fairly often, perhaps every 30 minutes. At first, I had only planned to attempt to catch bowel movements, but found that I was catching most pees as well. Prior to starting EC, I had been very frustrated that I could not seem to conquer Gabe’s minor but persistent diaper rash. All the baby books said to take off the diaper to let the rash heal but no one told me how to keep from getting pooped and peed on! Aha, I thought, this is the missing piece.

Holding him over the bowl was awkward for me, and the little potty worked much better. I held him in a sitting position on the potty and said ‘psss.’  If he needed to go, he would go within about 30 seconds. He had a 4 am poop until about 4 months old and that nearly always went in the potty because he wouldn’t go until I took his diaper off, which is why we started EC. Before we started doing EC, my mom casually mentioned that I should get a potty to set him on if I knew he was about to go instead of dirtying a clean diaper. I read up on EC and that is exactly what we did.

During the day, I took him when I thought he might need to go and eventually learned his patterns, but always kept cloth diapers on as back-up. Some parents report that their babies give them some kind of signal when they need to go, but Gabe still doesn’t do that at 11 months. He does look at his stream of pee or pile of poop rather inquisitively, though. The little potty worked great and I caught at least half of his day time elimination for about the first 6 months, although I did not try to catch anything at night unless it was poop. I did find that he never peed or pooped in his sleep, which indicated to me that he was consciously eliminating. I kept a potty in the car for EC away from home but it wasn’t always practical and I sometimes just let him go in a diaper. Some parents do EC part-time or only occasionally, especially if both parents work outside the home. 

When mobility set in, he started crawling off the potty and generally did not want to sit there.  I kept him in cloth diapers and only tried to catch the easy ones, such as upon waking.  Around 8 months, I discovered that he liked to pee outside. I held him in a sitting position with my hands under his thighs. I began holding him over the toilet and sometimes the shower in this position and he always went right away if he needed to go. Until about 9 months, he would pee wherever he was when he needed to go if no one took him potty. Then one day I noticed him squatting to pee on the floor. At first he slipped in his puddles, but later started crawling away right after he peed. This was around the same time that he really started to dislike wearing a diaper. When I put him in underwear full time, home and away from home, at 10 months, I noticed that he never peed on people or things. When we missed, he squatted and peed on the floor. Since we have hard floors, little puddles are very easy to clean up with a prefold diaper. I have always worn him a lot in a sling and he would pee on me when he was younger if he was not wearing a diaper and he had to go, but he has not done it since we’ve retired the diapers. Parents often say that their EC’ed babies do not eliminate while being worn. As long as he gets enough ‘pottytunities’, he doesn’t pee on the floor, but it’s nice to know that if I forget to take him, that he’ll just go on the floor and crawl away without making a huge mess. I bought two pairs of cotton training pants for when we are away from home, but he hasn’t peed in them yet. He has no problem peeing while being held over a public toilet. Lucky for me, his usual pooping time is a time when we are almost always home, although this certainly was not the case just a few months ago!

People usually think it’s cool that Gabe doesn’t wear a diaper, but when he was younger and still wore diapers as back-up, people would ask me questions like, ‘So do you take him potty because it will be easier to potty train him later?’ That’s not how I think about it. We do EC because it is a convenient way for our family to manage Gabe’s elimination. There are other benefits of EC, but convenience is very important to me. Potty ‘training’ in the conventional sense of the phrase will never really occur for Gabe. He does not have to be introduced to the potty or re-taught to listen to his body’s signals because he was never taught to ignore them.  Have you ever noticed that newborns often pee and poop as soon as the diaper is removed?  Babies may not have the level of control over their bowels and bladders that adults do, but they are aware of what is going on.   

EC is more environmentally friendly than either disposable or cloth diapers since it minimizes landfill waste and energy and water usage. Sometimes babies fuss because they need to eliminate and are not in a very conducive position. When baby fusses, parents go down the needs list: is he hungry, tired, hot, cold, sick? Parents practicing EC have one more: does he need to pee or poop? EC is more hygienic since babies don’t sit in their waste. It’s inexpensive. Even using back up diapers, you will not need as many of them as you would if you were full time diapering and baby will likely be out of them sooner. The goal of EC is not to have your baby out of diapers sooner than the Joneses’ fully diapered baby, but this often happens. An EC’ed baby will be cooler during the summer without wearing a hot diaper all the time. Older babies and toddlers are spared the frustration of being diapered. EC does not have to be time consuming and it certainly never has been in my family. Even if we stopped now for some reason, we would not think we wasted our time these past 9 months that we have been practicing EC. We are not looking for a pot of gold at the end of a rainbow. The connectedness that we have with Gabe in the present and the convenience of not worrying about diapers is the rainbow itself.

Before I started EC I had never really thought about life before the advent of diapers. I just assumed babies always wore diapers. I did wonder how caregivers in primitive societies kept from getting peed and pooped on all the time. I soon discovered that diapers, like so many other personal care products, are not as essential to life as advertising may lead us to believe. Even though a popular baby book asserts that diapers are part of civilized society, I maintain that there is rarely only one way to do anything and dealing with a baby’s elimination needs is no exception.

When Gabe was 3 months old, we were visiting with a family friend from China. When I excused myself to take Gabe potty, I started to explain what I was doing when I was interrupted and told that taking a baby potty is perfectly normal and babies are potty trained at 12 months in China. This happened again when Gabe was 6 months old and I was with an acquaintance from Moldova. American doctors began telling parents to wait 18 to 24 months to introduce the potty after Dr. T. Berry Brazelton’s 1962 study ‘A Child-Oriented Approach to Toilet Training’ was published in Pediatrics, which concluded that children have little to no control over their bowls and bladders until this age. From my observations at all the places I have been where babies and toddlers were present, I assume that most Americans have heeded this unfortunate advice and diaper trained their children.

Since it is warm where we live, Gabe wears underwear or training pants and a t-shirt every day. This leads people to ask me questions. Most people, especially mothers who have conventionally potty trained toddlers, are amazed that there is ‘such a thing’ as EC and want more information. A neighbor called Gabe ‘genius baby’ after she saw me take him pee in the yard and said ‘I wish I had known about that when my kids were little’. When a society has a deep-seated way of doing something, it is difficult, and maybe even perceived as radical, to think that there might be an alternative. EC may not work for every family, but based on the EC related conversations I’ve had, I believe that every family would benefit from knowing about it so they can consciously discover what works best for them.

For more information on EC, check out the Nappy Free! DVD, available from the Kindred shop.

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