By Laurie Boucke
Infant Potty Training and Elimination Communication
Have you ever thought about how babies were toilet trained in the days before diapers? Or how they are potty trained today in places without diapers? There is a growing community of mothers who are using infant potty training (IPT) with their babies, a method similar to the way mothers around the world have been handling the elimination issue for centuries.
It is important to emphasize from the start that IPT is about working with infants (as opposed to toddlers) towards accomplishing what is commonly known as "potty training." The ideal time to start is between birth and 4 to 5 months of age.
There is no English term to suitably describe “infant potty training" as a whole, since (a) an infant cannot sit on a potty and (b) the process is more akin to teamwork (with your baby) and interconnectedness than actual training. In other words, IPT is really about communication and responsiveness. It has little to do with what we normally call “training.” Communication is the key to connecting with your baby about elimination.
Let’s start at the very beginning of infant potty training
Perhaps the most unique characteristic of this method is that parents typically begin working with a baby before she can even sit. Instead of beginning research on toilet training around the time a child takes her first steps, parents need to consider this method during pregnancy or the first weeks/months after delivery.
I refer to this method as "infant pottying" and "infant potty training." Other terms include "elimination communication" and "trickle treat" (the title of my first book on this topic, now out of print).
Babies are smarter than we think! The big mistake that people make is to presume that a newborn baby is unaware of going to the toilet. We assume an infant is incapable of toilet learning since infants are small and uncoordinated and also because they cannot walk or talk. An infant is helpless in so many ways that it is hard for Westerners to imagine such a tiny being could be aware of peeing and pooping. It is even harder for us to believe that an infant has some control over elimination.
Learning to use diapers
With these preconceived and narrow views, we encourage and teach our babies to be unconcerned about wetting and soiling diapers. In short, we teach our infants to use diapers as a toilet.
A normal, healthy infant is indeed aware of the bodily function of elimination and can learn to respond to it from infancy. By using diapers, we condition and thereby train baby to go in them. Later the child must unlearn this training. This can be confusing and a traumatic experience for the child.
An infant does his best to communicate his awareness to you, but if you don't listen, he will stop communicating and gradually lose touch with the elimination functions. He will be conditioned not to care and learn that you want him to use his diaper as a toilet.
Not only is toilet training from infancy basically unheard of in the United States, it also strikes many as inconvenient. With relatively few exceptions, however, toilet training is by definition inconvenient no matter how you do it. If you wait for your baby to self-train at 2, 3, 4 or older, you are both subjected to years of diaper changes (not to mention laundry, baby wipes and other means of sanitation).
Diapers, especially disposable ones, are a temporary way to deal with toileting. We attempt to "plug up" our child's disposal system with diapers in the same way as we temporarily stop the flow from a leaking pipe. How many parents have pondered whether or not this is the most hygienic solution for the child? How many parents care about the effects of diapers on the environment? How many would care if they knew of an alternative to full-time diapers?
Who can use the infant potty training method?
Parents of infants, parents-to-be, grandparents, nannies and anyone else interested in lovingly and patiently working with an infant towards accomplishing potty training at the earliest possible age can use this method. "Infant" is the operative word here, as opposed to "toddler," in that a caregiver begins working as a team with an infant in the early months of life.
Infant potty training is best used by a parent who spends at least the first one or two years caring for baby, or a working parent with one or more trustworthy and reliable helper(s) such as a family member, nanny or friend.
What does it take?
Infant potty training takes time, diligence and patience. If you cannot devote these qualities or arrange for any assistance you may need, this is not the method for you or your baby. But if this method makes sense, if it resonates, go for it! It can’t hurt to try, and if it doesn’t work out, you can go back to full-time diapering.
When do you start elimination communication?
The ideal time to start is anytime from birth to 4 to 5 months old. During this time, there is a sensitive period where there is a window of learning open.
How long does it take?
The average age of completion in the west is around 2 years, although babies have fairly good control of elimination for many months before completion.
Is it safe?
Infant potty training is safe, of course, as long as parents have the right mindset. Parents must be relaxed and positive about working with their babies. Parents must exercise patience and gentleness; observe and respond to baby's signals on time whenever reasonably possible; and provide proper and loving support while holding their infants.
This is a non-punitive method. Punishment, anger and control are not a part of this method. Note that this method is different from the harsh "early toilet training" method used in Western countries until the 1950s.
Does it really work?
Yes, but not without some effort. Success does not just happen on its own. It takes at least one committed adult and several months of perseverance to complete infant potty training. Right from the very start, there are fun and exciting daily rewards for both baby and caregiver. Baby's communication is acknowledged and encouraged. Parents are amazed at the degree of their infant's awareness and are thrilled when he signals and responds so easily and naturally.
Does my baby have to be naked?
