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Natural Infant Hygiene:
A Gentle Alternative to Long-term Diapering

By Ingrid Bauer

I never dreamed I would end up living with a diaper-free baby in a culture where having a baby is synonymous with diapering. When motherhood graced my life 16 years ago, I believed all babies needed diapers and toilet training. I never imagined that any alternative to the raging debate between cloth and disposables even existed.

At the time, I was convinced that children simply lacked the muscles and communication skills to regulate their elimination before about 24 months. To expect otherwise would bring all kinds of nasty physical and psychological consequences. And these I was planning wholeheartedly to avoid.

Since then, I've had to re-examine everything I ever believed about toilet training. My youngest son, like millions of babies around the globe, experienced no difficulty in developing awareness and control of his body functions from infancy. We've been communicating about it since his birth, and he was out of diapers since he was four months old. His younger sister has been diaperless from birth. The consequences have been positive: a strengthened trust, an intimate bond and a child who is conscious and comfortable in his body.

A revolutionary concept with ancient roots
What I learned and came to call natural infant hygiene seems new, unusual and revolutionary in our culture. Yet throughout human existence, parents have cared for their babies hygienically without diapers. In many cultures around the world, mothers still know how to tune in, understand, and respond to their infants' elimination needs to keep them clean and content.

Natural Infant Hygiene is common in Asia, Africa and parts of South America and was traditionally practiced among the Inuit and some Native North American peoples. For these mothers, knowing when their baby "needs to go" and holding them over an appropriate place is (or was) second nature.

There is a small but steadily growing resurgence of interest in this practice among North American and European parents today. Parents are drawn to it because "it's natural," for the baby's physical comfort, to avoid diaper rash and digestive problems, to support the baby's body awareness, for environmental reasons, to prevent diapering and toilet training struggles and to reduce diaper use.

The greatest reason and benefit, however, is that parents feel they are responding to their baby's needs in the present moment, enhancing their bond and developing a deep and close communication and trust.

How does it work?
When the mother knows or feels that her baby needs to go, she can remove the diaper or clothing and hold the baby in a secure, close position over an appropriate receptacle. There are several facets to communicating with a preverbal baby about elimination.

Timing and elimination patterns
Watching closely, the mother learns when the baby usually goes and how this relates to other body functions, such as sleeping or nursing. For example, many babies pee as soon as they awaken and at regular intervals after nursing.

Baby's signals and body language
Once they begin watching for it, many parents are amazed to notice that their babies are actually signaling when they need to go. Though every baby is different, some common signals include: fussing, squirming, grunting or vocalizing, pausing and becoming still, waking from sleep, a certain frown, etc.

Many mothers find they are able to simply know when their babies need to relieve themselves, especially once they've been using natural infant hygiene for a while. For example, I could feel this even when I had my back turned to my child.

Cueing the baby
Natural infant hygiene is a two-way communication. Around the world, parents may use a specific sound (such as "shhh" or "sss") and a specific position to hold their baby when they eliminate. This serves as a kind of preliminary language that the baby comes to associate with the act and a way for the parents to offer an opportunity to go. However, it is always the baby who decides whether they need to or not. Sometimes the baby also begins to use this sound as a signal to the parent.

When parents first hear of natural infant hygiene, they may wonder if this means forcing or rushing a child to grow up before they are ready. This is a valid concern and one that is easily allayed when you've seen this gentle practice in action. Unlike conventional toilet training, the focus in natural infant hygiene is not on the baby contracting and retaining or "holding in" body functions. Rather, the baby communicates a need and relaxes and releases at will with the parent's support. The ability to retain develops at the baby's pace, as a natural consequence of his or her awareness.

Millions of mothers worldwide can attest to the fact that babies clearly can voluntarily regulate their elimination without any coercion or negative effects whatsoever. On the contrary, parents often feel an increased closeness and respect for their baby.

