Sunday, May 9, 2010

Elimination Communication: How To’s and Suggestions

Thought I would post this now, before the Unreliable Narrator grows up and I’ve totally forgotten what the early years were like.

Now, we didn’t just come to potty training blind. I started investigating Elimination Communication when I was pregnant. I was obsessing over the “disposable diaper/cloth diaper” false dichotomy (and it is false), when I came across some websites that mentioned EC. I’m an evolving greenie who’s trying to walk the walk over talking the talk, and also someone who, realistically speaking, lives in a hyper-modern, uber-urban city and is as alienated from the land and the natural world as anybody else these days. But, I really wanted to put theory into practice and commit to the reduction of plastic diapers in landfills.

So as weird as EC sounded at first (I have to let my kid wander around my house without a diaper? wha?), I knew it was worth trying.

Step 1: Educate

The best time to read up on EC is when you’re pregnant, before your first child. If that’s not possible, join some online discussion groups or show up at a local Diaper Free Baby meeting and open your ears and mind.

When I started, I read the main books on EC out there (Laurie Boucke) and then I boiled down the information for my husband and my in-laws and parents. Because they were also going to be helping with childcare and I wanted them on board.

I won’t lie: it was hard. My husband (HB) thought I was crazy. But he knew better than to cross a pregnant woman, especially if he wanted to stay married to me and also if he ever hoped to see me naked again. So he was on board, if skeptical.

My in-laws and parents are Chinese immigrants. Their take on the whole matter was, “We left the old country and old country ways precisely so we could enjoy all the modern conveniences and pollute the earth with non-biodegradable disposable diapers like the gwai lo.” Meaning, my mother and mother-in-law might have been potty trained the EC way (Chinese style, meaning, poop on the street from your split pants if you have to), but they considered themselves to have advanced beyond this. So in short, they thought I was crazy too.

It all changed when we brought the Unreliable Narrator home. (Before he could speak we called him the Cutie Nubbin.)

Step 2: Input and Output Are Related

Now ideally, while you’re thinking about what comes out, you’re also thinking about what goes in. We made the choice to breastfeed. That is, I made the executive decision to breastfeed and if HB was moved to lactate and help out, he was welcome to. If he wasn’t forthcoming with this voluntary assistance, then he could be chair of the Dept of Output.

Because we chose breastfeeding, we didn’t have any issues with ear infections or rashes. (Formula apparently tends to exacerbate ear infections and rashes in infants because formula is conducive to baterial growth in the eustachian tubes of sleeping babies, and also some babies are allergic to the composition of certain formulas, as it’s harder to digest than breastmilk.)

But even as the CN moved to solid foods, we decided early on to

  • encourage him to eat plenty of fiber in fruits and vegetables, and lots of whole grains
  • encourage him to eat ethnic foods (we’re Chinese; we also love ethnic foods ourselves)
  • eat lots of veggies ourselves so he would see a good model for this

Because iron is so important to the brain development of babies, we made sure to seek out both animal and non-animal sources of iron. Here’s a handy list. (There’s iron in breastmilk but it decreases after a while, which is why it’s good if first foods are iron rich.) Even today, at almost four years old, the UN mixes in iron-rich dry infant cereal mix into his regular oatmeal.

We consulted Super Baby Food and followed many of the suggestions. Now, I’m a food texture freak and not surprisingly, so’s my son. So there’s no way he’d consent to eating gruel for breakfast past his late toddler years. But what is helpful is the Super Baby Food technique of making up your own batches of pureed lentils, chick peas, cauliflower, what have you, and making ice cubes with them. These store for quite a while in the freezer. So I add these to beef stew or spaghetti sauce, and it’s like turbo-charging those foods nutritionally.

