How to Practice Elimination Communication | Natural Infant Hygiene 101

How to Practice Elimination Communication 101

Are you wondering how to practice Elimination Communication (EC)? This brief overview of  Natural Infant Hygiene 101 will explain the basics of how to get started.

There are two main pieces to EC:

  1. Figuring out when to offer Baby the chance to eliminate outside of a diaper
  2. Figuring out how to offer Baby the chance to eliminate outside of a diaper

If you are new to EC, please first read What is Elimination Communication?

When and How to Offer Pottytunities

When and How to Offer Pottytunities

(1) When to Offer a Potty Opportunity

The first piece of the puzzle is to figure out when to offer your baby a chance to eliminate (pee or poo) outside of a diaper. Offering a potty opportunity is often referred to as offering a pottytunity.

There are three main ways to figure out when to offer a pottytunity: based upon timing; noticing Baby's signals that s/he needs to eliminate; and following your intuition. It is usually easiest to start offering pottytunities based upon timing. However, to fully develop the communication aspect of elimination communication, it is best to strive to use all three avenues- timing, signals, and intuition to decide when to potty Baby.

(a) Pottytunities Based on Timing

If you want to know how to practice elimination communication starting right away, the easiest way to dive in is to offer pottytunities based upon timing. This may allow for an easy first catch.

Common Times to offer a Pottytunity:

  • As soon as Baby wakes from a nap;
  • During a diaper change (even if Baby just peed);
  • Before putting Baby into a carrier or car seat;
  • As soon as you arrive somewhere and take Baby out of a carrier or car seat;
  • Before and after a bath; and
  • During or right after nursing Baby.

When practicing EC, you may become aware of times during the day that your individual baby tends to eliminate, such as pooing first thing in the morning, peeing right after a feeding, or peeing frequently in the morning and then less often throughout the day. You can use your Baby's individual patterns to fine tune when to offer pottytunities based on timing.

(b) Pottytunities Based on Signals

You can become deeply attuned to your baby's needs by recognizing  your baby's elimination signals. Understanding what your baby is communicating can be very fulfilling as a parent.

Discovering your baby's unique elimination signals does require time and energy, but it is well worth the effort. When pottytunities are based upon Baby's signals, it helps Baby to retain awareness of his or her urge to eliminate.

Diaper-Free Observation Time to Watch for Signals

This is where diaper free time comes into play. It is easier to observe the body language and noises that Baby makes immediately prior to eliminating if Baby is not wearing a diaper.

If you do not feel comfortable leaving Baby completely bare butt you can do modified diaper free time by dressing Baby in a trifolded prefold cloth diaper with a diaper belt around Baby's waist or a fitted cloth diaper without a cover. You will be able to see or feel immediately when the cloth diaper becomes wet and can easily and quickly change the prefold.

Modified Diaper-Free Time with a Cloth Prefold and Diaper Belt

Modified Diaper-Free Time with a Cloth Prefold and Diaper Belt

Start by preparing an area for diaper-free time. Protect bedding or carpet by laying down a waterproof pad. Begin by practicing diaper-free time for half an hour per day for two to three days. If you are still uncertain of your baby's signals, feel free to practice diaper-free time for half an hour or a few hours in a row once a week or once a day.

Once you are aware of your baby's elimination signals, you can drop diaper-free observation time to once per month. It is a good idea to still practice diaper free observation time every now and then, since Baby's signals are likely to change over time, especially alongside other changes like becoming mobile. Remember, EC does not require Baby to be "diaper free" all the time. It is fine to use diapers as back-up until your communication is strong enough to move on to training pants or underwear.

During diaper free time, as soon as you notice your baby eliminating ,make your chosen cue sound, such as "psss" for pee and a grunt for poo. Quickly clean up the mess and continue observing.

Common Signals of the Need to Eliminate:

Signals for the need to pee or poo vary from baby to baby and also throughout an individual baby's stages of development. To make it easier to know what to watch and listen for, here is a list of some common signals:

  • Popping off the breast while nursing, possibly accompanied by crying;
  • Trying to crawl out of a baby carrier or someone's arms while breathing heavily;
  • Letting out a short cry upon waking from a nap or while being held;
  • Tossing head from side to side while rousing from a nap;
  • For babies who are not yet mobile: Arm and leg motions becoming more energetic;
  • Passing gas;
  • Grunting, making a strained facial expression, or turning red in the face;
  • Becoming quiet and still, with a look of concentration on Baby's face and possibly making eye contact;
  • For older babies and toddlers: Pulling or pointing at crotch, locking knees together and doing the potty dance, squatting, or pointing at or moving toward the potty.

