One of the big topics with infant rearing in this country is toilet training. “Have you changed your first diaper ?”, a new father is frequently asked. Parents begin to wean toddlers off the diaper and into the potty like adults somewhere around 18 months to two years of age. The popular notion here, promoted by pediatricians and other health practitioners, is that infants are simply not “ready” till they are 18 months to two years of age. Having spent their lives peeing and pooping into a diaper at will, asked to suddenly become aware of pee and poop, retain it till they get to a potty and do it there seems like too much work for them. So, you have the phenonmenon of disposable diapers for kids aged six years. And stories like the one told by a colleague of Shanthala where her kid would put on a diaper, poop in it and announce that she had pooped. And stories where using the potty became another line of control over which the kid and the parents duelled over. Starting toilet training around the time of the terrible twos seems like a decision fraught with control issues. I read a statistic that said that the average age by which a child is toilet trained is about three years now.
Like most other parents, we were considering a life with the convenience of disposable diapers, when we began to hear of the environmental costs of that convenience. Looking for alternatives, cloth diapers jumped out immediately. Where we live, there is even a diapering service, that deposits a week’s worth of clean diapers and collects a pail of the past week’s dirty diapers to clean and return the next week. You don’t even have to wash! Shanthala did some research and concluded that it’d be much better to just wash them ourselves and acquired some cloth diapers.
A couple of years ago, Shanthala had come across a book, in the new bookshelf section of the local library, called “ Diaper Free: The Gentle Wisdom of Natural Infant Hygiene” by Ingrid Bauer. Ingrid Bauer talked about toilet training done in other parts of the world where parents start the process much earlier on, as early as two months in some cultures; in India, parents start it somewhere around six months. One of the diaper free books states a New York Times report about “startled” adopted parents confronting the reality of their adopted children already toilet trained. Reading the book brought back memories of how we were raised. When we were infants, disposable diapers were unheard of. We were toilet trained at an early age. Our parents would carry us around butt naked and still mostly avoid the kind of disasters that would terrify Western parents in a similar position, pee and poop everywhere, all the time, to be cleaned constantly.
Ingrid Bauer writes that physiologically, there are two parts to toilet training, retention and release. The infant can be trained from early on to practice the latter and over time, as her muscles mature, she learns to retain till she’s taken to a potty. She says that physiological studies and looking at non-Western cultures worldwide is an indicator that infants possess the ability to release at will practically from birth. Our parents attest to this statement. Shanthala’s mother recalled how they had been training Shanthala to pee by placing her in a corner in their bathroom and saying “ssss”. Shanthala had taken the placing in the corner as the cue and on being placed in any corner would start peeing. My mother similarly mentions how she started training me to release by saying “ssss”.
Ingrid Bauer suggested a return to those practices. This technique is called elimination communication (EC). The basic idea is to train the infant to pee and poop outside the diaper, thus retaining her awareness of the elimination process so that as she gets older, she can shift gradually to asking to be taken to a toilet to finally, going there by herself. It is about not allowing the infant to learn that a diaper is the toilet.
EC consists of observing the patterns of elimination in an infant and cueing the infant to release just as she’s ready to relieve. Knowing when she’s ready to relieve comes from observing and from practice. So EC starts with the release part of the elimination and builds over time to handle the retention.
With the cloth diaper, we’d use a plastic cover as recommended. With her thrush, we stopped using the plastic cover so that we could change her diaper as soon as it got wet, thereby keeping her groin area as dry as possible. This proved beneficial to start noticing patterns about her peeing and pooping. We started saying “ssss” when we realized that she was peeing. We then started taking off the diaper a little before the time we thought that she wanted to pee, and holding her over a sink, we’d cue her release by making the sound “ssss”. Maya learned to associate the sound with peeing pretty quickly and we were off to the races.
