June 21, 2017 / 6:18 PM / a month ago

Physician couple toilet-trains newborn, skips diapers

5 Min Read

(Reuters Health) - When two California doctors were expecting their third child, they wanted to stop contributing to the more than 27 billion disposable diapers dumped yearly into U.S. landfills.

But washing cloth diapers in water-starved Los Angeles wasn’t an environment-friendly alternative, either. Then Dr. Rosemary She read about a way to skip diapers altogether.

Called elimination communication, the method has parents and caregivers tune into a baby’s cues and natural rhythms and bring the child to a toilet when it seems like the right time.

Skeptical but determined to find a workable alternative to diapers, She gave it a try as soon as she brought her newborn daughter home from the hospital.

“I put her over a potty, gently held her legs, supported her belly, and she went,” she said in a phone interview. “It was kind of mind-blowing.”

She and her husband, Dr. Jeffrey Bender, extoll the benefits of going diaper-free in an editorial published today in Pediatrics. She is a pathologist at the Keck School of Medicine at the University of Southern California in Los Angeles. Bender is a pediatric infectious-disease specialist at Children’s Hospital in Los Angeles.

“For young families interested in protecting the environment for future generations, who want to save some money and keep their kids healthy, this is a good option,” he told Reuters Health.

“It’s not for everyone, and we don’t want people to feel bad if they can’t do it,” he said. “We really want people to hear about it as an option.”

He would like pediatricians to spread the word about the benefits of going diaper-less.

Elimination communication not only spares the environment, it may stave off urinary tract infections and methicillin-resistant staphylococcus aureus, or MRSA, skin infections, Bender said. His practice is filled with cases of MRSA, and he tells parents that the best way to prevent MRSA abscesses is to get their children out of diapers.

Bender and She believe keeping babies’ bottoms bare also could improve parent-infant bonding, speed toilet training and make it easier for toddlers to walk unimpeded by bulky padding.

But Dr. Valerie Kimball, a professor at Northwestern University’s Feinberg School of Medicine in Chicago, is not sold on the health benefits of elimination communication and sees no reason to introduce the subject with already overburdened parents in her pediatric practice, she said in a phone interview.

During her 14 years as a children’s doctor, Kimball has heard about infants going diaper-free from a handful of parents whose own parents or grandparents brought the practice from Asia and Eastern Europe.

She would endorse the technique but would only raise the subject with parents who told her they already were considering elimination communication, she said.

“I wouldn’t want to put this out there and have people feel guilty,” she said. “There are so many other things I’d rather have them worry about,” such as breastfeeding and providing their children with healthy food.

“There are a lot of pressures, and this would be one other pressure. If someone came to me and asked about it, I would say, ‘give it a try,’ but I don’t think I would necessarily recommend it,” she said.

Some of Bender’s patients’ parents and grandparents told him they learned about the practice in their home countries, El Salvador and Bangladesh, for example.

Before She seriously considered going diaper-free, her mother mentioned that in her native Taiwan in the 1940s, in the decade before disposal diapers came on the American market, a caretaker would hold an infant over a latrine, whistle, and the child would urinate.

“I thought that was the most ridiculous thing I ever heard, and I laughed at her,” She said. “And here I am really supporting this idea and this option for young parents.”

She and Bender took turns caring for their diaper-less daughter, who is now 5, and enjoyed competing over which one of them had fewer accidents.

But it would have been difficult for daycare providers to care for a baby without diapers. So when the couple returned to work, they hired a nanny.

They didn’t at first realize that the nanny had her own experience with elimination communication. After she started working for She and Bender, the nanny learned that her Taiwanese grandmother had cared for her without diapers as an infant, too.

SOURCE: bit.ly/2sQ06Am Pediatrics, online June 21, 2017.

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