Two days after giving birth, Maya Eldror heard her newborn daughter crying. Eldror, 36, a sleep consultant who follows an attachment-based approach and a babywearing instructor, suspected the restlessness was connected to the baby’s need to relieve herself.
Instead of waiting for the diaper to fill, she held her daughter over the sink. Within moments, the newborn pooped.
“From the age of two days she was already pooping in the sink, and later we moved to a potty,” Eldror said. “For me it was a crazy moment, but also very natural. I realized I could identify one of her needs and respond to it before she was even able to speak.”
Eldror is one of a growing number of parents practicing what is commonly known as elimination communication, an approach in which caregivers try to identify a baby’s signals before urination or bowel movements and help the child relieve themselves outside a diaper.
During the first months, parents may hold the baby in a supported squatting position over a sink, bowl or toilet. Later, they can move to a potty or regular toilet. The signals vary from child to child and can include pelvic movements, kicking, restlessness, pulling away from breastfeeding, particular facial expressions or crying. Parents may also rely on predictable moments when babies are more likely to need to go, such as after waking, nursing or a car ride.
Eldror, married and a mother of three children ages 5, nearly 3 and 9 months, first encountered the idea long before becoming a parent. “When I was 19, I read online that babies could grow up without diapers,” she said. “I was shocked. I thought, how is that possible? Who are these crazy people?”
She did not try it with her oldest daughter. With her second child, however, she began when he was 10 months old, and within several weeks, she said, he had stopped having bowel movements in his diaper.
By the time she was preparing for her third child, Eldror had studied the subject and decided to begin almost immediately after birth. She stresses that elimination communication does not necessarily mean abandoning diapers altogether.
Some families go without them, others use cloth diapers, and Eldror uses disposable diapers as a backup. “At first I wondered how I would do this with two other children at home, but eventually I understood that I didn’t need to aim for perfection,” she said. “Even if I managed to respond to the need only some of the time, there was still communication between us.”
Periods of apparent regression are also normal, she said. During developmental leaps, such as learning to crawl, stand or acquire another new skill, a baby’s signals may become less obvious. “That doesn’t mean everything has been lost,” Eldror said. “You wait, let her get through that stage, and often the signs become clear again.”
Not a method, but an approach
Oren Baruch, who teaches parents elimination communication, prefers not to describe it as a “method.”
“When you call it a method, parents feel as though they are being tested against it,” she said. “Calling it an approach makes it possible to understand that this is a journey. Sometimes it works and sometimes it doesn’t, and it isn’t a linear process.”
Baruch became interested because of her daughter Nina. During the first weeks of Nina’s life, she struggled with bowel movements and sometimes went days without one. A friend suggested holding the baby over the sink.
“When she was 5 or 6 weeks old, I lifted her up, and she peed, pooped and then peed again,” Baruch recalled. “I was on top of the world. I felt like I had helped my daughter.”
Oren Baruch
(Photo: Reuven Kopitchinski)
Baruch later opened a WhatsApp group for parents, and in 2024 began leading support groups. She teaches that every baby communicates differently.
For one child, the cue may be pulling away during breastfeeding; for another, leg movements. With some babies, she said, parents may find it easier to rely on regular opportunities rather than specific signals.
She cautions against trying to catch every urination. “Babies pee a lot, and trying to catch every single time can become exhausting,” Baruch said. “You can choose one or two regular opportunities, focus on bowel movements, or simply observe. You caught it? Great. You didn’t? That’s also fine. The goal is to build attentiveness, not keep a scorecard.”
For Baruch, the main benefit is an additional form of communication. “We learn to identify another basic need of the baby and respond to it, just as we learn to recognize when the baby is hungry or tired,” she said. She also points to practical benefits, including reduced exposure to urine and feces, potentially less irritation, fewer wipes and creams, lower diaper use and less waste.
Still, she emphasizes that the approach is not a cure-all. Holding babies in a supported squat can make bowel movements and passing gas more comfortable, she said, but it does not eliminate normal infant gas associated with the maturation of the digestive system.
