Health & Parenting

Bye-Bye Diapers?

Recognizing the Cues continued...

Davidson likens elimination communication to how parents teach children to eat. "How do we know when a child needs to feed? We just have a sense and we feed them," she says.

"There's a nice logic to the elimination communication method," agrees Leslie Rubin, MD, a pediatrician at the Morehouse School of Medicine and Emory University School of Medicine, both in Atlanta. "If you become aware and sensitive to what the little ones are doing, you can respond accordingly. It may not be absolute because just like with feeding, sometimes you can't feed an infant when it's time to feed because for whatever reason, you might be distracted."

When to Potty Train

According to the American Academy of Pediatrics, there is no right age to toilet train a child. Readiness to begin toilet training depends on the individual child, the group states. But starting before age 2 (24 months) is not recommended as the readiness skills and physical development your child needs occur between age 18 months and 2.5 years. While the practice may sound like relative heresy in the U.S., it's embraced in at least 75 countries including India, Kenya, and Greenland.

This type of elimination communication "takes place in cultures where there is a greater degree of intimacy between parents and infants," Rubin says. "If indeed what they are talking about is learning to read babies' signals, that's wonderful because there is no question the baby will have signals when it needs to [go to the bathroom]."

Not so Fast...

"Obviously it would be great to have kids learn to use the toilet by age 1," points out Andrea C.S. McCoy, MD, the medical director at Temple Pediatric Care in Philadelphia. "Unfortunately, their muscles and nerves are not mature enough to really be able to consistently hold urine and stool, relax to allow spontaneous voiding and stooling, and recognize the need to 'go.'"

McCoy says that her greatest concern is the unrealistic expectations that the parent may have as well as the potential for struggles around an issue that ultimately only the child can control. "In older children, we see voluntary withholding that leads to constipation, inappropriate soiling, and voiding dysfunction if they are pressured into toilet learning before they are ready," she tells WebMD. "The same difficulties are potential problems for the child under 1."

A recent study in Pediatrics showed that the average age for completing toileting in girls is about 32 months and in boys is about 35 months. "I think there are subsets within the population that successfully accomplish toileting at earlier ages (18-24 months), but the trend really continues to be between 2 and 3 years of age," she says. "A generation ago I believe there was the same push to early training, but as with many things, the pendulum swings."