This is not a requirement. Many parents keep a diaper or training pants on their baby in between potty visits, while others prefer to leave their baby bare-bottomed or naked most of the time. In short, it is a matter of preference.
A wonderful discovery
My first two children experienced conventional potty training. When my third son was born, I dreaded the thought of another bout of conventional toilet training that would entail additional years of diapers and began seeking a better means to accomplish this task.
I learned the basis for an alternative technique through a lady visiting us from India. She was horrified when I told her the way Westerners handle the "waste disposal issue" and explained to me the way things are done "back home" in her culture. I was skeptical when she told me that there is no need to use "the cloths" on an infant unless it is "ill of the stomach," feverish or wets the bed most nights. I had been to India several times and had noticed families peeing and pooping their babies around the countryside, but had not paid close attention. Like many others, I mistakenly assumed that Westerners could not use this technique.
I begged my new friend to tell me more and to teach me how to hold my son and get him to "go" for me, which she gladly and effortlessly did.
I was spellbound watching her communicate with my tiny 3-month-old son, who somehow instinctively knew what she wanted him to do. I can only describe the exchange and instant understanding between them -- a stranger and an infant -- as a wonderful discovery.
I used the technique she demonstrated, slightly modifying and adapting it to a Western lifestyle, and found it to be far superior to conventional diaper-to-potty-training. From the day I started working with my 3-month-old son, he rarely needed a diaper, day or night. He stayed dry during most of the day at age 18 months and was finished with all aspects of potty training at age 25 months.
Outlook and source
The trickle treat method begins with conditioning and can be approached in a rational and scientific manner as well as an intuitive and spiritual one, or a combination of both depending on what works best for you and your baby. The rational approach involves timing and observation of elimination patterns and baby body language. The more spiritual approach involves intuition and "tuning in" to your baby in more subtle ways.
Remember, it is teamwork, something you do together via close and trusting communication. It is not something you are doing to your baby, and it is not something your baby can do without you. If you are willing and able and if your baby is healthy, your baby is ready for you.
Infant potty training is based on an elimination training technique used in much of Asia and rural Sub-Saharan Africa. The method has been adapted to the Western lifestyle in various ways, including the use of a sink, potty, toilet or other container; variations in elimination positions; part-time use of the technique; and, where desired, part-time use of diapers.
Synopsis of the elimination communication method
Observation Lay your undiapered baby in a comfortable, warm and safe place, then observe her:
1. timing (how long and how frequently she goes after waking or feeding)
2. body language (such as twisting or grimacing while defecating)
3. sounds (such as grunting while defecating
This can also be done using a sling. In fact, babywearing is one of the best ways to become familiar with your baby's elimination timing and patterns since you know straightaway when she goes. It is especially beneficial in cold climates or rooms without sufficient heating. Some mothers keep their babies naked in the sling, carrying them skin-to-skin, which keeps baby at a perfect body temperature. If so desired, you can keep a cloth diaper under her while in the sling. It is, of course, not a requirement to keep your baby naked in the sling. Even if she is wearing some clothing and/or a cloth dipe without a waterproof cover, you will know when she goes.
Anticipation or intuition Anticipate when your infant needs to go; then at that moment, make a watery sound such as "sss." Alternatively, if your baby starts to go while you are observing her, immediately make the "sss" sound. Within a few days, your baby will associate this sound with elimination.
Position and toilet place When you think your infant needs to go, hold her gently and securely over your preferred toilet place while giving an audible signal ("sssss" or whatever sound/words you prefer). Your baby will soon associate the sound, position and place with elimination. Use whatever location and receptacle are most comfy and convenient. Examples include the bathroom sink, a mixing bowl, a basin and the outdoors. Older babies can sit between your legs on the toilet.
Baby-mother communication From now on, pay close attention to baby's timing and signals. When you think she needs to go, hold her in position and give your signal. If it is near time to go, infants are able to relax those muscles upon receiving your cues.
How do I know when my baby needs to go?
You can know when baby needs to go by one or more of the following:
1. Timing (by the clock)
2. Signals and cues (including body language and vocalizations)
3. Patterns of elimination (relation to feeding, waking, etc.)
4. Intuition and instinct
How do I dress my baby for best results?
There are two main considerations that come into play and that need to be balanced: individual circumstances such as climate, lifestyle, health; and social pressures.
The fewer the layers of clothing on baby, the easier it is for both you and your baby to connect and learn and communicate about elimination. It is easier to read and respond to the body language and other signals of a baby who is unclothed, bare-bottomed or otherwise easily accessible. Wearing baby in a sling helps too since you are more likely to be synchronized.
The ideal situation (not always possible or desirable) is for baby to remain naked or bare-bottomed.
