As much as people may like cloth nappies, the prospect of a nappy free baby is also quite appealing to many. This is why we invited Amber Hatch to join us for our latest chat and tell us more about Baby Led Potty Training (BLPT) techniques and answer some of the most common questions about it. Amber founded the first UK nappy free group in 2008 and set up the website “Nappy Free Baby” with tons of information on the method. This year she has also published Nappy Free Baby: a practical guide to baby-led potty training from birth. So without further ado, here’s the write-up from this great chat:
Q: Could you tell us briefly how you do it and in which way it is different from the usual approach?
Amber: you can start BLPT right from birth – so in that way is very different from conventional potty training (PT). In a nutshell, taking off the nappy and holding the baby in a squat position triggers the baby to relax and release both the sphincters and the pelvic floor. If you offer the potty to the baby at this time, the baby will soon learn to make an association between passing waste and the potty. Over time, parents learn when their baby needs to pass waste, and the baby gradually learns to release bladder and bowel at the right time.
Q: I know a tiny bit about BLPT, but not much. I have an 18 month old who is getting ready to PT. Am I too late to use BLPT?
Amber: It’s not too late, but it certainly is harder. You can absolutely use BLPT to introduce the potty at 18 or 19 months. However – your expectations will need to be different to if baby is 5 months, due to the baby’s stage of development. At 18 months, babies are just beginning to acquire independent control of the sphincters (as opposed to conditioning), so I think it is a great time to introduce the potty. If you let them continue to use a nappy post 18 months – they may learn how to willingly use it to pass waste, and this can easily become entrenched, especially for poos and even more after 24 months. But the point is, you will need to be prepared for wet trousers – and at this age it’s best to have toddlers bare bummed, at least while they are learning. I have a whole section in my book devoted to BLPT at this age.
Thanks @Amber. So would you say that potty training should happen well before 24months? How long does it generally take using BLPT? Or is that very much dependent on the child?
Amber : Well I think with PT the earlier the better, but I don’t necessarily mean the completion stage. When a child is ready for that will definitely depend on the child, but I reckon most children are ready for more intensive PT somewhere from 18 to 24 months. Some children are ready much earlier – often it depends more on personality than bladder capacity/holding ability.
Q: What’s the best way to introduce it at that age? My son is 22 months old and I tend to leave him nappy free for a while in the morning. I remind him the potty is around and once or twice he’s sat on it and used it but more often than not he’s just gone on the floor whilst playing. More recently I’ve noticed him holding it until I put a nappy on and then flooding it which is not what we want. We use cloth so he definitely feels wet.
Amber: Holds on till he’s wearing a nappy? Sounds like a great sign – he knows how to hold on and put his wee were he wants it – so all you need to do is teach him to put it in the right place. Sounds like he is very ready to learn. I would have him naked and watch him like a hawk. When you spot him weeing – lift him over to the potty so that hopefully some of the wee goes in there. A few times of this and he will make the association very strongly. DO watch out though, as they can tire of this quickly. As soon as he has the idea – you need to be fairly consistent and explain that it goes in the potty every time. This takes a fair bit of work, so I would chose a time that makes sense – i.e. over a not busy weekend.
@Amber Thank you! That might be quite difficult as he’s just a very strong willed and energetic child, who gets totally absorbed in what he’s doing, and/or runs off to do the opposite of what I suggest!
Amber: My kids are very strong willed too! It’s important to buy consent though, as confrontation can be very damaging. But a switch in strategy could make a huge difference – taking him out of nappies would be an obvious one. Then he can see for himself what happens. I don’t think the decision to stay in nappies should rest with the child as they can’t understand what the ramifications are (social, environmental, health etc), but I think this is an area where we parents need to step in and use our judgement. And once nappies are off, it’s important to accept misses and their need for independence.
@Amber That’s really interesting. My son is getting out of bed when he’s done a wee in his nappy and coming to ask to go on the toilet (and I let him, because I want to encourage him to get out of bed if he wants to wee, rather than think ‘oh it’s ok, I’ll just do it in the nappy’). So that’s another sign that he’s ready really isn’t it?
