Diapers? We Don’t Need No Stinkin’ Diapers!

Seven-month-old Simone Schifsky sat grinning on her potty, dimpled thighs pressed against the red plastic seat and pink ruffled pants at her ankles. Then she peed.

"Oh, did you have a wee wee?" crooned her mother, Jo Schifsky. "Good girl. Do you want to do poos, or is it all done?"

Simone can’t walk. But she pees and poops in a potty a half-dozen times a day.

Her mother is one of a growing number of parents in the United States who believe babies can be trained virtually from birth to relieve themselves in response to an attentive caregiver’s cue.

Infant potty training, or "elimination communication" as it’s also known, flies in the face of conventional toilet training, which advises parents to start only after children can walk and pull down their own pants.

Even so, it’s attracting interest from parents motivated by environmental concerns, a desire to bond with their infants and the hope of avoiding potty training power struggles down the road.

Several books on the subject have been published. About 2,500 people nationally have joined Internet support groups run by the organization diaperfreebaby.org, up 20 percent in the past six months. And an online store run by a mother in northern Minnesota does a brisk business selling supplies like extra-small potties, tiny underwear and stickers that say "Born Potty Trained."

"It’s gentle, it’s not coercive or punitive and it keeps the babies in tune with their

having to go potty," said Gwen Krehbiel, of Hastings, who leads a monthly "diaper-free" support group in the Twin Cities. "We’re one of the few cultures that lets our babies sit in poopy, wet diapers."

Eliminating Trash / The idea of a diaperless baby seems bizarre in the industrialized West, but it’s the norm in parts of Asia and Africa. An article in the Journal of Pediatrics estimated that half the world’s babies are toilet trained by age 1.

Many parents in this country try elimination communication out of environmental concern. Babies go through six to 10 diapers a day — that’s 2,000 to 3,500 diapers during the first year. (North Carolina blogger Ben MacNeill actually counted the diapers his daughter Trixie used her first year and came up with 2,472.)

"We couldn’t believe how much trash we were taking out," said Schifsky, who put her oldest son, Roman, in disposable diapers. When Roman was 2 months old, she went out to eat at a Cambodian restaurant in St. Paul and asked where she could change his diaper. The immigrant owner happened to mention that her own daughter had never used diapers. Schifsky was intrigued.

A few days later, Schifsky supported Roman above the bathroom sink with his back braced against her

chest and his chubby legs in the air. Following instructions she had found on the Internet, she made a "ssss" sound.

"And he did it! It worked," recalled Schifsky.

Some infants grunt or pass gas when they need to go, signals that parents learn to watch for. Others stare intently into space, like Schifsky’s middle child, Lily. After a while, so the theory goes, the baby learns to release when held in a certain position or cued with a sound.

Roman, now 5, and his sister Lily, 2 1/2, used sign language to indicate a need to use the potty and were dry night and day by age 2, a year earlier than most children in the United States.

Schifsky puts 7-month-old Simone on the potty six or seven times a day. Away from home, she holds the baby over public toilets or reaches in her purse for the pop-up Tupperware bowl.

"We have a very busy life," Schifsky said. "So we’re not doing this 100 percent. If we notice that she’s giving a cue, then we give her the opportunity to use the toilet. But we’re not fixated on it. So it’s never been stressful for us."

Who’s Being Trained? / On average, children in the United States complete potty training around age 3. The American Academy of Pediatrics Web site doesn’t advise parents to even start training until their children display signs of "readiness" such as staying dry for two hours, having predictable bowel movements or asking for underwear. Most children are ready between 18 and 24 months, some as late as 30 months. Babies younger than 12 months cannot control their bladder or bowels, according to the pediatrician group.

"You’re not actually potty training the child," said David Burnham, medical director of HealthEast Maplewood Clinic, when asked about infant potty training. "You’re training the parents to respond to the child’s nonverbal cues for the need to stool. When I think of the definition of potty training, I think of a child with a reasonable amount of independence using the toilet."

Supporters of elimination communication say babies have more control than physicians suspect and point out that researchers have studied only children who wear diapers.

"A 9-month-old who has been diapered his whole life isn’t going to have control," said Massachusetts mother Melinda Rothstein, who co-founded the group DiaperFree Baby. "Take a 9-month-old who has been pottied and he will have some control."

Or even younger. A 1977 study in the journal Pediatrics describes how East African mothers help babies relieve themselves during the first few weeks of life by supporting them on the mother’s outstretched legs and making a "shuus" noise. The babies were "reasonably dry" during the day and night by 4 to 6 months. Around their first birthday, they were expected to walk themselves out of the house to void.

That’s the way it used to be in the United States as well, Krehbiel said.

