Elimination communication: How infant potty training works

Fans of elimination communication (EC) say it promotes bonding, is more comfortable for a baby, reduces diaper waste, and, well, gets the job done early! Infant potty training does take time and dedication, though.

What is elimination communication?

Elimination communication (EC), also known as infant potty training, is the practice of introducing your baby to the toilet or potty at a very early age – usually between birth and 4 months old.

Some parents who do this avoid diapers completely by racing their baby to the nearest bathroom (or potty) whenever they anticipate a poop or pee. Others use diapers on and off. By 18 months, in most cases, their children have "graduated" – that is, they know when they have to use the toilet and get themselves there successfully.

While the notion of potty training a very young infant seems radical to many American parents, it's not a new idea. According to the American Academy of PediatricsOpens a new window, the average age parents in the United States start potty training their children today is between 2 and 3 years. But in 1947, 60 percent of children were trained at 18 months. And today, most African, Asian, and European babies are trained well before their second birthday.

So why are American babies and their parents so attached to their diapers? Many think it's due in part to the changing views of experts about toilet training, as well as the invention of disposable diapers.

In the 1950s, pediatrician Benjamin Spock and other experts began advocating a more relaxed approach to toilet training. Then, in the 1960s, pediatrician and parenting expert T. Berry Brazelton advocated an even gentler, more "child-centered" philosophy: He encouraged parents to allow children to follow their own timetable when it came to giving up diapers.

Brazelton's view caught on around the same time as disposable diapers, which tend to be more comfortable for babies (they're so absorbent that babies don't feel wet) and easier for parents to deal with. Against this backdrop, it's no surprise that the average age of toilet training crept up.

Does elimination communication work?

That depends on what you mean by "work." If your goal is to use fewer diapers and get your baby practicing a skill that they'll certainly use later, the answer is yes. If your goal is to have a young baby who never needs diapers again and never has an accident, the answer is likely no.

Given parents' success stories, some babies apparently can learn to read their bodies' signals and get themselves to the potty as soon as they're mobile – but undoubtedly others will need more time to develop the skill (or, perhaps, the interest). There's no way to know how it'll go for your child unless you give it a try.

"I don't see any harm in jump-starting the potty-training process in infancy, as long as parents keep their expectations low and patience levels high," says Liz Donner, M.D., a pediatric hospitalist at Nemours Children's HealthOpens a new window in Orlando, FL.

If your baby isn't taking to elimination communication, though, it's probably worth waiting until they exhibit signs of potty training readiness.

How to use elimination communication

It's best to start between birth and 4 months, according to those who've used elimination communication. (If you start with an older child, it may take longer for them to learn, as they'll have to "unlearn" going in their diaper.)

Here are the basic steps:

Watch your baby and get to know their patterns. When and how often does your baby go to the bathroom? Do they always go at a particular time of day – right after waking up, or 10 or 15 minutes after eating, for example? Do they become very still or fuss a little? Do they make any particular noises, gestures, or expressions when they have to go?

When your baby makes one of their typical elimination signs, remove their pants and hold them securely and gently over a toilet, potty, or even a bucket or pot. Hold them in a squatting position, with their back to you. (Consider where the pee or poop will land!)

While your baby is relieving themself, make a noise that your baby will learn to associate with elimination (many parents use ssssss or some other waterlike sound; others use a word or phrase like "go potty").

Repeat this sound or phrase whenever you see that your baby has to go, and also while they're going, so they'll learn to recognize it as a signal and connect their own impulses with the act of using the potty. This is called cueing.

When an accident happens, be matter-of-fact about it and stay relaxed. Elizabeth Parise, a mother of six (three of them full-time ECed from birth), says your attitude helps your child stay relaxed about the process, too.

During the nighttime, you can opt to diaper your baby or keep a potty right by the bed. Put your baby on it before feedings or if they're restless during the night.

"For nighttime pottying, it's important to do what works best for the family as a whole," says Laurie Boucke, author of Infant Potty Training: A Gentle and Primeval Method Adapted to Modern Living.

Be flexible. You don't have to be a purist to practice elimination communication. As mentioned above, it's fine to use diapers sometimes (at night, or when you're out, for instance) if it makes life easier. If you can, use cloth diapers, since disposables are so absorbent that your baby often won't realize when they're wet or soiled.