Amber: Yep, it’s all covered in my book! Sign language can be a fabulous tool for BLPT. My kid learnt to sign for wee around 10 months and it was very useful. She hardly ever did it in advance though – more often it was during a wee when she was already on the potty. Children are very unreliable with signing, but super cute. So yes, that all points to a growing awareness. But many children are perfectly ready, even if they don’t show any sign of awareness – they just need to be shown different habits. Often strong willed children are far more compliant at night. My daughter was – but my son wasn’t. He hated to use the potty at night and I had him in disposables for night. I felt bad about using them so at 24 months switched him to cloth and he stopped weeing at night – the association was obviously different. you could try your son naked at night and see what happens.
Q: So the squat position is really important, hence holding them over the potty or loo. If you were doing nappy free time could you use puppy pads or similar and just get them to squat?
Amber: Do you mean if they are standing? Some children (boys and girls) do like to stand up at around age one. Our grandmothers used to hold babies over newspaper!
Q: What would be the main difference between normal PT and BLPT at an older age?
Amber: PT and BLPT at an older age can look very similar – in both cases we need to teach children to become independent. The main difference is that children who are accustomed to using the potty will have developed more control of their sphincters, and will know what the potty is for.
Q: You mentioned developing voluntary control of sphincters as something that develops around 18 months. What else do we know about the ‘science’ of potty training, if you see what I mean?
Amber: Actually voluntary control of sphincters will start to be noticeable from around 10 months – though like with all things baby, skills are acquired gradually.
In the first few weeks, reflex plays the biggest part in using the potty. All newborns wee when their nappy is changed, for example! Then over the next few months, they become conditioned to wee and poo somewhere, and that will be nappy or potty, depending whether families do blot or not. From around 10 -12 months voluntary control becomes more important than conditioned response, so it tends to become more haphazard at that age as babies practise holding on – sometimes even when they are on the potty. Also they may assert independence at this age and not want to go where you want them to! It’s all part of the fun of navigating toddlerhood. From around 18 – 24 months, habits start to become entrenched, so I do think it is unwise to delay PT until after this, but of course many children PT very happily post 24 months.
Q: As children get older they know what the potty is for either way, don’t they? My son knows, definitely (he quite often asks to go on the toilet when it’s too late; I think he just gets absorbed in what he’s doing and doesn’t notice he needs it until he’s suddenly aware that he’s done a wee). He’s in nappies, I’ve let him sit on the potty/toilet when he’s shown an interest in it for a while now, but haven’t tried to ‘train’ him as such. So he knows what it’s for – should I be trying to encourage it onto him more, in that situation?
Amber: That’s totally up to you if you are ready for PT – but it sounds to me like he’s ready. I think people worry so much about causing psychological damage that they tend to be extremely cautious about PT – but this can back fire in some cases as incontinence can also cause a lot of distress. Once children are biologically ready fro PT – then training them becomes a social skill – so my rule of thumb is that you should try to parent in this area in the same way you would in other areas – e.g. when he refuses to get in the car seat or throws food on the floor. It may be perfectly reasonably to say a firm no in these cases, same as if he wees in the wrong place. But you do need to teach them first, before you deal with accidents like that, of course.
Q: I read an article not long ago by some American bowel guy and he was giving dire warnings of harm to children from potty training too early. It sounded very convenient for makers of disposables to me. Are we potty training much later these days? If so, why?
Amber: I think disposables have massively contributed to delay in PT – but mostly because parents find them fairly convenient and they have become intolerant of accidents and wet trousers. I know the article by Dr Steve Hodges, it’s a shame he is so blinkered as he makes some very important comments about constipation and the affect on continence that we all should take note of. It is very important that children should not develop holding habits. However Hodges puts that down to PT under 3, whereas it is quite clear that holding habits can develop long before PT – and other studies show PT age has nothing to do with constipation.