With Super Baby Food I learned the principle of feeding nutritionally dense foods to little ones, in 5 small meals a day. I’ve still continued on this path: it feels like a waste of an opportunity to me if the UN eats a nutritionally-empty snack like potato chips. We almost always offer fruit or vegetables in unlimited quantities, sometimes in combination with nut butters now that we know he’s not allergic, or cheese and crackers, or something of that ilk. A snack is just a little meal, with just as much nutritional attention paid to its composition–a snack isn’t a throwaway. I’ve heated up leftovers from dinner the night before as a snack. If we’re home, why not? Also, offer milk or water with every meal.

Now just because I’m extra tightly wound, I kept all the milk/dairy foods together in one meal or snack, and paired vitamin C rich foods with the high-iron foods. That’s because as a general rule, vitamin C aids absorption of iron and calcium inhibits iron absorption. Beef and broccoli: yes. Beef and cheese: what’s the point? The beef and cheese are kinda canceling each other out.

So I’ve spent a lot of time on the Dept of Input (my bailiwick) because following the law of conservation of matter, what goes in will come out. Quality in, quality out.Constipation is not normal. Explosive poops, while they happen, in my experience were not everyday occurrences. There shouldn’t be crying, straining, bloody, or otherwise traumatic poops happening at your house. If there is, examine what solid food is going into your baby. Juices are sometimes a problem, or cow’s milk. There could be a food allergy or a cold/flu coming on, or other issue that needs investigating.

Step 3: Get Ready to EC

Ok, ideally you’ve thought through the ideas and principles behind what you’ll feed your baby/toddler and how you’ll handle elimination. You’ve given everyone plenty of time to think you’re nuts and warm up to the idea of how nutty you are. (Hopefully you’ve spammed anyone who’ll be in a position to do anything about it with variousNYT and other mainstream media articles on EC to bolster your case.)

For your backup to EC, I’d recommend cloth diapers from a service. You could be changing 12-16 diapers a day on your newborn. The hospital or birthing center will tell you how many wet diapers you should be seeing.

Get your feeding down. I chose breastfeeding; it took a while before we all figured it out.

Cradle your newborn/older baby so that baby’s chest is against your back and you’re holding his/her thighs in your hands. Bring the baby to the sink/toilet/tub/wherever, and make a little prompting noise. Some people say “sss,” “wee,” “psss,” “poo-poo, pee-pee” whatever. Just be consistent.

Now the beauty of starting with a newborn is almost instant, guaranteed success. That little one will be voiding so often during the times s/he’s awake, I know for certain one time you take the diaper off and out will come something into the sink. (We used the sink as it was higher and easier for dad to hold the baby over.)

Good times to see if anything’s ready to come out:

  • first thing upon waking
  • about 10-15 minutes after eating
  • after a nap
  • before bedtime

Older babies will have increased the intervals in between when they void, so it’s more of a crapshoot (ha ha) when you’re able to catch something coming out. (See below; fine tuning.)

And the feeling of triumph when you and your baby do your first catch is a bit like the euphoria of scaling Everest. You know why? Because you and your tiny baby just did something TOGETHER. The result is right there in the sink. How cool is that? And, you’re beginning to envision finitude to YEARS of diapering. The end is in sight, so to speak.

This was HB’s “aha!” moment. When mom-in-law had her first “aha!” moment, somehow I went from being crazy to again being the mere means to an end (the end being the grandchild, that is) and SHE was the one who invented EC. So, people will want to own it in whatever way they can. As annoying as it is, let them.

That’s one less dirty diaper that needs laundering or clogs up a landfill.

Now wipe up and put that clean cloth diaper back on. You can of course use disposables, and we did when we traveled and during the wiggly-can’t/won’t-stop beginning walker months if we left the house. Which we tried to do, for sanity’s sake, often. But the advantage to using cloth is that your child gets instant feedback as to what’s happening in there. Today’s disposables are so absorbent, it’ll feel dry an instant after your child pees. While convenient for the parents/babysitter, this disrupts the normal feedback loop and “diaper trains” your kid. It’s hard to untrain a “diaper-trained” kid, as many parents find to their chagrin when their kid is 4 and 5 and 6 years old.

