Sunday, May 2, 2010

Elimination Communication explained

With the debate still current as to whether disposable, eco-disposable or cloth nappies are best, there is another alternative that many people are unaware of. It’s the cleanest, greenest and probably the oldest way of dealing with babies’ elimination. Elimination Communication (EC), also referred to as Infant Potty Training or Natural Infant Hygiene, is rarely practiced in Western society but it is the most common way of managing infant hygiene in the world today. While ECing makes good sense where water is scarce or disposable nappies are unavailable, there are many other advantages that babies and parents can also enjoy.

What is Elimination Communication?

Parents carry their babies before they can walk. Mothers help their baby to the breast before they can lift our shirts and self-serve. We help babies get to sleep when they are tired until they are old enough to do this unassisted. With Elimination Communication we are simply helping the baby to eliminate, just as we do, into a receptacle and not into their clothing until such time as they are capable of using a toilet independently. When a baby is never trained to use a nappy or taught to ignore the body’s signals that tell them they need to eliminate, they never have to learn to use a potty or re-recognise their body’s urges at a later date.
We are commonly told by doctors, child health experts and other parents that children develop bladder and bowel control between the ages of 18 months and 3 years. We also assume that babies are unaware of the sensation of having the need to eliminate before this age. Human knowledge of anatomy and physiology reveals both of these beliefs to be misconceptions. Not a new practice; the use of EC has been the norm in many non-western cultures for centuries and is still widely practised today.
We know that babies have bladder and sphincter control from birth. All mammals, including the human newborn, instinctively avoid soiling their nest and will follow the lead of their parents as to what is expected of them to achieve this. All babies are born capable of feeling the need to eliminate and if consistently given the opportunity, can easily learn to communicate to us when they need to eliminate as well as understand when we would like them to eliminate.
In contrast to toilet training, Elimination Communication is primarily about parent training. A close bond between baby and primary carer is essential as the adult must learn to recognise when baby needs to “go” through timing (regular elimination patterns), baby’s cues (body language) and intuition. For this reason, it is consistent with Attachment Parenting as the parent and child are in-tune with each other. This is achieved by being rarely separated, co-sleeping, baby-wearing and parenting instinctively and responsively.
Different parents approach EC differently but a common factor is the adult teaching the child a cueing sound (e.g. “ssss”). When the baby is newborn, the parent makes the cueing sound as baby eliminates and baby soon learns to associate this with elimination. Once this cueing sound has been learnt by the child, the parent can hold their baby over a suitable receptacle and ask the child to eliminate by making the cueing sound.
In time, babies learn how to clearly communicate to their parent their need to eliminate through their body language, baby talk or in some cases by using a hand signal that they have been taught or have invented on their own. Most ECed babies clearly signal either a full bladder or bowel from around 3-4 months onwards and are able to wait long enough for their carer to get them to an appropriate spot to eliminate.
Parents practising Elimination Communication might occasionally use a nappy as back up e.g. for long car trips or when baby is ill with diarrhoea. Some parents choose to EC part-time, perhaps during the day using a nappy only at night or perhaps only when at home. The human body in any healthy person excretes an anti-diuretic hormone during sleep which lessens the need to eliminate during sleep.
Contrary to popular belief, with the exception of people with medical conditions, humans don’t eliminate in their sleep but become semi-conscious when they need to eliminate. The mother who co-sleeps with her child and who is in tune with her baby can awaken to their stirring as they come out of deeper sleep and can respond to their baby’s elimination signals.

What are the advantages of Elimination Communication?

The most obvious benefit is avoiding the time and effort involved in frequently changing wet nappies and the sometimes unpleasant task of dealing with soiled nappies. This is a boon for me who started out as a mum wothout a washing machine and now manages using a twin tub which is very time consuming(see my very first post about off grid washing) It is much easier and generally quicker to take a child of any age to the toilet than it is to change their nappy. Avoiding using nappies means that there is no need to pack a nappy bag and lug it about whenever out of the home.

Elimination Communication is the cleanest choice for the environment

Disposable nappies and the plastic bags they are usually wrapped in once dirty are a major contributor to landfill. For those environmentally conscious parents who choose cloth over disposable nappies, ECing saves the environmental cost of nappy production plus the extra laundry detergent and water involved with washing 6 to 12 reusable nappies per child daily, nappy covers and soiled clothes from nappy “blowouts”.

It’s cheaper

With Elimination Communication we avoid the financial cost involved in both the initial purchase of the nappies plus all the other nappy changing essentials such as change mat, baby wipes, creams and nappy liners. For users of cloth nappies as well as the initial outlay there is the associated costs of laundry powder and running the washing machine which can add up over the years. Clothes fit for longer without the bulk of a nappy.