Q: Regarding cloth nappies, do you believe the claims that using cloth makes potty training more likely, because they can understand and feel that wetting has occurred? I’ve heard this expressed from a professional but I don’t know whether it was just their opinion.
Amber: Most babies I have come across seem perfectly happy to sit in a wet cloth nappy, so I’m not convinced it encourages them to PT. But yes it is important for them to make the link between full bladder and wee coming out, and cloth can make this easier. Also when parents BLPT – they tend to change wet nappies straight away. There’s no rule about that, but it’s common. If you do an action – i.e. change a nappy – every time they are wet, that draws attention to the act of urinating.
Q: Night time training seems to be a highly sensitive issue. People seem to be scared to even let their children try going without a nappy at night until they wake with a dry nappy, for the fear they could psychologically damage them. I’ve heard that night time dryness has to do with a hormonal change. Do you know anything about that? Are some of our children actually being trained to wee in their nappies at night while they’re trained to use the loo in the day?
Amber: I was hoping someone would ask about nights. I do think that PT at night should start much earlier! Our expectations about nights are way out of what children are capable of. Of course we train them to wee in their nappy at night! Yes, I know about vassopressin. It’s a hormone which concentrates our urine so that we wee less when dehydrated or asleep. Vasopressin production increases as we grow older, so we can go for longer stretches when asleep. There is nothing anyone can do about that. It’s often used as an argument to delay night PT. However – some people NEVER have enough to stop them from needing to use the loo at night. I can think of two people in my extended family ha ha! So it’s still necessary to teach children how to hold on at night, and how to use the potty if they need to, and also first thing in the morning, as many children wee first thing because they aren’t taught any different. Nappy manufactures just tell us to wait with our fingers crossed and meanwhile stock the supermarkets with night pants for age 8 – 15.
@Amber, Wow, so actually you’re saying the hormone ‘excuse’ is a pretty poor one as night time training might be the one thing that enables you to be dry at night, because you have the faculties to wake up and go to the loo. That’s a game changer.
Amber: Exactly. I think it’s a really shame that parents don’t help their children more with night training. I don’t blame the parents though, because that is the message we get all around. Checking to see when the baby or child wets at night is always the first thing I recommend for beginning night training, so you know what’s going on. But often, as you found, once they’ve realised they have to use the potty or loo, they prefer to stay warm and snuggly and just hold on till morning. May children are capable of holding a bladder at night, they just don’t know they should. And conditioning is very strong when sleepy, so the association between nappy and weeing is very strong.
Q: Regarding nights, do you think that lifting to wee at a specific time is good or bad? My 3 year old is dry at night so long as he doesn’t have a drink too soon before bed, BUT, if we lift him to wee one night, he always wets the bed the next night. (We only lift if he’s had a drink just before bed).
Amber: that’s interesting! I know many people who lift at night – and it can work very well, but it sounds like in your case it’s sending him the message that it’s ok to wee in the sleep. I would try waking him up and make him walk to the loo. Sorry that sounds mean!
@Amber No not mean – you’re saying exactly what I was thinking! He very rarely wakes to wee, he just wakes up dry in the morning. If I understand, that means he has good levels of vasopressin but has learnt not to wake up if he does need to go. Thanks for that, I feel very clear about the next steps!
Q: This is a lifestyle question really: we are a very out-and-about family because we don’t watch much TV and the kids hit the roof if we stay in too long. Would this make BLPT from birth impossible?
Amber: Not at all. I often found BLPT much easier when out and about as I wasn’t distracted by the washing up etc. Transitional moments – arriving and leaving, may offer enough opportunities to keep baby clean and dry. Also if you carry the baby in a sling they normally signal pretty hard when they want to go.
