A substitute for elimination communication

When individuals converse of “toddler potty coaching,” they’re typically pondering of technique known as elimination communication. It really works like this:

  • A father or mother notes these instances of day when a child usually eliminates. The father or mother additionally pays consideration to the sounds and actions {that a} child makes shortly earlier than voiding. 
  • Having realized the child’s patterns, the father or mother makes use of this data to anticipate. Is the child able to urinate or defecate? If that’s the case, the father or mother holds the child’s naked backside over a bathroom or different appropriate receptacle.
  • Because the child voids, the father or mother makes a particular sound to sign elimination. Over time, the child learns to affiliate this sound with the deed.
  • As soon as the child has realized the sign, the father or mother can use it to encourage elimination at a handy time. For example, if you’re about to depart for a stroll within the park, you may maintain your child over the bathroom and make the sound. The newborn will get the message, and empties his bladder.

In tough define, that is the method utilized in many conventional cultures around the globe.

Does the method work? Mother and father are happy with the outcomes, which can embody “commencement” to using a potty chair by 9 months (Duong et al 2013a). Furthermore, infants could develop wholesome voiding patterns at an earlier age (Duong et al 2013b), and so they could present much less resistance to the whole elimination of disposable diapers (Yu et al 2023). As well as, Western advocates argue that going diaper-free reduces a child’s threat of infections and dermatitis (Bender and She 2017).

However the conventional method to toddler potty coaching isn’t for everybody.

As I observe on this evidence-based evaluate of elimination communication, the follow requires plenty of vigilance, and messy accidents are inevitable.

So are diapers the one various? No. Not precisely.

Many years in the past, one other potty coaching technique was investigated by developmental psychologists and pediatricians. 

This technique ought to solely be used on infants who’ve developed the power to take a seat up — straight and regular — with out help. So it isn’t a whole substitute for diapers. Relying when your child reaches the milestone of impartial sitting, you might need to make use of diapers for 3-6 months.

However as soon as your child has mastered the power to take a seat up unaided, you may discover success with this method to toddler bathroom coaching, and scale back your dependence on diapers.

Is it value making an attempt? That is dependent upon your private preferences and objectives.

Like most bathroom coaching strategies, this one requires that oldsters spends plenty of time every day attending youngsters on the potty. However if you wish to dump the diapers earlier than your child is 12 months previous, that is one option to get there. When Paul Smeets and his colleagues examined it on 4 youngsters, ranging between 3 and 6 months in age, the researchers discovered it was each secure and efficient. 

Right here’s the process.

baby approaching potty chair, leaning over and looking in

Shaping self-initiated potty coaching in infants (Smeets et al 1985) 

Infants have been educated by their very own dad and mom. To accommodate busy dad and mom, researchers accepted that infants would skip coaching on some days.

A “coaching day” was outlined as a day when dad and mom spent at the least 2 hours coaching their infants.

Earlier than coaching started, dad and mom noticed their infants to study what physique indicators precede voiding. Then they progressed via three phases of coaching.

Section I.

The objective of Section I used to be to show the child to affiliate his personal physique indicators with utilizing the potty.

Mother and father stored infants inside visible vary of a potty chair all through the session. When dad and mom judged that infants have been able to remove, they tapped the potty chair to get their infants consideration, then sat their infants on the potty.

If infants eradicated inside 3 minutes of being positioned on their chairs, dad and mom confirmed their enthusiastic approval. In any other case, dad and mom eliminated their infants from the chairs and tried once more later (when the infants confirmed extra indicators).

When infants had accidents, they have been modified with out a present of emotion. Mother and father continued these classes till their infants had at the least 18 bowel actions within the potty chair and had skilled at the least 8 out of 10 coaching days with out bowel accidents (Smeets et al 1985).

Section II.

After graduating to section II, infants have been stored inside 30 cm of potty chairs all through the day (by putting child and potty chair in a playpen, for example).

