Sunday 5 October 2008

It's not potty training, it's... elimination communication



We were on the plane to Cape Town. Over the engine noise, Kolya started fidgeting. There was a queue three-deep to get to the toilet. No way is this child going to wait that long, I figured. But the signals were hard to ignore. I stood in the queue, baby in arms, wishing that the other passengers wouldn't take so goddamn long. Eventually the little door sign clicked green. We popped into the loo, and I whipped K's nappy off, convinced it would be a complete disaster zone. Nothing there. I held him over the tiny airplane toilet, feeling like a freak. "Chhh chh" I whispered sheepishly. "Just in case you want to go."

And, super-matter-of-fact, 4-month-old child did just that. Did his thing in the aeroplane loo, probably with better aim than most adults on the flight. I tried hard not to feel smug, but the truth is that one of the best parts of being a parent is feeling that you've succeeded in meeting one of your child's needs, especially when he's too young to spell them out to you verbally.

Elimination communication - otherwise known as natural infant hygiene. Big terminology for a fairly basic concept. I first heard about it while I was pregnant, and (like so many of the ideas I read about, and later ended up taking on board) it sounded weeeeeeird (no pun intended). But intriguing.

See, the commonly held western view about babies is that they can't control their pee or poo. Leave them alone and they'll squirt the stuff liberally all over everything. Enter the nappy industry. A baby therefore must be wrapped up for about the first three years of its life in a nice, tightly-fitting absorbent nappy at all (or most) times.

Question is: what about those aeons that passed before nappies were invented and marketed (a mere 200 or so years ago)? And: what about all those children in places where people don't have access to - or can't afford - nappies?

The answer is elimination communication. Except that in the places where it's most commonly practiced, it doesn't have a name at all. It's just what people do.

Turns out that this idea that babies have no bladder or sphincter control - it's something of a myth. They don't have great control, but they do have an awareness about when they need to go. In a nappy-wearing culture, this awareness will be trained out of the child within the first six months. (Then, ironically, about two years later, the parents will embark on the project of trying to re-establish that awareness in order to "potty train" the now nappy-trained child.)

However, in cultures that don't rely quite so heavily on nappies, children are given opportunities to pee or poo when the mother gets the sense they need to go. Usually the mother will hold the child in a position that encourages them to go, generally holding the baby's back against the mother's stomach, with fingers hooked under the knees so that the child is in a deep squat facing away from the mother over an appropriate receptacle (toilet, bowl, potty etc). The mother makes a "pssss psss" sound for a pee and might make the same or different (e.g. grunting) sound for a poo.

So, when Kolya was a day or two old, we tried this - holding over the basin, making the "pssss" noise. Pretty soon, he was taking the cue to pee into the bathroom basin, or into the toilet. For the first couple of months, we wouldn't do it all that often - a few times a day, at nappy change time, or when he seemed particularly restless or fidgety. Because I was the one staying with him most of the time during the day, I was also the one most familiar with his daily rhythms. So I tended to have more regular success with this than his dad (who claimed "yeah, well, economists predicted 11 out of the last 4 recessions" - as in, if you pre-empt enough of them, you'll catch a few).

But here comes the interesting part. At around 4 weeks, Kolya started having nightly crying sessions. You might even call them screaming sessions. They would last anywhere between half an hour and two hours, and they were the dreaded bit of my day. They would usually happen sometime between 7pm and 9pm. We could usually calm him for a while with a bath, but afterwards it would start up again. Long walks in the sling, singing, rocking, feeding - sometimes one or the other would calm him down and lull him off to sleep. Sometimes not. It looked pretty much like the mysterious "baby colic". I have to admit, I don't really believe in colic. Colic seems to be the doctor-name for the phenomenon of "baby crying without known cause". It's a peculiarly Western phenomenon, which does not seem to affect babies in rural or traditional societies. It has something to do with digestive discomfort, but no one really knows what. And no one really knows how to alleviate it, either.

The screaming (colicky?) sessions continue on and off for around three months. It doesn't seem to make much difference what sort of a day we've had - whether it's been hot or cold, whether we've been out and about or stayed home, whether he's eaten or slept much or little. Some days are screamier than others. We count ourselves lucky that it's only for an hour or so a day, and we get on with the business of taking care of baby.

Until, at around 4 months, I decide, what the hell, I'm going to give this EC thing a bit more of a concerted bash. After all, I'm alone at home with Kolya most of the time. I should be able to leave him without a nappy for at least a few hours a day. I subscribe to an online mailing list that offers support for parents who are "doing EC". I chat to a couple of other mothers I know who are doing it. I buy a little potty. I ignore Nikolai's looks of skepticism when I'm holding Kolya over the potty for the third time in half an hour.

The change is phenomenal. Within a few days, we're getting 9 out of 10 poos in the bathroom, instead of in the nappies. (For a family using exclusively cloth nappies, this is a massive bonus - it's never all that charming sticking loads of shit into your washing machine.) Kolya also starts signalling more clearly when he needs to pee - he'll get a bit fidgety, or whimper a few times. We don't have anywhere near a 100% hit rate, but he's getting loads of time out of nappies, which is better for his skin, better for the environment (fewer nappies to wash), and great for our communication. And - weird but true - the screaming sessions at night just stopped.

I kid you not. I don't have the research to back this up - I have nothing but my own experience and a comment I read by a doctor who said that she suspects that colic might be nothing more (or less) than babies reacting with upsetment to their unmet elimination needs. Dunno. But happy, clean, chilled-out baby makes it thoroughly worth all the effort involved in holding him over loos (and potties and flowerpots and airport basins) - and worth withstanding all the funny looks from other parents.

For more info and support about trying EC, there are some useful books out - I got Christine Gross-Loh's The Diaper-Free Baby, which was hugely helpful. Also, there's a mailing list on yahoo called eliminationcommunication.

The eliminationcommunication group has tons of useful resources, including a list of reasons to EC. Here are a few:

  • Health reasons - less irritation for child's skin by keeping urine and excrement off body, so less chance of nappy rash; children learn how to urinate on cue (is not only convenient, but can prevent healthy problems due to holding urine or bowels)
  • Attachment parenting - encourages the development of a trusting relationship with children through communication about a basic human need; it's more comfortable to carry a baby not wrapped in a big nappy; fosters greater security in a baby - "Mummy and Daddy listen to what I am saying and respond when I need to go."
  • Environmental reasons - reduces the use of disposible nappies, a major contributor to landfill; reduces the use of water and detergents used to wash cloth nappies; reduces the use of disposible wipes used to clean baby's bottom
  • Fun - pottying is more fun than changing diapers; teaches parents how to trust their intutions; baby bottoms are only tiny for a short time; why cover up the cuteness?
  • Common sense - conventional toilet training starts with learning to "hold it" while EC starts with learning to "let go" - this can make a big difference on a baby's perception of elimination and and of life in general; contrary to the promises in advertisements, diapers don't keep the baby clean and dry, but only his clothes and environment. Who would want to wear their toilet?

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