Eventually, Baby may learn the cue sounds you use and make those cue sounds to signal the need to potty. You can also teach the American Sign Language (ASL) sign for "toilet". Once your toddler is talking, s/he may simply tell you in words that they need to go.

(c) Pottytunities Based on Intuition

As well as offering pottytunities based upon timing and signals, follow your intuition. You may just feel that Baby needs to go. Or perhaps you will find yourself thinking, "He couldn't possibly have to go again!". When that thought crosses your mind, it is a good time to offer a pottytunity.

Now that you know some possible times to offer a pottytunity, let's delve into how to do so.

(2) How to Offer a Potty Opportunity

Offering a pottytunity involves three parts: where to allow Baby to eliminate, the position to hold Baby in while s/he eliminates and the use of cueing sounds.

(a) Where to Allow Baby to Eliminate

When practicing EC, you allow your baby to eliminate somewhere other than in the diaper s/he is wearing. (Although with a newborn, you could allow the baby to eliminate onto an open diaper.) It is important to choose a culturally acceptable place for Baby to eliminate. Part of natural infant hygiene is teaching Baby where it is or is not okay to eliminate.

Possible receptacles include:

  • Toilet
  • Small Potty
  • Nature

The regular toilet can be used either by holding Baby over the toilet or adding a toilet seat reducer for baby to sit on. The advantage of using the regular toilet is that, as long as your aim is good, there is very little clean up, since the waste can simply be flushed.

Another option is to use a small potty especially designed for children. Some popular options include BABYBJORN Smart Potty and BecoPotty. If the child is too small to sit up on the potty, you can hold him or her over the potty. There are also small round potties known as top hat potties, which can be placed between your thighs while sitting, with Baby held over the potty.

Another option is to allow Baby to eliminate in an appropriate place in nature. This is one of my favorite options, and another reason I do not like to call EC "infant potty training". Baby is not necessarily being taught to eliminate in a potty. S/he is just being taught to eliminate in an appropriate location other than the diaper she or he is wearing. If you are in the great outdoors and find a secluded tree or grassy area, you can allow baby to pee onto the ground. I prefer this option for pees only. If Baby does poo, please be sure to clean up afterward!

There are other possible receptacles, as well, but the toilet, potty and nature are the most common and a good starting point.

(b) Positions / Holds for Elimination

As well as choosing the receptacle, you can also choose how to position Baby while s/he eliminates.

Possible positions / holds include:

  • Baby sitting on a potty or toilet seat reducer
  • Classic EC hold
  • Cradle hold

If the child is able to sit up on their own or with your assistance, they can sit on a potty or toilet seat reducer.

For young babies who lack strong neck muscles and head control, it may be easier to hold the baby in your arms over a receptacle. Keeping Baby close to your body can also help Baby relax, making elimination easier. For the classic EC hold, face Baby away from you, with Baby's back resting against your belly and hold onto Baby with your hands under each thigh.  Stand or squat over the receptacle, and be sure to aim.

You can also use a modified cradle hold. This works especially well when nursing Baby over a top hat potty or the insert from a Baby Bjorn Smart Potty. Hold baby cradled in your arm with his or her head resting in the bend of your elbow. Use that same arm to hold under Baby's farther away thigh. The other hand can be used to hold the closer thigh, or kept free.

(c) Using Cueing Sounds

The third element of how to practice elimination communication is the use of cueing sounds. You can choose one cueing sound to indicate pee and one to indicate poo, or a single cue for both. Common cueing sounds include "psss" or "pee pee" for pee and grunting for poo. I personally say "poo-poo" for poo.

Especially when you are beginning to practice natural infant hygiene, make the cueing sound every time that you notice Baby eliminate. This applies even if Baby is wearing a diaper at the time. The aim is for baby to associate this sound with the feeling of eliminating.

When you are ready to offer a pottytunity and Baby is bare bottom, hold Baby in the proper position over the receptacle, and make the cueing sound once. When Baby starts to eliminate, make the cueing sound one more time. This is the portion of elimination communication where you are communicating to your Baby. You are letting your Baby know that it is an appropriate time and place to eliminate.

The goal is that, just by holding Baby in a certain manner and making a particular cueing sound, Baby will understand that it is time to pee and/or poo. I was surprised at how quickly my baby caught on. He would pee on cue starting from about two-months-old.

That wraps up the basics of how to practice EC.


Do you have any tips to share or questions regarding how to practice elimination communication?

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