Maya pees every 15-20 minutes after she drinks milk, for about three or four times, and then it tapers off to maybe every 25-30 minutes. However this pattern varies considerably, especially if she is going through a growth spurt; the weather also seems to affect this timing. So, keeping a dry diaper through the day is impossible. Some days, we catch enough that we use only a single diaper for about five or six hours. Other days, we’re both off kilter and we end up using a diaper every 20 minutes or so. Some days, she’d look like she was signaling that she wanted to pee. Other days, she’d just pee with no prior warning.
Offering a release immediately after she woke, either in the morning or after a nap, almost always produces a pee. From when she was three months old to almost seven months or so, she even remained dry throughout the night. Somewhere around seven months, she started peeing in the night and we had to make a diaper change or two in the night. We started carrying her without a diaper for extended periods of time, sometimes getting wet in the process, but usually doing quite well. I also noticed that she was better at signaling and I was better at noticing that she wanted to pee, when I held her. If I put her down in a chair or her jumperoo, she’d pee without prior warning. Maya indicates fairly consistently that she has no pee/poop by arching her back if we start taking her to the toilet or her infant potty.
Luckily for us, Maya poops only once a day. Infants apparently learn to control their anal muscles much before their bladder. We found this to be very true. For the past six months, we have had only four incidents where she pooped in her diaper; they were all caused because I was engrossed in something and missed her signal that she wanted to poop. Otherwise, she’s been pooping very successfully in the toilet. This in itself is a very welcome change for us because it makes cleaning her diapers so much more simpler.
We were a little apprehensive whether we’d lose it all when we hired a nanny. Luckily for us, Ginez while unfamiliar with the practice, was eager to try and soon became proficient at it. She even takes the infant potty with her to the park and makes Maya use it. She says proudly how she and Maya are the star attraction at the park with the people being completely amazed at Maya’s ability to pee on command and stay dry. Ginez is also happy with the process because she has no mess to clean up as Maya poops in the toilet.
When we travel outside, we usually don’t get a chance to get Maya to pee in a toilet. So we either carry a handful of cloth diapers or we use a disposable diaper. We acquired a regular pack of disposable diapers when she was born, to tide over the initial days, and we still have a lot of them left. When we start traveling, we’re planning to carry a pack of gDiapers, an eco-friendly diaper that can be even thrown into a compost or flushed down a toilet, as we may no’t be able to wash her diapers. After some reading, it appears that gDiapers aren’t as good as I originally thought them to be.
Nothing comes for free. Toilet training an infant this way requires considerable effort from the parents, or at least it did from us. As Ingrid Bauer writes:
No book is written from a wholly objective viewpoint. This one is no exception. Though backed by extensive research, I write from my personal experience with a bias that reflects my parenting philosophy. I believe babies are happiest when they spend their first months and years in close contact with their parents, particularly their mothers. I think babies usually thrive best when they are nurtured at their mother’s breast. I assume that babies sleep most securely with loving parents in the family bed. I believe that children are simultaneously far more capable than we often give them credit for and far more dependent than we appreciate.
As a parent, I want to be my child’s ally, and I want to cultivate compassion, creativity, and a willingness to take my child’s needs seriously. I believe that a prompt response to a child’s needs helps that child maintain and develop an innately secure interdependent nature. And I believe that Natural Infant Hygiene provides a wonderful part of that picture.
Our reading of anthropological studies of infant rearing in books such as Meredith Small’s “Our Babies, Ourselves” had already won us over to this philosophy. Over time, EC has become natural and less stressful. As I was writing this entry, Maya signaled that she wanted to poop and I took her to the loo. It seems quite effortless now to be in tune with her needs this way. There are times when I’ve felt constrained from letting Maya play for a longer period of time because I had to take her to pee. Then there are times when I couldn’t catch a single pee and this only added to the frustration and exhaustion. But I learned that it’s OK to let her pee in the diaper if I was too busy or exhausted or I didn’t want to interrupt her play, I learned that interrupting her play was more an interruption in my head than in hers.
Whether EC will ease Maya’s transition to normal toilet usage is something that we’ll know, only in time.
References:
- Christine Loh’s Book Diaper Free Baby is a very easy and practical introduction to EC.
- DiaperFreeBaby.org is a very useful online resource for EC including information on local support groups.
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