"If you go back and talk to your grandma or great-grandma, they’re going to tell you they were potty trained at 12 months," Krehbiel said.

Convenience Vs. Effort / A bare-bottomed baby in Africa is one thing. A diaper-free baby in the United States, where many of us have carpeted floors and mothers head back to work a few weeks after giving birth, is another. Even if it sounds intriguing, most people think it sounds like too much work.

Parents who have ditched the diaper bag say it requires more attentiveness but is more convenient in the long run.

"It’s easier for me to go into the bathroom at Whole Foods and have him pee in the toilet than have to lay him down on a changing table," Rothstein said. "And as they get older, the more convenient it becomes. I’ve been in New York with a baby and let me tell you, you cannot find room to change a baby in a New York restaurant bathroom!"

Is it too much work? Judge for yourself.

By noon on a recent weekday morning, Amy Martin, of Chaska, had already put her 8-month-old daughter, Lylah, on the potty a half-dozen times. The baby woke up at 4 a.m. to nurse and relieved herself into a bowl held between her mother’s legs. She peed again into the bowl at 7 a.m. Less than an hour later she urinated while her mother held her over the bathroom sink, her favorite place these days because she likes to look at herself in the mirror. (Yes, Martin cleans the sink afterward.)

Then Martin drove her older daughter to school. Before they went into the building, Lylah peed into a plastic potty Martin keeps in the van. The baby hung out for about an hour in a baby sling at school. Back at home, Martin offered the potty but this time Lylah did not go. She offered again before Lylah’s nap.

Martin catches almost every poop and misses about two pees every 24 hours, which she considers good since she also cares for two older foster children with special needs and Lylah is at a distractible age — she’s teething and starting to crawl.

"A poopy diaper is almost always a negative experience, especially with the formula-fed baby," Martin said. "The potty is almost always fun. And when she goes, we say, ‘Good job, what a good girl.’ Then it’s off to the next thing."

She also hopes her effort now will pay off when Lylah is a toddler.

"What I like about this is that a child doesn’t have to unlearn something later," Martin said. "I have to say that part of the motivation for me was having seen kids who have learned to go into their diaper. We know kids who are 4 and 5 and who are autistic who just have to have their diaper to poop in."

‘You Can Do It Part Time’ / While there are a few ultra-dedicated parents who hover over their infants and actually try to catch every pee and poop, most "diaper-free" parents use back-up diapers and make accommodations to suit their family.

"Nobody can do it full time," said Laurie Boucke, author of "Infant Potty Training.""Really, you’d go nuts — you couldn’t do anything else. But you can do it part time."

Amy Johnson-Grass, of St. Paul, who works as a midwife, has her 7-month-old son, Liam, make all his bowel movements in a potty. But she lets him pee in the diaper.

"I actually think it’s a little easier this way," she said. "We haven’t had to deal with diaper rash. We haven’t had to deal with blowouts and poopy clothes."

Another mom compromises by putting her 7-month-old in a diaper at night so she can get some sleep. And, while most parents using the approach are home with their children full time, some working parents are trying it. Rebecca Wright started infant potty training when her daughter Clara was 4 weeks old. Now she is back working full time as a clinic manager at Children’s Hospitals and Clinics of Minnesota, and grandma is caring for the baby. In a couple of months, Clara will enter a day care, which, like most child care centers, does not make a practice of offering babies the potty.

"But even if we’re not doing this hard-core, she is maintaining an awareness of when she goes," said Wright, who puts Clara on the potty in the morning and evening. "I don’t think she’s ever going to be a kid who had this issue of not wanting to put her poop in the toilet. That’s a really common thing. And I’m hoping we can avoid it."

Even so, when Wright counts the rewards of the approach, it has less to do with the number of pees and poops in the potty or the number of diapers diverted from the landfill. It’s more about the bond she feels she has developed with her daughter:

"I wouldn’t be doing it if it wasn’t fun."

Maja Beckstrom can be reached at 651-228-5295 or mbeckstrom@pioneerpress.com.

TO LEARN MORE

ONLINE

DiaperFree Baby was started in 2004 by two Massachusetts moms, including Melinda Rothstein, who loosely modeled it on the breastfeeding support and advocacy network La Leche League. They offer a Web site (diaperfreebaby.org) and a network of free support groups. Minnesota is among 31 states where parents meet monthly to swap tips on how to support a floppy newborn over a potty or what to do when your toddler starts having accidents.

BOOKS

– "Infant Potty Training," by Laurie Boucke

– "Diaper Free: The Gentle Wisdom of Natural Infant Hygiene," by Ingrid Bauer

– "The Diaper Free Baby," by Christine Gross-Loh