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Karin Susskind, MD, FAAFP: Infant-Based Potty Training

By Karin Susskind, MD, FAAFP
Family Medicine

Did you know that it may be possible to “potty train” your newborn?

Years ago while working in Kenya and Senegal, I noticed the babies weren’t wearing diapers, but only rarely were there signs of a mess. I didn’t think much about it until years later when I was working at Boulder Medical Center, a grandmother visiting from India accompanied her one-year-old grandson to his well child check.

She was surprised that the boy was still wearing diapers and asked if this was normal for children in America (yes, it is). Her question reminded me of the babies I observed while in Africa, so I researched infant-based potty training and found several local parents who were eager to try this. Many of the parents had fun and enjoyed the extra layer of communication with their infant. Some quickly abandoned EC, saying they were feeling overwhelmed with the demands of new parenthood but happy they gave it a try.

Elimination Communication (EC), is a practice in which parents use timing, signals, cues, and intuition to address their infant’s need to eliminate waste. An alternative to traditional “potty training”, EC is a respectful, safe, and easy way to interact with your child.You will pay attention and act on your baby’s cues as you already do when he’s hungry, tired, uncomfortable, or wet. Not only will you be attending to one of your baby’s basic needs, you’ll also decrease the amount of laundry she generates and/or the disposable diapers she uses.

Anyone who has cared for a newborn has probably experienced the routine of checking to see if your little one needs a diaper change, and suddenly he soaks you both. With EC, rather than checking the diaper and changing after soiling,  babies diapers are changed regularly (approximately every two to three hours).

This helps them to instinctively hold back their urine and stool until their diapers are removed. You can take advantage of their innate desire to avoid soiling their nests by holding them over a toilet, sink, or Tupperware-type container marked specifically for this purpose. Using your belly as her backboard, you simply hold your baby (sans diaper) by her thighs while she relieves herself. At most, it will take one to two minutes.

When she urinates, you can make a “sshhhhh” sound. When she stools, you can make a guttural sound. That way, she can eventually link her undiapered body, plus her positioning, plus your verbal cues with the urge to release her bowel and bladder.

The best time to practice EC with your child is immediately after feeding, upon awakening, when he starts to squirm, or, conversely, anytime he stops his activity and averts his eyes sideways. The bearing down/grunting/becoming red in the face are also strong hints that it’s time to try.

I recommend using diapers in between attempts, as you will likely not catch each one. If you decide to practice EC, I suggest gently introducing it to other family members or friends only if they can remain neutral. I have twice seen couples excited to show the grandparents that their four-month-old baby was potty trained using EC. In both cases, the grandparents squealed in surprise during the demonstration, which scared the babies, who subsequently refused to practice EC.

One last caveat: once your child has started eating solids, use the toilet, not the sink for elimination.

Good luck, be well, and congratulations on the arrival of your newborn!


About Karin Susskind, MD, FAAFP
Family Medicine

Dr. Karin Susskind enjoys working with her patients toward optimal health. She combines a deep commitment to her patients with a passion for community and international health.

Board certified by the American Academy of Family Physicians, her practice offers a range of care, including:

  • Evidence-based preventive care and treatment of illness for growing families
  • Immunizations
  • Women’s care
  • Pediatric care including well-baby and well-child checkups
  • Elimination communication / infant-based potty training

Learn more

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