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'''Elimination communication''' (EC) is a practice in which a caregiver uses timing, signals, cues, and intuition to address  an [[infant]]'s need to eliminate waste.  Caregivers try to recognize and respond to babies' bodily needs and enable them to urinate and defecate in an appropriate place (e.g. a toilet). Caregivers may use [[diaper]]s (nappies) as a back-up in case of misses some or all of the time, or not at all.  EC emphasizes communication between the caregiver and child, helping them both become more attuned to the child's innate rhythms and control of urination and defecation. The term "elimination communication" was inspired by traditional practices of diaper-less baby care in [[Developing country|less industrialized countries]] and [[Hunter-gatherer|hunter-gatherer cultures]].<ref>[http://www.diaperfreebaby.org/index.php?module=pagemaster&PAGE_user_op=view_page&PAGE_id=61&MMN_position=14:14 Practicing Elimination Communication - DiaperFreeBaby<!-- Bot generated title -->]</ref> Some practitioners of EC begin soon after birth, the optimum window being zero to four months,<ref>{{cite book|last=Olson|first=Andrea|title=EC Simplified: Infant Potty Training Made Easy|year=2011|url=http://ecsimplified.com}}</ref> although it can be started with babies of any age.  The practice can be done full-time, part-time, or just occasionally.

==Origins==
The terms ''elimination communication'' and ''natural infant hygiene'' were coined by Ingrid Bauer and are used interchangeably in her book, ''Diaper Free! The Gentle Wisdom of Natural Infant Hygiene'' (2001). Bauer had traveled to India and Africa, where she noticed that most mothers would carry their diaperless babies constantly, yet she saw no elimination "accidents" as would be expected in industrialized countries where babies wear diapers almost continuously from birth. Subsequently, she raised her own children with minimal use of diapers, and eventually began to share her approach with other mothers and caregivers &mdash; initially through Internet-based parenting support groups and eventually through her book and website.<ref>'Diaper Free! The Gentle Wisdom of Natural Infant Hygiene'' (2001)</ref>

Prior publications introducing [[Western world|Western]] parents to this ancient practice include the booklet ''Conscious Toilet Training'', by Laurie Boucke (1979), book ''Trickle Treat: Diaperless Infant Toilet Training Method'', by Laurie Boucke (1991), a pamphlet entitled ''Elimination Timing'', by Natec (1994), and the more extensive ''Infant Potty Training: A Gentle and Primeval Method Adapted to Modern Living'', by Laurie Boucke (2000). Boucke was influenced by an Indian friend who taught her how mothers in India care for babies without diapers, and she adapted it to fit her Western lifestyle. Boucke later co-produced an in-depth DVD entitled ''Potty Whispering: The Gentle Practice of Infant Potty Training'' (2006) and co-authored articles for medical journals.<ref>[http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=DetailsSearch&term=boucke+rugolotto&log$=activity Search for medical journal articles by Boucke et al.]</ref>

While the terms ''elimination communication'' and ''infant potty training'' have become synonymous, many caregivers who practice EC do not consider it to be a form of "training", ''per se''. EC is viewed primarily as a way to meet the baby's present needs and to enhance attachment and communication in general. In that sense, EC is often likened to [[breastfeeding]]. "Toilet mastery is, of course, an inevitable consequence", writes Bauer, "Yet it's no more the goal of Natural Infant Hygiene than weaning is the goal of breastfeeding." (2001, p.&nbsp;217)

Today, one often hears the terms ''natural infant hygiene'', ''infant potty training'', "nappy free" and "elimination communication" used synonymously.

==Benefits==
According to "The Diaper-Free Baby" by Christine Gross Loh, EC offers a large range of advantages. Because EC lessens families' reliance on diapers, this helps reduce the number of diapers sent to landfill, and is cheaper. ECed babies are free from the problems of conventional diapering: diaper rash; diaper change battles; not being able to explore this area; vulnerability to urinary tract infections; potentially delayed or difficult potty training. Gross Loh also reports that EC creates a unique and wonderful bond between babies and caregivers.<ref>"The Diaper-Free Baby" by Christine Gross Loh (Los Angeles: Regan, 2007)</ref> Parents report that the squat or ‘potty’ position that parents tend to hold their baby in order to go seems to be very comfortable for babies. Just as for a laboring mother, the position helps to relax the pelvic floor muscles. This seems to help babies who are suffering from mild constipation. Some babies find defecating to be an unsettling process, especially when they are eating solid food. With EC, parents feel they can offer emotional and physical support.<ref>http://www.nappyfreebaby.co.uk/</ref>  In "EC Simplified: Infant Potty Training Made Easy", Andrea Olson, M.A., adds that EC also helps accelerate the learning process, allowing infants to experience cause and effect. Olson writes that infants feel their bladder fill, which they then release, and once released, produces a sensation of wetness. Furthermore, EC gives infants the opportunity to explore their own bodies, helping them develop a positive self-perception around sexuality, cleanliness, and his or her body image.<ref>{{cite book|last=Olson|first=Andrea|title=EC Simplified: Infant Potty Training Made Easy|year=2011|url=http://ecsimplified.com}}</ref>

==Criticisms==
Conventional potty training advice is based on the research by T Berry Brazelton who introduced the idea of the "readiness approach". He writes that "widespread acceptance of readiness and independent toileting have since been supported by clinical experience and resulted in agreement that a child should be ready to participate in toilet training at approximately 18 months of age and be trained completely by 2 or 3 years old." He argues that trying to toilet train before this age could be coercive and therefore psychologically damaging.<ref>Instruction, Timeliness, and Medical Influences Affecting Toilet Training by T. Berry Brazelton, MD et al.*</ref> Brazelton acknowledges that EC is both possible and desirable, but he believes it is difficult to perform in Western society. In particular he cites a mother's return to work as an obstacle to EC. He also argues that parents should not be made to feel guilty if they cannot communicate with their babies in this way.<ref>[http://www.deseretnews.com/article/1,5143,645192504,00.html?pg=1 A new/old way to toilet-train baby] ''Deseret News'' Archives, by Berry Brazelton and Sparrow]</ref> Anecdotal evidence from parents suggest that EC is not as convenient as conventional diapering.<ref>[http://groups.yahoo.com/group/eliminationcommunication/ Yahoo group supporting parents who EC]</ref>

==Components==
The main components of EC are [[#Timing|timing]], [[#Signals|signals]], [[#Cueing|cueing]], and [[#Intuition|intuition]].

