Dumping diapers: EC, the elimination-communication way of toilet training

Eilish Volta with sons Thor, 7 months, and Milo, 21/2, at their Norris Square home.
Eilish Volta with sons Thor, 7 months, and Milo, 21/2, at their Norris Square home. (ALEJANDRO A. ALVAREZ / Staff Photographer)
Posted: August 22, 2013

No one, surely, would dispute that one of the lesser joys of parenthood is that interminable stretch of time when diaper upon messy, stinky diaper must be changed.

Except for Eilish Volta of Norris Square, that is. The mother of an infant and toddler rarely faces the yucky chore. Seven-month-old son Thor handles his business in a most civilized way. He uses one of the potties scattered around the two-story house. And 2½-year-old Milo has used the regular commode for some time now.

The Volta household practices a toilet-training method called elimination communication, or EC for short. Put simply, it is touted as a way to communicate, even bond, with an infant around issues of the pot. EC involves noticing the cues - grunting or squirming, for example - that indicate a baby needs to go, then holding the infant over a potty, toilet, or often a sink while making a psss (for No. 1) or grrr (for No. 2) sound. Eventually, the sounds signal the child to eliminate.

"I was skeptical at first, I admit," Volta, 31, says. So was her mother-in-law.

In an age when general wisdom welcomes 3-year-olds and beyond in diapers - Pampers makes disposables for children weighing up to 41 pounds - the idea of infant toilet training from Day 1 might seem absurd, certainly challenging, perhaps even harsh.

But ECers swear by this diaperless - or at least far fewer nasty nappies - method. While variations on the practice have waxed and waned over the years, the current resurgence seems to appeal particularly to hip urban and eco-friendly parents. Berkeley, Calif.; Cambridge, Mass.; and trendy areas of New York City are known to be strongholds.

"EC is all about learning to read your child," says Lisa Baker of Atlanta, who is the director of programs for DiaperFreeBaby. The nonprofit support organization based in Boston has an international membership.

Baker still marvels at her first attempt at EC with her newborn daughter, who had just woken from a nap. Holding her over the bathroom sink, "I went psss," she says. "It sounds like water running. Immediately, she peed into the sink. I was blown away. I just had a conversation with my 2-week-old baby."

"I think people are getting interested in responsive, gentle ways to parent their kids," says Miriam J. Katz, a career and life coach who coauthored The Other Baby Book: A Natural Approach to Baby's First Year, self-published last year. It devotes a chapter to elimination communication.

At the Volta house, Thor's mother takes off his cloth diaper and holds him facing outward, with her hands placed under his chubby thighs and his head and back supported against her chest and stomach. He is then held over the pint-size potty in the upstairs bathroom, and Volta makes the psss sound a couple of times. Voilà! A stream of urine trickles into the pot. She also says grrr, but Thor, sucking his fist, apparently is not in need of major relief at this time.

All done - in under 30 seconds.

"I just want the potty to be an option," she says. "I don't aspire to catch every elimination."

EC was a novelty with her firstborn, something she heard about from a friend and YouTube videos. It became more crucial, she says, when Milo developed a urine reflux condition (a disorder that has nothing to do with EC) and had to provide multiple urine samples on demand. Typically, a catheter is used, but a 3-week-old Milo was able to pee on cue into a cup at the pediatrician's office, sparing him that discomfort. Now, EC is the norm.

"There certainly is a sense of fulfillment in taking care of baby's needs," Volta says.

While EC is often associated with diaper-free babies, in part because of Ingrid Bauer's Diaper Free! book in 2001 that popularized the method in America, actual practices vary. Some ECers use disposable diapers, taking them off to hold the child over the potty or toilet and then putting them back on. Others opt for extended periods of buck-naked time, nonchalant about "misses" - accidents being too judgmental a word.

"My house is pee-proofed," Baker says. "Hardwood floors. Leather furniture."

Still, sanitation is a concern when children are diaperless, especially when out and about, says Carol Weingarten, associate professor of nursing at Villanova University. Some EC families are known to let their children make use of a tree when nature calls. "If it's one child, that's one thing," she says. "You're talking about a thousand children using a tree as a bathroom, you have a different situation. It's a public health concern."

Developmental behavioral pediatrician Mary Pipan, who is affiliated with Children's Hospital of Philadelphia, has no issues with EC, as long as child and parent are not stressed about it. She notes that the successful use of the method is "not truly toilet trained." Rather, the child knows a routine. "Later toilet training requires awareness of your need to void, the ability to control it, the ability to communicate that need to others, the ability to pull pants down and up, and the ability to follow the routine for hygiene with wiping and hand washing independently," she says.

For many, EC makes sense. Its proponents argue that diapers, especially stay-dry disposables, condition babies to ignore their body's innate cues, that is the sensation of needing to go. Then as toddlers, they have to be reconditioned to notice those bodily signals during conventional toilet training - an often stressful period for all. That's why the EC method should begin as soon as possible, practitioners say, certainly within the early months.

Julia Nakhleh of Collegeville is a mentor with DiaperFreeBaby and coordinates monthly support meetings in the Philadelphia region. "My motivation was to reduce dirty diapers, to reduce dealing with poop," she says of her own EC trial. A side benefit of teaching "potty independence" this way ( training is for dogs, she explains) was a stronger bond with her children, Alea, 6, and Rami, 3, both EC'd from infancy.

Developmental psychologist Marsha Weinraub finds the EC concept "brilliant," noting that diapers are "a very modern, 20th-century experience."

But the practice hinges on a caretaker with the "wherewithal to be sensitive and responsive to the child," notes Weinraub, chair of the psychology department at Temple University. "Babies eliminate five to six times a day. You really have to be on top of things. . . . Many mothers are just not available to do this."

The method, if not the name, has a long history. Many rural or poor areas of Asia, Africa, and Russia do not use diapers and teach children from birth to relieve themselves in the appropriate facilities. Until the mid-1900s in this country, most children completed toilet training by 2. Government publications encouraged starting at 3 months. For a period in the early 1930s, parents were advised to use thin bars of soap as suppositories to get children on a regular schedule.

T. Berry Brazelton, baby expert, gets credit for advocating the later start of 18 months currently recommended. He said a child should have sufficient language skills to communicate with caretakers about his needs. The American Academy of Pediatrics also recommends introducing toilet training at 18 months or when the child appears ready.

ECers maintain that newborns can communicate too, just in more subtle ways.

"In our culture, we're not used to reading the potty signals," Baker of DiaperFreeBaby says. "But once you do, it's really obvious.

"Sometimes," she says of those nonverbal cues, "I'll notice when adults need to pee."

Contact Lini S. Kadaba at Lkadaba@gmail.com.

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