When I went to India last year with my 3 month old daughter I saw other babies wearing underpants, not diapers, and thought back in wonder to all the babies I had held without incident on buses, trains and in villages where diapers are unheard of. Imagine my surprise to discover a busy internet forum where parents from Colorado to Canberra supported one another in reviving natural infant hygiene, also known as elimination communication or ec in societies that lost it more than a generation ago.
Behind this intriguing term is the simple fact that babies let us know when they need to eliminate and would prefer not to wet or soil themselves. Just as we learn when babies need food, sleep, and play, parents who tune in to babys signals can toilet them without the use of diapers. On the other hand, babies who are left in diapers and only changed according to parents timetables, may give up signaling and tune out their own bodily functions, thus requiring toilet training at a later age. The more absorbent the diaper, the longer babies wear them.
In the U.S. where disposable diapers have become the norm, children typically learn to use the toilet at age 2 or 3. Babies wearing cloth diapers may learn somewhat earlier, between walking and talking. But babies who dont wear diapers at all enjoy the dignity of a clean, dry bottom from early infancy. In India, where the vast majority of people practice ec without thinking about it, imported disposable diapers are now available in any urban corner store for Rs. 10-15 apiece. A TV ad for Luvs diaper shouts, holds like the Hoover dam!" And indeed, like large dams, diapers unhealthy, costly and wasteful are being questioned and rejected by a small yet growing community in the first world while being marketed to traditional societies that have been doing much better without them.
Indeed, traditional parenting methods have made a comeback in the North. Prominent doctors and infant researchers have discovered significant physical and intellectual developmental benefits enjoyed by babies carried in slings, the cornerstone of the Attachment Parenting trend growing in the U.S. Its other tenets, including breastfeeding and co-sleeping are also the norm in the majority of the world. Pediatrics Professor William Sears, a strong proponent of Attachment Parenting writes, Fortunately, we dont export our parenting ideas.
But the wide majority of Indians are in no hurry to diaperise their babies. Sorting out my daughters outgrown clothes and nappies, I asked a woman from an urban slum, would any folks you know use these? She politely took them. I probed, but does anyone use nappies? She replied, no all the urine just collects there, right? [sab udharhi jamma hota hai na, pissab?] She would no sooner put one on her baby than wear one herself. Nodding, I said, then why start using them now? She smiled, your baby should also wear plain underpants. [sada cheddi pehne do]
And so she did. In Bombay when I bought the large size nappies I had also asked for extra large. The shopkeeper looked at me like, How long are you planning to make your child wear those?
He is not unlike Irene Wambui, the Kenyan shopkeeper who recently started selling strollers but told a Washington Post reporter that she couldnt understand why anyone would want one of these. Our babies do not sit like lumps, she said. They are carried in slings and move about the world along with their mothers.
Yet, with creative marketing the stroller industry may be able to change the way Kenyans care for their babies. And once babies start sitting like lumps will diapering be far behind? Just as the sling promotes communication, the diaper dispenses with the need for it. And once babies are leak-proofed, will the infant fashion industry rest? In spite of prime time TV ads, in India the diaper is met with disgust by rich and poor, old and young alike. When the larger majority of parents, grandparents and even babysitters are willing and able to care for babies without them, diapers end up being marketed only as a status symbol.
The truth is that infant formula, cribs, strollers, diapers these products come with a philosophy of detached baby care (or training) which dominated modern Western societies in the post-War era. A generation later, these have come under attack in the West and are reaching markets elsewhere. Early weaning, from breast and bed, undermines intuitive family practices. Perhaps a small number of Indian parents give formula milk and put their babies in cribs not because it feels right to them but to keep up with the Joneses. Similarly diapers are heralded as another advancement from the modern West.
Of the ills diapers bring on, rash is the most visible. Again, to quote Dr. Sears: When you begin diapering, a rash is soon to come babys skin rebels at losing its freedom to enjoy fresh air and sunshine. Start with ultrasensetive skin, add the chemicals of urine and stools, occlude the area with a big bandage and rub it all together. Presto! You have diaper rash.
In India I find zero tolerance for rash. At the first spot of red my mother-in-law insisted that baby go bare-bottomed, and preferably stay that way. While in the early months diaper-free life created more laundry, it had benefits beyond rash-proofing. After eliminating, my 4 month-old daughter would try to move from the site an incentive to roll. As a result, very little remained on her bottom. Whereas when she wore a diaper, Id have to check every crevice and would often just bathe her at each change. She started using the potty at home when she was 6 months old.
My friend from Virginia took her 2 month-old to Bangalore where her mom told her, Your son is not going to wear a diaper in my house. Diapers are for strangers and strange places. When we went to friends homes they would say, ayyo, poor baby, remove that diaper! Now rather than a bulky diaper bag I simply carry a small potty that my daughter uses in public restrooms, on planes and trains.
Half-a-dozen varieties of diaper rash ointments packaged in soft tones vie for our custom. I remember calling the doctor when I spotted a rash on my 2 month olds bottom. Its not humanly possible, he explained, to change the diapers frequently enough. If diapers are the cause of diaper rash why not eliminate the cause?
But, the harried urban parent may ask, what about convenience? Isnt it more convenient to flush a toilet than to change a diaper? Only when we are persuaded that babies cannot signal their needs would we subject them to diapers, diaper rash, and the discomfort of wetting / soiling themselves. At least in India those who can afford diapers can also afford a washing machine or to hire someone to do the laundry. If childrens rights were recognized, the ads for diapers that need only be changed after baby wets 5 times would be banned.
Obviously there is the environmental angle, to problem of disposables in general, not merely diapers. In Water Wars Vandana Shiva describes a train journey through villages where water is served in biodegradable earthen cups, while inside the train Aqua Fina water (a Pepsi label) is served in plastic pouches. What would happen, she asks, if 1 billion Indians switched from the traditional mud cups to the plastic pouches? Likewise, what would happen to our sewers and canals if everyone used diapers? The diaper market size in India may be tiny today, but there is no gainsaying the risks.
In societies where diapers are the norm, natural infant hygiene, better for the earth as well as physically and emotionally healthier for our babies, is uphill and against the tide. Laurie Boucke, author of three books on diaper-free baby care in the carpeted-and-upholstered U.S., describes how she learned to communicate with her infant from a friend visiting from India. Today, parents of diaper-free children the world over eagerly share news of their infants potty progress on bulletin boards and e-groups. Minus the technology, this kind of support is already available in our own backyards, and many Indian parents are taking advantage of it.