When the infants confirmed physique indicators of elimination, infants have been prompted to the touch or seize the potty chair. If infants didn’t contact the chair after they have been verbally prompted, dad and mom gently guided their arms. Then infants have been positioned on the potty chair as in Section I (described above).

Infants have been additionally positioned on the potty chair in the event that they spontaneously touched or grabbed the chair, or in the event that they confirmed no indicators however have been overdue for a voiding.

Section II continued till infants began to achieve for the potty with out prompting for greater than 50% of the trials for 4-6 days working. Infants have been additionally required to have a low fee of accidents—not more than 10% of the whole eliminations.

Section III.

Coaching continued as in Section II, besides that the potty chair was moved farther away (as much as 4 meters, relying on the child’s crawling expertise) and oldsters have been advised to “hold the variety of each day prompts to a minimal” (Smeets et al 1985).

Coaching ended when infants had accomplished 15 out of 18 consecutive coaching days with out an accident and at the least 80% of reaching/grabbing responses have been adopted by eliminations.

As famous above, all 4 infants accomplished this toddler potty coaching program earlier than they have been 12 months previous–earlier than any of them may stroll. Furthermore, no damaging uncomfortable side effects have been reported.


Are you able to mix elimination communication with the potty coaching method examined by the Smeets staff?

I don’t see why not. Once you place your child on the potty chair, use your loved ones’s designated elimination sign to encourage your youngster to void.

When precisely can I start elimination communication? How early can infants be potty educated?

You can begin elimination communication in the course of the new child interval. However if you wish to attempt the Smeets technique, you’ll want to attend till the child can sit upright with out help — a milestone that the majority infants don’t attain till they’re 3-6 months previous.

What about fast-track strategies? Can I potty prepare a child in 3 days?

That’s not life like, not if by “child” you imply a toddler beneath the age of 20 months. Within the Smeets research, infants took round 4-5 months to finish coaching. 

You might need heard of “3 day” packages, however these are usually aimed youngsters who’re at the least 20 months previous. You possibly can find out about “fast-track” potty coaching strategies right here.

Extra details about toddler potty coaching

For a extra normal dialogue of toddler potty coaching, together with strategies for infants who can not but sit up by themselves, see my article on toddler potty coaching. Moreover “how-to” data, it additionally discusses toddler bladder physiology and toddler potty coaching attitudes around the globe.

When you’re questioning how the timing of potty coaching may impact your youngster, see this text about on the advantages and downsides related to coaching at completely different ages.

For a evaluate of bathroom coaching strategies for older youngsters, see this text on potty coaching strategies.

References: Toddler potty coaching

Bender JM and She RC. 2017. Elimination Communication: Diaper-Free in America. Pediatrics. 140(1).

Duong TH, Jansson UB, Hellström AL. 2013a. Vietnamese moms’ experiences with potty coaching process for youngsters from beginning to 2 years of age. J Pediatr Urol. 9(6 Pt A):808-14.

Duong TH, Jansson UB, Holmdahl G, Sillén U, Hellström AL. 2013b. Urinary bladder management in the course of the first 3 years of life in wholesome youngsters in Vietnam–a comparability research with Swedish youngsters. J Pediatr Urol. 9(6 Pt A):700-6.

Smeets PM, Lancioni GE, Ball, TS, and Oliva DS. 1985. Shaping self-initiated toileting in infants. Journal of utilized conduct evaluation, 18: 303-308.

Yu JT, Mao QF, Ji FP, Zhao Y, Hu HJ, Zhang YP, Yang J, Wang QW, Lu W, Wen JG. 2023. Delayed elimination communication is a vital consider disposable diaper dependence in Chinese language preschool-aged youngsters. Entrance Pediatr. 10:1053118.

Written content material of “Toddler potty coaching” final modified 9/2023

picture of child approaching potty chair by istock / ElenaNichizhenova