It can often be pretty difficult to convince a determined two year old to quit nappies.
To avoid this conflict, many families are adopting a different approach to toilet training, one that is more commonly used in other parts of the world, including China, parts of Africa, India, and South and Central America.
This method, called Elimination Communication (EC or assisted infant toilet training), is becoming increasingly popular in the West.
It involves starting toilet training from birth by following the child’s cues.
Toilet training from birth
Instead of using nappies, children learn to go in an appropriate receptacle from two weeks old. Babies are placed on the toilet or some other suitable place (such as a cup, a potty, a bucket or even the ground) after a meal or when they show signs of wanting to eliminate. If the baby does this right, it is rewarded with food or affection.
As far back as 1977, researchers suggested,
sociocultural factors are more important determinants of toilet training readiness than is currently thought.
Research shows this process can help babies quickly learn to eliminate in a convenient place.
How effective is it?
Some argue, based on this cultural difference, that babies are aware of their need to eliminate from birth. Others suggest that infants prefer to be dry and would rather not be left in a dirty nappy. It is this preference that makes elimination communication easy.
One study found that children who used this method (from 33 days) were toilet trained by five months of age.
In this study, the parents noted the child’s signal to eliminate and held the infant’s back to the caregiver’s chest while sitting over a toilet.
While the baby eliminated, the caregiver used vocal signals to reinforce the behaviour.
Usually these signals are a “psss” sound for urine and a different sound for faeces (we’re trialling this method and using a “plop” sound).
Cultural and social differences around nappy use
Parents in western countries generally use nappies to manage babies’ and young children’s waste.
Some parents prefer disposable nappies, which are said to reduce nappy rash – a red and inflamed rash around the nappy area, caused principally by wetness and bacteria or yeast – and other skin conditions including eczema.
For others, environmental concerns mean reusable nappies are preferred. Reusable nappies are usually made of cotton.