Wednesday, May 8, 2013

Elimination communication: crazy or effective?

"My 2-month-old has used the potty five times today!" Is this a phrase we commonly hear in the United States?  Of course not.  Babies use diapers for their potty needs and that's all there is to it, right?  Maybe not. Some parents are using a technique called "elimination communication" to help non-verbal babies learn that voiding should be performed in a bathroom and not a diaper. 

When I first heard about elimination communication I thought it was absolutely absurd.  Young babies can't communicate potty needs, can they?  Actually they can.  Babies have an innate dislike of soiling their diapers.  A young baby with a wet diaper will fuss as he grows increasingly uncomfortable and eventually the parent will take the hint that baby needs his diaper changed.  Even young babies can learn cause and effect: I pee in my diaper, I feel wet and uncomfortable.  Or: I fuss and cry, mom changes my diaper.  Babies wearing disposable diapers miss this cause and effect.  Since disposable diapers absorb urine almost instantaneously, baby does not associate urinating with becoming wet.  This explains why children raised in disposable diapers have a more difficult time with potty training. 

Because babies in cloth diapers can more readily identify when they have urinated, elimination communication and cloth diapering go well together.  However, even cloth diapered babies can become accustomed to sitting in a soiled diaper if they are not frequently changed.  Therefore, elimination communication requires an enthusiastic parent who is aware of his or her child's needs and willing to help baby stay dry and comfortable.  The parent will need to be able to predict times when baby may need to void, and look for subtle cues from baby.

Cloth diapers like prefolds, flats, or fitteds that lack "stay dry" linings, can help baby recognize when the diaper becomes soiled.  This is the first step in helping baby begin to establish cause and effect: peeing in diaper = wet and uncomfortable diaper.

Behavior conditioning involved in elimination communication:

  1. Baby recognizes that peeing in a diaper results in an uncomfortable feeling
  2. Baby has the urge to urinate and expresses discomfort (or parent predicts baby's needs before they are expressed: such as needing to urinate after a long nap)
  3. Baby recognizes situational cues (we're now in the bathroom and my diaper is gone!)
  4.  Baby gets praise from parent

Elimination communication is really just a type of behavior conditioning.  Most babies eventually grow accustomed to soiling their diapers, however techniques like elimination communication can help babies maintain their innate distaste for being in wet clothing and allow for faster potty training as baby gets older.

We accidentally started using elimination communication when our 7-week-old was struggling with an on-and-off diaper rash. I was giving him extra diaper-free time to help eliminate the rash. I was also changing his diaper frequently, sometimes immediately after it became soiled.  On a whim I took baby to the bathroom when he was dry but he was fussy.  I knew he had just eaten and wasn't sleepy.  Baby immediately urinated when we arrived in the bathroom, and after a few more bathroom trips that day (and some patient waiting in the bathroom) we had suddenly established a situational cue for urinating.  Over the next few days I noticed baby holding his bladder longer, and indicating when he may need to go.  Although I was a skeptic about elimination communication, I was amazed by how easily a young cloth diapered baby can recognize his bodily needs and communicate those needs to a parent.  I was also enjoying when baby began going multiple hours without soiling his cloth diaper: it was significantly reducing diaper laundry and helping prevent rashes from developing on his very sensitive skin.

Unfortunately since little guy is starting daycare in a few weeks, we won't be able to practice elimination communication much during the day.  However, I plan to continue using elimination communication during times when we are home in hopes of facilitating a quicker potty training experience.

Is elimination communication something you have tried?


  1. Fascinating! I think I'm WAAAAAY overdue on getting my 2yo into cloth, and I'm stoked to get my baby who's due in July into cloth and elim comm right away. Thanks for sharing your experiences and thoughts - you're so helpful!

    1. I'm excited to hear your planning to start cloth diapering and using EC! EC has been so helpful for our little guy, I hope it works well for you too. He used to cry and fuss in the evenings because his tummy would bother him, but now I just take him to go potty 30 minutes before bed and he is so much more comfortable and relaxed.