===Timing===
Timing refers to identifying the infant's natural timing of elimination. Newborns tend to [[urination|urinate]] every 10–20 minutes, sometimes very regularly, which makes timing extremely useful.  Older babies may still be very regular, or may vary in timing based on when they have last eaten or slept. As infants get older, the time between eliminations will increase.  By six months, it is not uncommon for babies to go an hour or more without urinating while awake (babies, like adults, rarely urinate during a deep sleep). Timing varies radically for [[defecation]], as some infants may have several bowel movements a day, while others may only have one every few days. Parents report that some babies as young as three months will appear to hold all their bowel movements until they are held in a particular squat position, as long as this is offered regularly enough.<ref>http://groups.yahoo.com/group/ecuk/</ref> Parents also offer the potty at various times according to routine, e.g. after a feed, after waking, just before bath or bed.<ref>http://www.nappyfreebaby.co.uk/</ref> In the west, infant potty training historically relied on timing as the main method of training.<ref>Lekovic, Jill M. Diaper-Free Before 3. New York: Three Rivers Press. 2006.</ref><ref>Schaefer, Charles E. and Theresa Foy DiGeronimo. Toilet Training Without Tears. New York: Signet. 1997.</ref>

===Signals===
Signals are the baby's way of informing a caregiver of an elimination need. Some babies signal very clearly from the beginning, while others may have very subtle signals, or no signal at all. These signals vary widely from one infant to another, and include a certain facial expression, a particular cry, squirming, a sudden unexplained fussiness, as well as others. Signals are most effectively observed without diapers for the first couple of weeks of starting elimination communication.<ref>{{cite book|last=Olson|first=Andrea|title=EC Simplified: Infant Potty Training Made Easy|year=2011|url=http://ecsimplfied}}</ref> Babies who are nursing will often start delatching and relatching repeatedly when they need to eliminate. For defecation, many babies will grunt or pass gas as a signal. As babies get older their signals become more conscious and babies often point to, or look at, a caregiver or potty to indicate need. Older babies can learn a gesture or [[baby sign]] for "[[potty]]". Later they may learn a word as part of their early acquisition of language.<ref>http://groups.yahoo.com/group/ecuk/</ref><ref>"The Diaper-Free Baby" by Christine Gross Loh (Los Angeles: Regan, 2007)</ref>

===Cueing===
Cueing consists of the caregiver making a particular sound or other cue when the baby is in an appropriate place to urinate or defecate, in order to develop two-way communication. At first, the caregiver can make the cueing sound when the baby is eliminating, to develop an association. Once the association is established, the cue can be used to indicate to the baby that he or she is in an appropriate [[toilet|potty]] place. This is especially useful for infants who may not recognize public toilets or unfamiliar receptacles as a "potty." Common sound cues include "psss psss" for urination, and "hmm hmm" (grunting) for defecation. Older babies (late starters) may respond better to more word-like cues. Cues do not have to be auditory; the act of sitting on the potty itself can serve as a cue, or the sign language for "toilet" can be a cue. The American Sign Language sign for "toilet" involves forming a hand into the letter "T" (a fist with the thumb inserted between the first and middle fingers) and shaking the hand side to side from the wrist.<ref>[http://www.lifeprint.com/asl101/pages-signs/b/bathroom.htm American Sign Language - Bathroom]</ref>

===Intuition===
Intuition refers to a caregiver's unprompted thought that the baby may need to eliminate. Although much intuition may simply be subconscious awareness of timing or signals, many parents who practice EC find it an extremely reliable component.

==See also==
* [[Attachment parenting]]
* [[Infant potty training method]]
* [[Dunstan Baby Language]]
* [[Toilet training]]

== References ==
<references/>

==External links==
* [http://tribalbaby.org ''Tribal Baby''] - Excellent resource on EC including a free eBook, [http://tribalbaby.org/7-Secrets-for-Elimination-Communication.pdf''Discover the 7 Secrets to Elimination Communication'']
* [http://web.archive.org/web/20080601033146/http://www.natural-wisdom.com/nihgentlealternative.htm ''Natural Infant Hygiene''] - Ingrid Bauer's article summarizing EC
* [http://www.aitt.evassist.it International Board for the Study, Research and Promotion of Assisted Infant Toilet Training] - Supportive pediatricians, medical journal articles and research

[[Category:Toilet training]]

[[es:Higiene natural infantil]]
[[fr:Hygiène naturelle infantile]]
[[ru:Естественная гигиена новорождённого]]{{Baustelle}}
Windelfrei <ref>http://de.wikibooks.org/wiki/Babybuch:_Windelfrei</ref> ist eine Begrifflichkeit aus der natürlichen [[Säuglingspflege]] und steht im deutschen Sprachraum als Synomym für ein breites Spektrum von Elimination Communication <ref>http://en.wikipedia.org/wiki/Elimination_communication</ref> über TopfFit <ref>http://www.topffit.de/</ref> zu Babys ohne Windeln.

== Einzelnachweise ==
<references />