Q: My 4, almost 5 year old has been PT since 3.5 for wees but has always struggled with poos. It’s only in the last 9 months that he’s stopped doing them in his pants reliably but continues to have ‘accidents’. It’s not much, but enough to cause smell and need cleaning up and a change of pants. He knows to go to the loo when he feels the ‘tickle’ and he often does make it in time but other times he just lets go. I’m not sure if it’s a case of not wanting to go in case he misses something, as often it’s just at home while playing or watching TV. We’ve tried rewarding good, ignoring mishaps, getting angry, being nicey nice, talking it through, reward charts but it just doesn’t seem to be getting through. He’s had no developmental delays, is a bright happy lad, home life is good, he has a new sister but this was happening long before she arrived or was thought of. We try reasoning with him but he just says ‘sorry, I won’t do it next time’. This happens both at home and with the childminder.
Amber: This sounds distressing. It’s hard to know exactly what’s going on – but I think you are right to pursue it as this doesn’t sound totally right to me. I would definitely go to HV or to see a doctor and thoroughly check for constipation. It sounds like he is unable to comply, even when offered motivating rewards. It could be impaction, which would mean uncontrollable excretion. Of course it may not be that at all. But he obviously needs a lot of support from you to learn healthy habits and if his bowel needs clearing he may need medication – so I’d say it’s a really good idea to investigate sooner rather than later. You’ll probably need to buy compliance to spend periods sitting on the toilet to establish a healthy routine – perhaps rewards. Check out ERIC has some brilliant help for this.
Q: I plan to EC part time once I get around to buying a potty (my baby is 4 weeks old). My husband is up for it, but when we’ve mentioned it to the family I get the idea that they think it’s a bit strange! Can you tell me more about cultures where EC is considered normal, and/or historically in this country (or where can I read a bit more info). That way I can tell the family about it and maybe they will realise that it makes more sense than training babies to soil themselves! Any tips on clothing to make things as easy as possible? My newborn baby is naturally choosing to wait until her nappy is undone before having a poo. She often wees when her nappy is undone too. I think that I will be able to catch quite a few of these wees in a potty. When she is awake, she quite often shouts or fusses when she does a wee so that I change her. Is there a way of communicating with her to get her to the potty in time to catch these wees too?
Amber: You can certainly read more about this in my book ha ha! My favourite fact: in 1958 5000 UK mums were surveyed. 85% introduced a potty before 6 months, and 60% before one month. It’s almost certainly how your grandmother PT your mother! What changed? in 1961 Pampers was invented and 1962 Brazleton published a paper advising parents to delay until 18- 24 months. He was worried that parents would put too much pressure on toddlers once they began to take up voluntary control of the sphincters at around age one. And it is important to remember that this age is a bit haphazard. Parents used to punish 12 month olds when they soiled at this age. But if you don’t make a conflict over it, it’s fine to use a potty at this age, as long as we do it respectfully and with realistic expectations. At this age you may find a bowl more useful than a potty as you won’t be sitting her on it. Or you can use the basin/bath/loo. Have her in the right position in your arms before you take the nappy off, then she’ll be in just the right place. Once she has made the association, she’ll wait a little while between nappy off and weeing, giving you time to get her to the potty. In just a few days or shorter, probably. At this age, it’s so easy to get some catches and start building up the association.
Q: In a discussion on the Facebook group one of the mums was saying that she co-slept and the children used to let her know they needed during the night from a really surprisingly early age.
Amber: Yes, I started potty training my daughter at night at 8 weeks, and she was very reliable. I took her out of night nappies at 15 months, and she rarely wet the bed. Using the potty at night maybe half the time. Until around 3.5 when she never went at all. I did nothing with my son except switch him to cloth at 24 months and he got dry by himself – very rarely needing to use the loo at night – maybe once every 10 months. They will learn to signal to you at night if you encourage them to.
A massive thank you to Amber for taking so much time and care in answering all our questions (the chat was nearly 2 hours long!). Amber also mentioned she’d love to hear from any of you who might choose to try BLPT, so if you have any questions or comments do go on her website www.nappyfreebaby.co.uk and get in touch!