A different kind of work
When people first learned that I took my baby regularly to pee rather than relying on diapers, they often commented that it sounded like an awful lot of work. This puzzled me at the time, because it seemed to me a lot less work (and much more enjoyable) than changing a baby and washing wet or poopy diapers for years. As well, parents who waited till their child was older and "ready" to toilet train still seemed to spend a tremendous amount of energy for a much longer time, focusing on helping their children learn as well as avoiding or cleaning up accidents both during the day and at night.

As I considered the paradox, it became apparent to me that natural infant hygiene is neither more nor less work. It is an entirely different kind of work, a different frame of reference altogether. The primary focus of elimination communication is not about cleaning up after baby (though that may still be required for a time). It's about tuning in to a baby's needs, being in the present moment with your child, listening deeply and acting responsively. It's about not disturbing the natural rhythm in the first place, so nothing need be done to fix it later.

Seen superficially, this may seem far less convenient than conventional toilet training, since you can't just rely on leaving the baby in a wet diaper while you finish some important project. In this way, it resembles other responsive parenting practices, which because they are not the norm, seem to require more effort and attention to answering your baby's needs. For example, a mother who chooses to fulfill her baby's needs by total on cue breastfeeding is in a similar position. She gives up the possibility of going out without her child for extended periods, a "convenience" most nursing mothers happily trade for the convenience of being able to meet their baby's needs for comfort, security and optimum nutrition.

Tuning in to your baby in this way does require commitment and effort, as does being a responsive parent in general. Most parents prefer to use diapers at least part-time during the early learning process, on outings and sometimes at night if they don't waken in time to respond to their baby's need to go. Most children become reliably toilet independent with this method between about 10 to 20 months. Yet many of the parents I've interviewed say they would choose natural infant hygiene again even if it were to take just as long as conventional training. They value the closeness and communication.

I think the real work of natural infant hygiene is that of being in the present moment. There are days when it can seem like the most difficult thing in the world to do. And there are days when you have glimpses of enlightenment.

Another opportunity for gentle nurturing
Parents who follow nature's plan for infant care have a distinct advantage in responding to a baby's needs fully. Babies who are breastfed and have frequent or constant contact with their mother's bodies feel satisfied, secure and content. In turn, this strengthens the parent's confidence, pleasure and responsiveness. Studies have shown that these infants are more likely to have their subtle signals heeded and cry less. Even when these babies cry, they do so in the loving arms of a parent who is doing their utmost to understand and help.

It's clear that babies are not the passive beings they were once believed to be. They are absorbing and processing new stimuli and sensory information moment by moment. They are also signaling in both subtle and not so subtle ways throughout the day, trying to communicate to their caregivers exactly what they need, when.

Natural infant hygiene opens another avenue for parents to tune in and respond to their baby's primal needs. This opportunity for strengthening the intimate parent-child relationship relies on practical tools designed by nature to work. Yet natural infant hygiene offers much more than just another parenting technique for dealing with a baby's elimination. Ideally, it is fundamentally a way of being with our babies. This way of being focuses on relationship and communication -- a lifestyle, rather than a chore.

The greatest gift you can give your baby is yourself: your body, your acceptance, your responsiveness, your time and your energy. Nothing could be simpler or more challenging, more vulnerable or more empowering. Nothing could be more freeing or health and life enhancing.

Copyright © 2001 Ingrid Bauer; reprinted with permission.

Ingrid Bauer lives with her family on an island on the West Coast of British Columbia, Canada. She is the author of the new book Diaper Free! The Gentle Wisdom of Natural Infant Hygiene and many articles on parenting, gardening and natural living. To order Diaper Free! contact Natural Wisdom Press or call 1-888-661-5545 toll-free or 250-653-9123.


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"The media have become the mainstream culture in children's lives. Parents have become the alternative. Americans once expected parents to raise their children in accordance with the dominant cultural messages. Today they are expected to raise their children in opposition to it."
-- Ellen Goodman, Boston Globe columnist

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