An environmental motivation
Anat Assaf, 36, a mother of four who guides families in elimination communication and teaches workshops through her “Living Simply” platform, came to the practice partly because she wanted to reduce disposable waste. “During my first pregnancy, I was bothered by the amount of stuff that comes with a baby: diapers, wipes, bottles and products that are thrown away again and again,” she said.
Unable to find much information in Hebrew, she turned to English-language material and read about communities in which mothers recognize when infants need to relieve themselves and move them away from their bodies. A few hours after her oldest daughter was born, Assaf noticed a movement in the baby’s pelvis and asked her partner to hold the newborn over the sink. The baby urinated. “What made me fall in love with this approach was discovering that from the very first day, a baby can communicate much more than we are accustomed to thinking,” she said.
Anat Assaf
(Photo: Courtesy)
Assaf said the family used almost no diapers during the first months, though they returned to them during demanding periods, including extended military reserve duty, moving between homes and long stays as guests.
She does not regard temporary diaper use as undoing the process. “The harshest reaction I ever received was that this was abuse,” Assaf said. “It was unpleasant, but I know my children and I can see what suits our family. Every family has to choose for itself.”
‘Elimination communication isn’t a religion’
Inbal Elboim, 29, a social worker and attachment-based sleep consultant, began practicing elimination communication with her son Asif when he was 3 weeks old. She would take him to the toilet after sleep or nursing and watch for signals such as tension in his legs, a particular facial expression or pulling away from breastfeeding.
Pain in her arms made it difficult to hold him for long periods, so she combined the practice with diapers. Sometimes, instead of removing the diaper, she simply brought his knees closer to his body to make it easier for him to relieve himself. When he learned to sit, she moved him to a potty. After a while, she said, he stopped having bowel movements in his diaper, and later, when he began speaking, he would announce “poop” even during car rides.
Inbal Elboim
(Photo: Courtesy)
For Elboim, diapers are not incompatible with the approach. “A diaper can serve as a safety net while the parent continues offering the potty in the morning, after sleep or when there is a clear signal,” she said. “Elimination communication isn’t a religion. You do what works and what suits the family.”
Returning to work and sending a child to daycare can make the approach particularly difficult, she acknowledged. Most childcare settings are not equipped to monitor an infant’s subtle cues or repeatedly offer a potty.
“You have to choose what is practical for the family and not expect daycare to do something it cannot do,” Elboim said. “You can continue at home in the morning, evening and on weekends without turning it into a struggle.”
‘The focus must not become only pee and poop’
Maria Titov, a developmental psychologist with Clalit Health Services and a senior professional at its child development institute in Elad, sees value in the approach’s emphasis on observing babies.
A newborn, she explained, does not initially distinguish between hunger, fatigue, pain or pressure in the bladder. Parents gradually learn the child’s behavior and help give meaning to those sensations.
But Titov also warns that elimination communication can become too dominant. “What I connect with less is that the approach can create a kind of tunnel vision, where all that interests the parent is pee and poop,” she said. “The process can also become something belonging to the parent rather than the child, even though the baby is not yet mature, does not have awareness and is not an active partner in the process.”
Maria Titov
(Photo: Courtesy)
Infants do not have voluntary bladder and bowel control from birth, she emphasized. “At infancy, elimination is largely reflexive,” Titov said. “When a position, sound or regular time is connected with relieving oneself, conditioning and shared learning develop. That is not the same as a baby independently deciding to hold it and go to the toilet.”
Voluntary control depends on physical, neurological, linguistic and emotional maturation that develops gradually, she said. Titov therefore recommends that parents remain attentive without turning successful trips to the sink or potty into a measure of achievement.
“It is important that the focus not narrow only to bodily functions and that no pressure develops around success or misses,” she said. “Independent toilet training is the child’s process. Parents can accompany, offer and put things into words, but they should also trust the child’s pace of maturation.”
(Photo: Shutterstock/Nastyaofly)
For parents interested in trying the approach, Eldaror offers similar advice: Lower expectations.
“Even if you managed to identify only a small portion of the times, there was still communication,” she said. “The moment it becomes a measure of good parenting, you’ve missed the whole point.”