What’s Elimination Communication and Should I Try It?

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My friend swears by the elimination communication potty training style and insists that she really can recognize her baby’s cues before they have to go. I can’t imagine holding my infant over the toilet, and it feels like diapers are so much easier. Am I making potty training harder on us later on if I don’t do this? Is there any research to back this up?

— Potty Training (Really) Early

“Elimination communication,” or EC, has gained (minor) popularity in recent years. For those who have never heard of this, it’s a method of potty training that begins at birth. Parents attempt to perceive their child’s toileting cues (grunting, making faces, could be anything — you’re supposed to learn over time) and hold them over a bowl or toilet when they pee or poop. Over time, the theory goes, parents will get better and better at this, and it will get easier.

A 2017 perspective piece in the prestigious journal Pediatrics reviewed the experience that the authors (two doctors) had with using this with their youngest. This piece is notable for hitting all of the arguments for EC: environmental benefits, convenience, early potty training, better connection with your child, etc. The authors argue this was not difficult to achieve, and by 6 months, they were able to be out of the house with limited supplies. By 18 months, their child was toilet-trained, which is much earlier than the current average (around 3).

However, despite these claims, the evidence on the efficacy of this approach and its outcomes is very poor. There are some parental surveys on how this works, and some claims that it contributes to less crying. But there are generally no control groups in these studies, and they are certainly not randomized. That’s a big problem because choosing to do this is definitely not something families do at random or on a whim.

It is a rare choice and requires a lot of investment from parents and caregivers. It will be a challenge to find a child care center, or even a nanny, who wants to forego diapers. As a result, it is more or less impossible to say whether trying this would have any of the impacts that proponents claim, let alone all of them.

Using diapers is fine. Billions of people have done it. Potty training is often a pain, but you will be able to do it, even if you use diapers and do not hold your baby over a bowl. I promise!