Me, I’d rather do a focused, intense 24 months or however long, than drag out diapering for a long stretch of many years.

Step 4: Fine Tuning

Everyone has seen the “poo face”: baby squirms, grimaces, reddens and or grunts.

Yep. You know what comes next.

So why not get your baby to the toilet/sink/receptacle, whip off their diaper, and let them void into the receptacle, BEFORE the poo happens?

EC is in large part reading your child so you can get ahead of the curve instead of behind it.

What can help you is knowing the general length of time or interval between pees/poos.

Again, because I am just that tightly wound, I made a chart broken into 24-hour segments. I wanted to keep on top of both how long it took before the CN got hungry again and needed to nurse, and how long it was before he needed to void.

You don’t need to be so tightly wound. I suggest observing and noting IF IT HELPS YOU. If it leaves you a nervous wreck or if you’re not able to do it, then save yourself the worry.

But I do want to say: your watch is your friend. What an incredible advantage you have over a person who can’t tell time. You can, and you can anticipate when your kid will be hungry next (and head off the low-sugar meltdown weepies), or you can anticipate when your little one will probably need to go. In the early stages, timing will be your best friend. That, and watching your kid for the signs he or she will exhibit.

Step 5: Listening

Offer a chance to eliminate at the common times above. Use your verbal signal or cue, and teach your baby ASL for “toilet” (make the letter T –fist with thumb between index and middle finger, shaken side to side). Babies can understand what you tell them long before their mouth and tongue muscles develop the ability to form clear speech. So give them a way to tell you when they need to relieve themselves. You might feel, as i did, like a complete idiot chatting and talking and making ASL signs to a young baby, who is probably just drooling and smiling at you. But they’re taking it all in. And the communication will come back to you paid tenfold.

Which leads me to:

WHEN YOUR KID SIGNALS, RESPOND IMMEDIATELY WITH ASSISTANCE.

You’d think it kinda goes without saying, but there, I said it. Loud.

Recently I observed a mom with her 3-year old toddler. In the middle of eating, he stopped and announced he had to poo. To my surprise, the mother kept doing what she was doing (it wasn’t mission critical, or open heart surgery, or even a conversation being interrupted). I even overheard her confiding that her son has constipation issues. Well, the poor guy needed to go, and no one was taking him. Teach your kid it’s always ok to tend to your body’s needs.

Elsewhere, I’ve noticed older babies making the “poo face” and then been surprised to see no activity by the attending parent, who was maybe 3 feet away. And in some cases, laughing at the “poo face.” I don’t get it. It’s okay for your kid to wear feces for say, longer than the minute it took you to notice?

My point being, if you’ve gone through the trouble of teaching your kid verbal and non-verbal cues to let you know when they need to go, PLEASE meet that need immediately. Encourage communication with supportive action.

Step 6: Listen to No’s

This one is hard. Sometimes you will know as sure as you have synapses and a pulse that your child has to go. All common sense and reason will dictate that they have to go. You’ll offer, and nothing will happen. Or it’ll happen outside the chosen receptacle.

Or five minutes later after you queried/offered. It will be exasperating, but you have to listen to the no’s as much as the yeses.

What you are trying to instill in your child is the ability to listen to his/her body and attend to its needs. Hopefully you’ll have begun cultivating this in your infant, so telling you they need to eliminate is as second nature as breathing (and why Americans wait til the defiant toddler years to start potty training is a mystery). But children will be children and there is no child alive who has skipped testing out the word “no.”

So even if your kid is grievously mistaken about his or her need to go, try with all your might to chalk it up as learning by doing. That is, an error in judgment that your favorite little person in the world made, because they’re still tiny and learning. Learning involves making mistakes. They wouldn’t be human if they didn’t make a mistake, and they wouldn’t be a human child if they didn’t make about a thousand mistakes.