Stay positive. Don't use pressure or punishment. No matter the approach you decide to take, potty training should be gentle and positive, and done with a sense of humor. The goal is to help your child get in tune with their body and feel good about using the potty.

Advantages of elimination communication

There's little scientific data on toilet training in general, much less on infant potty training. But proponents say elimination communication has many advantages:

It may promote parent-baby bonding. Advocates assert that infant potty training brings you closer to your baby. Because you're constantly watching your baby for signs of being about to pee or poop, they say, you become more in tune with their needs.

Elimination communication "enhances bonding through closeness and communication," says Boucke.

Parents who use the technique are also likely to embrace attachment parenting – an approach to childrearing that encourages practices like extended breastfeeding and carrying your baby close in a sling.

It may be more comfortable for your baby. Infant potty training advocates believe that babies often cry and fuss because of diaper discomfort, even when they're wearing disposables, and that you can spare your baby diaper rashes by allowing them to go diaper-free.

It may allow your child to assert their growing independence. As they become more mobile and start wanting to do things their own way, it can be easier to encourage older babies and toddlers to "crawl to the potty" or "go use the big kid toilet" on their own than to engage in daily diaper-change battles.

It can reduce diaper waste. According to the Environmental Protection AgencyOpens a new window, disposable diapers last for centuries in landfills, and the U.S. generates over 4 million tons of them a year. Using fewer cloth diapers helps the environment, too, since those require energy and other resources for washing and delivery. And reducing your diaper use isn't just good for the earth; it's a nice break for your family's budget.

It's normal and natural. Infant potty training mimics the time-worn practices of women in parts of Africa and Asia, where mothers often carry around their undiapered babies. These moms avoid being soiled by their bare-bottomed children by learning to anticipate their elimination needs: When a mom notices a signal or pattern that suggests her child is about to relieve themself, she holds them away from her body.

In the United States, proponents of the method aim to get their baby quickly to a potty. Boucke explains, "It's not as if your baby is running around peeing and pooping everywhere."

And it doesn't require an unrealistic amount of attentiveness, says Parise. "You don't have to sit at home and stare at your baby all day looking for signs. The awareness just becomes part of your routine – the same way you notice signals that your baby's hungry or sleepy."

Disadvantages of elimination communication

Some experts are skeptical of the approach, and the effort involved may be too much for many parents (especially those in the thick of sleep deprivation).

It takes lots of time and dedication. While infant potty training enthusiasts say you don't have to use the technique around the clock for it to be helpful – you can let your baby go diaper-free just during a certain time of day, for example, or only when you're at home – you're more likely to succeed if you use the technique as often as possible.

It may not be possible for parents who work full time. Elimination communication can be hard to do if you're a working parent, particularly if you and your partner both work full time. No daycare facility would be willing – or permitted under licensing restrictions – to enroll a diaperless infant. (This is one reason some parents choose to do EC part time, say on the weekends and in the evenings.) If you use a nanny or babysitter, however, they may be willing and able to handle infant potty training.

Your baby might not be physically ready for elimination communication. Some child development experts, including physicians at the American Academy of PediatricsOpens a new window, say that babies are just starting to be aware of the sensation of a full bladder or rectum by 12 months old and have only slight control of their bladder or bowels by 18 months.

You may not have much support. Friends and family may be skeptical, or even critical, of your efforts. That might be fine with you, or you it may make you uncomfortable.

You'll have trip-ups along the way. Infant potty training isn't always a snap. BabyCenter's Elimination Communication Community group is full of comments from parents who find the process difficult and exasperating. Some babies use the potty for a few weeks, then go back to having frequent accidents; others pee or poop without ever giving a signal.

Messes are inevitable. With infant potty training, accidents are par for the course. While advocates insist that the approach is overall less messy than diapers, you'll want to be ready with cleaning materials for the times when your baby's signals don't work perfectly or you can't quite get them to the potty in time.

Learn more:

• Baby poop: Everything new parents need to know
• Baby milestones
• Baby growth charts
• Development-boosting games to play with your baby