If this is not an option, strive to dress baby in as few layers as possible. Use clothing which can be quickly and easily removed (avoid buckles, buttons, etc). There are many different ways to dress your baby for easy access. Be creative and adapt to your situation and to baby’s different phases of development. Many mothers prefer to sew their own baby clothing.
Aside from using diapers as a backup, here are some other suggestions:
1. Poquito Pants, custom made to fit any size infant
2. For neonates, "baby bag" pajamas that tie at the bottom
3. Long shirt or dress (optimum length varies depending on mobility of baby)
4. Stretchy shorts or pants (terrycloth, cotton knit or wool knit) with elastic waists
5. Training pants
6. Chinese baby clothes with open crotch, available at WeeBees, and Discrete Chinese Pants available at home.socal.rr.com..... and www.charlottescloset.com
Benefits of infant potty training
The three big winners in infant potty training are baby, parents and the environment. Here is a more complete list of the benefits of infant potty training.
1. Enhances bonding through closeness, natural communication and loving patience
2. Responds to infants’ natural elimination communication and timing
3. Taps into first window of learning (sensitive period) for toilet learning
4. Helps environment by conserving/saving trees, water, petroleum and landfill space
5. Eliminates or drastically reduces diaper use
6. Allows babies to achieve reasonable control by 12 to 18 months
7. Lets baby complete potty training at a relatively young age (around 24 months)
8. Frees baby from diapers and all negative associations (bulk between legs, chemicals, etc.)
9. Avoids/eliminates enuresis (bed wetting)
10. Prevents diaper rash
11. Provides hygienic respect for your baby
12. Eliminates embarrassing "accidents" for toddlers
13. Allows dads or other close, trusted ones to bond and communicate with baby
14. Yields big savings on diapers and laundry costs
15. Keeps babies in touch with their own bodies
16. Reduces risk of urinary tract infections (UTIs)
If you would like even more reasons and benefits to try infant potty training, read 101 Reasons to EC Your Baby.
What do medical experts think?
Although infant potty training is not well known in the West, there is a growing number of doctors and pediatricians who are supportive. Many of these have either traveled abroad and witnessed the method firsthand or else are (spouses of) immigrants who grew up in cultures where this method is commonplace. Some medical experts have used this method with their own babies.
Like so many other things in life, theories and opinions on when to start toilet learning have gone back and forth over the years. Until the 1950s, most Western families started relatively young, anywhere from 3 to 10 months, and finished relatively young. Then came the disposable diaper industry, more hectic lifestyles and a new theory that it is better to delay and let baby self-train when ready.
The tide is beginning to turn again, with new European research (August 2000) concluding that the current Western views on bladder and bowel control are flawed and that it is often better to start earlier than to delay. Despite varying Western medical opinions and psychological theories, infant toilet learning has been the mainstream method used by billions of happy and well-adjusted babies in many societies for centuries. No one can deny this fact.
What about babies 6 months and older -- is it too late?
Many parents have started potty training their babies at 6, 9, even 12 months and have done okay by making some modifications. It is usually harder to start with a mobile baby who has been "trained" to go in a diaper or who wears disposables and does not associate the feeling of wetness with elimination.
It mainly depends on your convictions. If this method resonates, if you feel it is right for you and your baby, and if your healthy baby takes to it, it is certainly worth an honest try! As long as there are no major upsets in your family life or health, you are likely to be open and receptive to your baby’s elimination communication.
Another factor to consider is that there is not a fixed cutoff age at which all babies lose their connection with the elimination functions. Each child is unique and develops in his own manner. There are parents who have learned about IPT or who have started other methods of toilet learning when their babies were 6 to 18 months, 2 years or even older and who have been delighted to find that their little ones were ready, receptive and communicative about toileting at these ages.
In short, the window of learning seems to remain open or accessible for some older babies. No matter what age your baby is when you first learn about IPT, I usually recommend that parents give this gentle and nurturing method a try for a few weeks, then assess whether you want to continue. Read more tips about late starters for babies over 6 months old.
Infant Potty Training Terminology
Different expressions are used to describe infant potty training, and you will encounter these as you travel around the internet. Here are some of the more common ones:
Infant potty training (IPT)
Trickle treat (TT)
Elimination timing (ET)
Elimination communication (EC)
Natural infant hygiene (NIH)
Infant Potty Training Links
IPT Links (on the topic of infant potty training)
General Parenting Links
Book: Infant Potty Training
Book: Infant Potty Basics
© 2004 Laurie Boucke. Used with permission.
Laurie Boucke, Phi Beta Kappa University of California, is the mother of three sons and has authored eight books, including three on the topic of this article; Infant Potty Basics (2003) and Infant Potty Training (2002) are the most recent. She also works as a court reporter for the deaf and encourages sign language as a means of communication with all infants. For more information, visit her web site or call (800) 382-7922.
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