Tuesday, March 15, 2011

EC/ Diaper-Free Baby

Disposables or cloth? Or... nothing?  There is another way to respond to an infant's potty needs rather than what has become traditional in industrialized nations.  It is called Elimination Communication (EC), or Diaper-Free Baby, and it is the norm in all other areas of the world, and its use is on the rise here.  The basic premise is that babies are born potty trained, and don't want to soil themselves or their caregivers.  They need us to just show them where to potty and help them get to that place until they are big enough to do it themselves.

We practiced this when our son was young, and have really enjoyed the added closeness it has afforded our family.  Our son is now 2.5 and has been in underwear every day since 10 months and is about 85% miss-free while sleeping at night and about 95% during naps.  He has been reliably pooping in the potty from three months of age.  He tells us when he has to go, or takes himself.  Sometimes he likes to sit on the potty alone for ten or fifteen minutes (hello, shower! or Facebook time...) and read a book or play with a toy.  He always tells us, "All done!" when he is ready to come off, and has been starting to wipe himself and hop off.  Sometimes he likes company when he sits there, and we read together or talk.  

Our son at 3 weeks old being held "in-arms" over potty.
It can be done full or part-time, though, and most families who choose this method start by three months of age, and their babies usually "graduate" around eight or ten months of age (girls are anecdotally quicker than boys).  Families who practice part-time have graduates later, but reap many benefits along the way, with the greatest being their baby's continued awareness of their body's need to eliminate.

Other benefits of EC include using fewer diapers, and using them as back-up rather than relying on them.  The ecological footprint of the baby is reduced enormously, especially since poops usually can go into the potty within two or three months very reliably, which means families choose cloth diaper backup without a lot of the messy clean-up sometimes associated with cloth diapering.  Babies rarely sit in a dirty diaper, which helps avoid diaper rash and the possibility of a baby UTI.  

One of the purposes of EC, to keep the baby's awareness of elimination, is increased with the use of cloth, since they learn to tell you when they are wet and connect being wet with an internal feeling.  Cloth lets them feel wet, but disposables are so advanced and wick the moisture away so quickly, that babies who wear them never feel wet and never associate the bodily feeling of eliminating with any feeling of wetness.  With EC, the caregiver who uses cloth changes the baby ASAP out of the wetness, so the baby never becomes accustomed to that wet feeling.  Many babies who are "diaper-free" actually wear cloth training pants most of the time, so they can feel the wetness but not make a mess every time they have a "miss."

EC also helps caregivers and babies feel more connected, since the caregiver has another way of communicating with the child and understanding their needs.  They avoid the distaste associated with diaper changes, which could be misconstrued by the baby as distaste towards them.  It is often likened to breastfeeding and associated with the attachment parenting style of care-giving.  Elimination, when using this method, becomes a time to communicate and bond with the baby.  When my son was younger, we used to spend our time on the potty reading books and exploring some toys.  

On vacation in Hawaii at 9 months, taking a potty break.
Potty time has always been a special time for my son and I.  I used to get frustrated, though, when I would go to a group or baby activity and need to excuse us to go potty, then I realized the other moms had to spend the same time changing their babies, although it was deferred.  It also gave my son and I time to re-connect when in a busy place that could be potentially overwhelming.  And now, later, I hardly think of his potty needs without him telling me, and others are still spending this time changing their toddlers. I was glad for the activity of going to the potty, though, when we were at home alone together when he was young.  It gave me a little more of a sense of purpose while being home with him, and a little extra time to connect with him.  When Dad was home, it gave him a way to connect and meet our son's needs in a similar way that nursing allowed me to connect with him.  Moms who work often have their caregiver do EC as a job requirement, or choose an EC-friendly daycare.  Some also do part-time EC at night and on the weekends.

Moms with more than one baby report that the extra time spent with the younger baby on the potty doesn't interfere with time needed to attend to siblings.  I have read that EC if often easier with older siblings because the siblings are more attuned to the baby, and often point out when the baby has to go.  Supposedly it becomes another family activity.

I also chose this method because it was appealing to me to have his pottying in the toilet as a matter of course, and I didn't want to introduce it after he got free will and a greater interest in things besides his caregivers.  We treated it a lot like nursing.  There was never any praise, just like there was never praise for nursing.  There was also never any punishment or disappointment for "misses," just a quick clean-up.  The only verbal acknowledgement was a quick (and semi-rare, actually), "pee pee/ poo poo goes in the potty."

At 11.5 months, playing with a favorite toy (sunscreen bottle) on the toilet insert.
We used timing as one of our main methods of EC.  By paying attention to him as an infant, we learned when he had to go potty.  Immediately after waking was always a time he had to go.  Whenever he woke up, we would take him right to the potty.  This was the easiest "catch" of the day!  We also always took him when changing activities, too, and before and after a car or sling ride.  Timing was strong for us: preemptive peeing helped keep our EC practice about emptying the bladder more than holding it.