The harder “no” comes from the newly mobile toddler who can’t be bothered to stop to potty or change a diaper (or even have a diaper checked), EVEN THOUGH PRIOR TO THIS THEY WERE OK WITH IT. This happened to me, and I know why: I got busy on my documentary, life was chaotic, the Cutie Nubbin had made huge language leaps and was fast becoming the Unreliable Narrator, he wanted to run and skip and do everything he could on his little legs, he was starting to wean–basically, all hell broke loose developmentally-speaking, and using the potty was last on his list.

The UN’s “no” lasted for a good eight or nine months. Periodically the sun would shine through the clouds and we’d get an easy potty here or there, but we basically went to our backup, cloth diapers. I felt like a failure.

Then I read the comments of other people who also went through a slump. I realized that because kids are so much about the moment, that you too can also get caught up in that moment determining who and what they are for all time. I realized I needed to chillax, and that this phase would pass.

What got us through was not-so-subtle propaganda. We read Everyone Poops, Potty Time With Elmo, we gave stickers/used a star chart with stickers, we bought Thomas the Tank Engine underwear, we talked about slightly older kids he knew who were learning to use the potty.

Most importantly, we made up a little book of kids’ pictures who were using the potty. Whenever HE sat on the potty, I took pictures. Pretty soon we stopped looking at the book of other kids pottying and focused on the book of pictures of him pottying. (You can draw stick figures if you’re not into photographing.) Little by little he got back on track. Our life got less chaotic. He figured he was ready to wean, and he did that and got back to pottying regularly around the same time.

Looking back, I’d say it was “two steps back to make a big jump forward.” And with the perspective I have now, I’d say to parents in a similar bind: “Don’t beat yourself up over it. And go easy on your kid.”

Your mantra for that bumpy time is: no one ever went to college still needing to use a diaper.

Because giving up nursing and going on the potty for good? Those are two huge steps into Big Boyhood, and we grownups forget that it takes a lot of bravery to set aside “baby” things and move on to other things.

Step 7: Forearmed and Forewarned

Get out and about with your kid.

Learn every public restroom’s location in the places you frequent. If you’re asking for communication, sooner or later you’ll receive it, so you’ll need to know how to follow through. It’s your job as parent to help your kid. Elimination is a basic human need. A little advance prep saves on laundry and accidents.

Travel with a potty if you need to. I keep a portable potty in my trunk. There is no shame in pottying on the floor of the back seat of the car. If ya gotta go, ya gotta go. Little bladders are not able to hold out like camels. So have some empathy and make accommodations.

If you’re out and about in that delicate stage of flying solo without diaper-backup, offer the potty frequently.

Be prepared for some accidents. this would happen anyway even if you were completely reliant on diapers of any kind. So just take it in stride.

I’m not a fan of boys who treat the entire planet/any available bush/the sidewalk as a urinal, so I never encouraged that. But in an emergency, I think a parent has to do what a parent has to do. Plus, if you’re sufficiently crunchy that your boy peeing on the tree in your yard doesn’t bother you, then go for it.

Step 8: If You Tell Me You Need to Pee/Poo, You Can Tell Me Anything

The beauty of Elimination Communication is not having a child who’s potty trained at the age of 14 months (it happens that early for some kids; for other kids, they’ve found a groove at 28 months, like my son, for example). The beauty of Elimination Communication goes back to that first time you removed your baby’s diaper because a sixth sense told you they needed to go, and voila! they did. And the two of you grinned at each other in the mirror over the bathroom sink.

You did something together. And it met your child’s need and they knew you were listening. Listening hard. (Ok, you were highly motivated to listen, but the key thing is that you were listening.)

Elimination Communication puts emphasis on the signalling–otherwise it’d be just the parents intuiting when the baby needs to go. But what I think is more valuable is the quality of being mindful and attentive to your child. Hopefully, by modeling that for them, they will know what it is to live mindfully, and be attentive to what you have to say.




Source:http://cynematic.wordpress.com/2007/10/16/elimination-communication-how-tos-and-suggestions/