Nurse Rebecca Mottram

Most of us with babies reach for a nappy without thinking. But what did people do before nappies? Nurse Rebecca Mottram helps you to find out what your favourite nappy brand isn’t telling you about the impact of using nappies, and what to do about it.

Nobody wants to get weed on or pooped on, so it’s great that nappies were invented to help protect our floors and furnishings. They’re relatively cheap and convenient and it’s easy to see why they are used so widely. But did you know that worldwide, over 50% of all babies DON’T use nappies? ¹.

Not just because access to them is unaffordable, but also because these families are applying an age-old art of infant toileting.

Babies can use a potty from birth

Yes! It is perfectly possible, if not completely sensible, to help your baby “eliminate” in something other than a nappy. Helping infants and young toddlers to use a potty is not a new concept; it was the norm in the UK until disposable nappies became popular in the 1960s and is still practised routinely in many parts of the world today.². Do I mean potty training? Not in the beginning, but helping your baby use a potty,  even only occasionally, can pave the way for quicker and easier potty training from 18 months ³ – a lot sooner than your nappy company would make you believe is possible.

Holding your little one over a potty or toilet instead of using a nappy means using fewer nappies, and that’s not good for Mr Nappy’s bank balance. UK nappy lead Proctor and Gamble was valued at £324 million in 2016⁴: nappies are big business.  Mr Nappy wants your baby to use his brand as long as possible – no way he’s going to tell you to potty train sooner and ditch his product completely. Thanks to the promotion and “stay-dry” science of disposable nappies and “pull-ups”,  babies are becoming disconnected from their own bodies and as a results, babies are wearing nappies longer than ever before⁵. The result? Nowadays just 4% of babies in the USA are potty trained by age 2, compared to over 90% just 30 years ago ⁶. But it doesn’t have to be this way. You don’t have to put your baby in a nappy until they are 4 or 5.

Why would you want to potty your baby?

Although disposable nappies are cheap, they take hundreds of years to decompose and are made from toxic substances.⁷. Although cloth nappies can be washed, nobody enjoys washing a pooey one. And what about the baby? Put yourself in their position (literally) and you’ll see it’s not so nice, or easy, to poo lying down. Humans are physiologically designed to void in a squatting position, and it’s cleaner too.

Helping your baby use a potty instead of using a nappy means you save money (potentially around £800 per year ⁸. Using fewer nappies also reduces the environmental impact of using disposables or cloth nappies. From birth, babies can show us through their body language what they are doing and we can respond to them just like when hungry or tired⁹.

Using a potty takes seconds and is quicker than cleaning after a soiled nappy.

But aren’t babies better off learning other things? Shouldn’t we just let them be babies?

Well, the answer is yes, of course! Babies learn all the time, regardless. And they will be babies, no matter what! And that means they will pee and poo, no matter what, too. So the questions is, where do you want them to do it? Of course a very young baby is too small to sit on a potty unaided, but that doesn’t mean their only option is to use a nappy. Remember, humans are not born wearing nappies and survived for millions of years without them!

Are we potty training too late?

Alongside the introduction of disposable nappies, with their “feel-dry” chemical gels, various children’s doctors along the way have suggested parents “wait for readiness”¹⁰.  But the evidence base for this approach is flawed. A key piece of research used to frighten parents into taking the “wait till ready” approach actually relates to children with constipation – not all kids! ¹¹. Another prominent doctor who advocated for the so-named “child-directed method” was subsequently employed by Pampers ¹². Does that sound impartial to you?

Somehow, along the way, the advice became to let the child decide when to potty train. Now, I’ve only got two kids but I already know that their sense of when things should happen is not always rational, or even reasonable. Children need direction and potty training is something that should be parent led, not baby led. Both used potty from birth with no ill effects, and my eldest was out of nappies for good by 20 months (day and night). You can read the research yourself, and I promise you will not find any scientific literature showing that helping your baby use a potty from birth is harmful.

Won’t potty training “early” cause problems?

Confused and well-meaning parents are now waiting longer than ever to start potty training their babies. But remember this is mainly due to propaganda by the disposable nappy companies, rather than a basis in anything scientific. Recent research has demonstrated that a gentle parent-led approach to potty training actually helps avoid problems such as constipation in the long run ¹³. Perhaps it is time that we re-calculated what we mean by “early” in the context of potty training. We can apply a parent-led method of potty “learning” right from birth, which is naturally followed by formal teaching from around 12 months ¹⁴. This is a far cry from teaching babies to firstly ignore their natural instincts, become accustomed to soiling and wetting a nappy, and then have this learning reversed later down the line after years of continuous nappy dependence.

50% of babies in the world still do potty train at 12 months, with no ill effects. You can read a full review of the available evidence in my other post, here.

Knowing when to use a potty

One of the most common questions I’m asked is “but how do you know when she needs to go?” Well, the answer is that sometimes it’s obvious, and sometimes it’s not. It’s a mixture of paying attention and using timing. Have you noticed that your baby often wees just after you take a nappy off? Sometimes its about taking advantage of these things. In fact, babies often go at predictable times, eg. after waking or after a feed. Often, you can tell a poo is coming before it does. So on these occasions, you can hold your baby over a potty or the toilet, to catch the output (or “elimination”) there instead. It’s that simple, and there’s no “training” about it.

Once you get started

Whilst your baby is eliminating in a potty or toilet, you may also start to tell your baby what their body is doing, using a chosen word or sound to help build an association (NB you can do this if they are using a nappy too, to help maintain awareness). Next time, when they are ready to go, you can help them release it by reminding them with this sound or word.

You don’t need to go nappy-free to potty either – you can still use a nappy and potty successfully. But as time goes on, you may become so in tune with your baby that having regular nappy-free time is something you can consider. And in so doing, your baby not only enjoys the unencumbered movement and feeling of being nappy-free, but they may also start to signal more clearly. With regular pottying, we can connect to our babies in a way that works in harmony with their bodies, and the environment.

Of course, there is more to baby potting (otherwise known as “elimination communication”) than can be described in a simple blog piece. But next time, maybe just give it a go? What’s the worst that could happen?

Nurse Rebecca Mottram is an advocate for Baby Pottying and a potty training expert. She is the author of two books; The Baby Pottying Guide and Positively Potty, the host of the Go Potty Podcast and founder of the Little Bunny Bear shop. If you are trying to resolve a potty problem, you can explore Rebecca’s free resources, join her Facebook group or request a private consultation.

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