EC is the healthiest choice for babies

There is no doubt that EC is kindest to babies’ delicate skin. A baby in nappies will have them next to their skin almost continually for many years which can lead to irritations. With disposables there is the issue of chemicals used in the production and in the absorbent gel which can enter a baby’s bloodstream and in the case of girls get into their vagina. With cloth there is the constant issue of keeping baby dry so they are more comfortable and sleep better. With both cloth and disposable nappies there is the age old problem of nappy-rash which can be painful and difficult to clear up. An ECed baby will never have nappy rash and ECing parents will never have to purchase nappy rash salves or preventative barrier creams. Elimination Communication reduces the risk of UTI’ and constipation plus enables parents to take closer note of baby’s elimination patterns to develop a better sense of a child’s digestive system and potentially react to allergens more quickly.

Elimination Communication supports positive child development

EC is considered to be the approach to toileting that optimises healthy sexual development. A baby who is constantly wearing a nappy becomes to an extent desensitised to that area of the body and can’t get in touch with their bodies uninhibited by a nappy. EC respects babies’ abilities to communicate their needs from birth which builds the baby’s self-confidence. Older siblings can be involved in the EC process thereby reducing rivalry and also helping them to develop healthy attitudes about bodily functions.

Elimination Communication leads to enhanced bonding

Perhaps most importantly, the development of a trusting relationship between the parent and the child is enhanced through communication about a basic human need. Baby feels more secure: “Mummy and Daddy listen to what I am saying and respond to my needs.” Parents learn to trust their instincts through accurately reading their baby’s body language building their confidence in their parenting ability. They have an additional parenting tool under their belt because they understand that a baby may be crying due to the need to eliminate and can therefore respond in the appropriate way.

What happens when a nappy free baby is old enough to use the toilet?

Achieving toilet independence for nappy free babies means a gradual transition from needing help to confidently using the toilet on their own. One big advantage for families is that many children are dry at night from around 12 months of age and have achieved complete toilet independence by 14 months. However, while early independence is common with ECed babies due to their increased awareness of their bodily functions, that is never the aim and indeed some ECed babies are independent from an age that might be considered late.
While the focus of being nappy free is primarily on being responsive to our babies and respecting their awareness of their elimination needs and ability to communicate those needs from an early age, the benefits to the whole family as well as to society are many.


Janelle said...

Thank you for this explanation, it clears up some of my questions. I've heard of EC, but never looked into it because I work part time and can't commit to the dedication it requires. I've always wondered how parents managed this - especially since both of my (breastfed) kids seem to do their business during a feeding...but I suppose it makes sense that they can learn to develop control over this. I'm curious - do you do this with your children?

Fran said...

Hi Janelle, I never did do EC with my two although I did try with my second, Kaya, for a few weeks by wrapping cloths around his bottom, it was very messy! I think our society has gone too far away from the knowledge which gives us the confidence to recognise the signals from our babies. Definitly the signals are there loud and clear but sadly we are not. ie present in ourselves! Again a result of our society is we are often lost in our thoughts/feelings etc..
So even though i've been able to be with both my children 100% of the time I didn't have the self confidence to make EC work.
However with encouragement from my partner, my first born Gwendoline, was nappy free, day and night, before the age of 2. Shortly after Gwendoline's 2nd birthday we introduced a potty to the kitchen and she soon got keen to use it, there were plenty of misses along the way as well as a few wet beds. After a short while, and luckily it was warm enough for her to wear only a summer dress she was gong nappy free a lot and just wearing a nappy say, in the car seat, or if we were going visiting. With Kaya(he has just turned one) again, we introduced the potty, but even earlier, at around 10 months. Within 2 months he's having about half of his wees in the potty, a lot directly on to the garden and yes, a few on the floor! The best time to almost always get a wee in the potty is to offer your child to use it directly after taking a nappy off, directly after feeding and directly after waking. Again luckily it's summer time here now so bare bottoms is all the go. I can see Kaya is possibly going to be totally nappy free before 2 aswell. Isn't that great? That goes totally against what we are led to believe. ie that girls are dry much earlier than boys. Kaya is naturally looking to Gwendoline. He obviously recognises the sensation of weeing and pooing because we have taught him and allowed him to be nappy free most of the time during the day. I will finish up by saying that it definitly makes the process quicker if cloth nappies are used as babies clearly don't like the sensation of soiled cloth on their skin. Whereas with disposable nappies when wet they don't feel the sensation of wet. It's all about recognising the sensation, so we have to give them the fullest opportunity to do so. Our children are much more in tune with their bodies than we imagine. Hope that helps. I could write more.....

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