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What Is 'Elimination Communication'?

When the day comes to stop diapering, most moms couldn’t be happier. Apart from being a chore that takes place five to 10 times a day, it’s expensive. A 2009 Consumer Reports article said that the typical baby uses as much as $2,500 worth of diapers until being fully potty-trained, or over $2,700 in 2013 dollars.

One alternative is elimination communication, or “EC.” With this practice, a caregiver reads physical cues to determine when baby is about to go, and then places the child above the potty. This reduces the use of diapers when used part-time, or eliminates them entirely if used exclusively. This may sound like a radical new child-rearing technique, but it isn’t.

EC has been practiced for thousands of years in ancient cultures, and is still practiced today in the developing world. It was popularized in the U.S. by Ingrid Bauer, in her 2001 book Diaper Free! The Gentle Wisdom of Natural Infant Hygiene. But EC is the subject of books released several years before, such as 1991’s Trickle Treat: Diaperless Infant Toilet Training Method by Laurie Boucke, who had already published the 1979 booklet Conscious Toilet Training, which covered the same ground.

Not everyone is a believer, however. Dr. Steve Hodges, a pediatric urologist, wrote an editorial in The Huffington Post in April 2012, in which he warned that children who EC run the risk of developing a pattern of “chronic holding,” which he characterized as “the root cause of virtually all toileting problems, including daytime pee and poop accidents, bedwetting, urinary frequency and urinary tract infections.”

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On the other hand, pediatrician Dr. Leslie Rubin told WebMD that he saw benefits to the practice. "There's a nice logic to the elimination communication method," he said. "If you become aware and sensitive to what the little ones are doing, you can respond accordingly. It may not be absolute because just like with feeding, sometimes you can't feed an infant when it's time to feed because for whatever reason, you might be distracted."

The medical community hasn’t reached a consensus as to whether EC is helpful or harmful to children. “In a thorough literature search, the present authors were unable to locate or identify a single outcome paper on infant toilet training,” the American Academy of Pediatrics said in a paper called Toilet Training and Toileting Problems: How Do We Advise Parents? To get to the bottom of it mom.me spoke to two moms who practiced elimination communication, and got their takes on the day-to-day reality of using it.

Go to the next page to see how they feel about the practice...


Cathie Butler is 32 years old and has four children. Her oldest are 13, 10 and 7, and her youngest is 3 months old. She said that she saw a mom put her 2-month-old over a potty to do its business, and was so impressed that she decided to try it herself with her third child.

“When we tried it with my 7-year-old, his first pee after he was born, we were able to get in the potty, right from birth,” she said. The telltale sign was his wiggle. “Babies don't like to be wet. They wiggle and fuss a bit, and you pick up on those cues.” She also noticed that babies won’t do their business while sleeping or eating.

“If you’re nursing or bottle feeding, they'll turn their head, so just put them over the potty,” she advised. She also said that EC helped her husband get more involved in child care. “When babies are tiny, a lot of dads feel excluded and tend to be hesitant,” she said. “But this is something dads can totally dive into.”

She cautioned that EC becomes more challenging once baby turns into a toddler and becomes mobile. “When babies walk around, they're distracted and it’s harder to tell when they need to go,” she said. “But there comes an age where they'll take themselves to the potty, and they become independent about pottying earlier.”


Miriam Byroade, 36, has a 4-year-old daughter named Sophie. She first learned about EC from some fellow moms but was skeptical that the technique could actually work. That changed when she and her husband got the chance to observe the process just before Sophie was born.

“We were visiting my friend when her baby girl was only 3 weeks old, and she pottied her while doing a diaper change,” she said. She and her husband decided to try it with Sophie. “I would hold her over the potty for a moment during a diaper change or right after she woke up or had just nursed. She took to it very well.” Miriam then began to learn the cues.

“Needing to poop is easy to spot, her face would get scrunched up and red, with pushing,” she said. “Sometimes it was just a really subtle thing, like she would stop squirming around and get really still.” But difficulties arose as Sophie got older.

“Between 6 and 9 months, EC got more challenging, because she was so much more busy with movement and exploring,” she said. “She was much more interested in crawling than in sitting on the potty.” However, Sophie transitioned to exclusive potty use by the time she was 2, which Miriam described as simple, since the potty had been in use for a while.

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So what advice does Miriam have for other moms considering EC?

“When people asked me about it, I’d say you just have to be really Zen about it,” she said. “The single best thing was the smooth transition to full potty training. There was no struggle, fighting, bribing.” Finally, she had some wisdom for those who wonder if EC is right for them.

“I know EC sounds weird, but once you’ve seen a tiny baby use a potty, then you’ll believe it’s possible.”

Do you practice elimination communication? Lets us know how you feel about it in the comments section below.

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