Elimination Communication: Diaper-Free in America.

Abstract

* Abbreviations: EC — : elimination communication MRSA — : methicillin-resistant Staphylococcus aureus When we were planning to have our third child, we made a conscious decision to not use disposable diapers. We felt sheepish that we had already contributed 2 children’s worth of diapers to our nation’s landfills. Unfortunately, washing and drying cloth diapers could triple the amount of work for us. Further, exchanging disposable diapers for energy- and water-consuming laundering was not an environmentally guilt-free option. How did we as humans take care of children before disposable diapers? Researching this question, we soon learned about elimination communication (EC). EC, also known as natural infant hygiene, is the practice of using the infant’s natural timing and cues to recognize when they need to defecate or urinate. By identifying these cues, caregivers can coordinate elimination in the toilet rather than in a diaper. Contrary to the notion that infants relieve themselves randomly and constantly throughout the day, infants naturally eliminate at predictable times, such as on waking or after feeding. Caregivers can incorporate audio cues (soft whistle or hum) to associate with the act of eliminating. With practice, many children learn to eliminate when they are in proper position and hear the cue. EC is not a new concept. Humans have been doing this for millennia and still do in most resource-limited regions. As little as 3 to 4 generations ago, most Americans did as well. So, why has the pendulum in mainstream American culture swung so far away from EC? The disposable diaper was first patented in 1955.1 In 1962, pediatric developmental specialist Dr T. Berry Brazelton published … Address correspondence to Jeffrey M. Bender, MD, Department of Pediatrics, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS 51, Los Angeles, CA 90027. E-mail: jbender{at}chla.usc.edu