He also gave us signals when he had to go, and still gives us signals!  They used to be things like squirming a certain way, or a particular cry/ yelp, or having gas if he had to poop.  When nursing, he would pop on and off the breast when he needed to go, then he would potty, then finish his nursing session.  His signals now are grabbing himself, or squeezing his legs together.  Gas is still a signal as well.  The child often uses sign language when they are slightly older to tell the caregiver they have to go, and families develop a "potty sign" or use the ESL sign for "urine." Some families report their babies blowing raspberries when they need to go.

At 16 months, using our family potty sign.
We used intuition to learn when to take him to the potty, although not as much as many who use this method.  Some people report just knowing their child has to go, and taking them, and others report feeling a faux-miss in the form of warmth under where the baby is sitting on them, and taking them, and the baby urinates.

When taking the baby to the potty, cuing is the main way that two-way communication is developed.  Basically, when first starting out, the caregiver makes a cuing sound whenever the baby is eliminating (often "pss pss" for urine and a grunt for defecation).  Then the caregiver takes the baby to the toileting location and gives the cue, and the baby knows that this is where they are supposed to eliminate.  When young, caregivers hold the baby "in-arms," which is basically having the baby in a squat between the caregivers arms, with the adult hands under their thighs and their bottom over a receptacle like the toilet.  Many EC-ers transition as soon as the baby can sit to a little potty or put a potty seat on the toilet.  Babies soon learn their regular potty locations and don't need the cue sounds.  It is useful to maintain them for times like public toilets or airplanes.  

Cues are also useful for pottying a child in the middle of the night when they are half-asleep and give a signal like a yelp or thrashing around.  In the middle of the night, older children will often wake up and yell "pee pee!" or take themselves to a little potty in their sleeping area.  At 2.5 years old, our son wakes and calls for us to take him to the bathroom.  He pees before bed, then my husband takes him before he goes to sleep a few hours later, then he sometimes wakes one or two more times in the night to go.  Many children never have to wake to go to the bathroom.  There is a theory that night peeing is related to food intolerances and allergies, but we haven't done the legwork for our son in this area.  To us, the advantage of his bodily awareness overshadows his nighttime need for us.  Many EC families choose to only do daytime EC and use diapers at night until the child is older and wakes with dry diapers.

There is special clothing that makes EC easier, but is not necessary.  It is easier to get a baby to the potty quicker with less clothing to remove, so babies often live in a shirt and baby leggings or split-crotch pants when at home and cloth training pants when out.  There are even drop-flap training pants to make it easier to offer opportunities for a dry-diapered baby to potty without using a changing table.  The degree of special clothing depends on the degree of commitment to EC, though.  Other items like waterproof pads help protect laps and furniture.  Tiny potties are available as well.  All of these items together still cost less than conventional diapering, and most have resale value.  A lot are also easy to make, and there are websites to help you do this with minimal skill and experience (like www.doityourselfec.blogspot.com).  The internet is invaluable when finding other EC-ing families and resources to make EC easier.  There are even an Diaper-Free groups that meets regularly around the country.

In split-crotch pants while hosting a play group at 7 months.
Choosing to practice EC full-time was one of the best parenting decisions that we made.  His peers are starting to potty train, and I can't imagine trying to get my strong-willed two-year old to learn how to do this now.  At the time, he just did it because "pee pee goes in the potty."  He never had a diaper rash, and I have a stash of cloth diapers and training pants in excellent condition (they never got pooped in).  I will re-use them then re-sell them.  He stayed in touch with his bodily functions, and poops every day (some of his friends went a week between when they were little).  He got the benefit of learning to sit, crawl, and walk unencumbered by diaper bulk.  He also got extra cuddle time and my husband and I got extra time to feel like we were meeting his needs, and I think he cried and fussed less because it was one more need we were able to attend to when he was pre-verbal.

Taking Dolly to the potty at 23 months.

"The Diaper-Free Baby" by Christine Gross Loh: an excellent basic overview book about EC and how to do it.  A little heavy on explaining the gear choices, but useful and accessible.
"Infant Potty Training" by Laurie Boucke: a detailed explanation of the history and methods of full-time EC. She is one of the first who brought EC to Western nations, and gives some valuable insight.  Slightly extremist in her implementation of EC, but a good read nonetheless.
Diaperfreebaby.org: Nice site for basic information and resources.
tribalbaby.org: One woman's experiences in great detail. Quite helpful.
http://groups.yahoo.com/group/eliminationcommunication: Listserve that is an easy way to get advice from other parents around the country who are also doing or have done EC. Valuable resource. 
http://groups.yahoo.com/group/EastBayDFB: Listserve for East Bay Diaper-Free families that is useful for meeting others in the area who are practicing EC.
doityourselfec.blogspot.com: Really useful resource to make any of the clothing items at home yourself (and some are really easy)
theecstore.com: shop that sells useful EC items

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