ROCKVILLE – Liam Ratner of Potomac made it through a three-hour meeting without wetting or soiling his pants.
Not much of an accomplishment for most, but Liam is only 9 months old.
Of course he was helped out by his mom, Ilana, who periodically peeled off his pants and took him to the bathroom so he could do his business.
While most parents in the U.S. resign themselves to changing several dirty diapers a day, Ratner and her husband, Daniel, are trying a different approach: elimination communication, or, as it’s also known, natural infant hygiene or infant potty training.
It’s possible, practitioners say, for parents to begin immediately after birth. Liam’s parents started when he was 3 months old, after his mother learned about the method while reading about baby care on the Internet.
Now, just six months later, she is mentor for DiaperFreeBaby, an organization dedicated to educating people about EC, and on Dec. 7 hosted Montgomery County’s first meeting at AISH Center for Jewish Learning in Rockville.
The biggest elements of EC, Ratner tells the four mothers in attendance are “communication, bonding and responding.”
All babies communicate their needs to their parents, including the need to relieve themselves, Ratner said, but if parents don’t notice and respond, then they will stop communicating that need.
Babies have their own signals for when they are about to go to the bathroom, Ratner said. Paying attention to those signals can help parents help their babies avoid the discomfort of wet and dirty diapers.
“If you respond to them by holding them correctly and making a cue sound, they respond and go,” Ratner said in an earlier interview.
The cuing sound can be a “sssss” for peeing and a grunting sound for defecating, or it can be one sound for both, Ratner said.
Holding babies correctly can differ from child to child and with age. Using a doll, Ratner demonstrated a variety of methods for holding babies of all ages over a toilet, potty chair or potty bowl (the official model looks like a sand pail without a handle, but any bowl about that size will do).
Many methods, especially for the younger ones, involve holding the baby’s bottom over the toilet with legs up and upper body propped against yours.
“They don’t poop on you?” asked Alison Horowitz of Rockville, who was due to deliver her first child in two weeks.
It certainly looks like they might, but Gayleen Carpenter of Urbana, who started using EC only three weeks after giving birth to now 15-month-old Grace, said it’s only a problem when they are tiny because infant poop is runny.
As for pee, Ratner said, with boys you have to learn to aim them in the right direction.
Horowitz also asked how to deal with the reactions and judgments of friends, family and even strangers. Her mother and grandmother saw a television segment about EC and told her “this is nuts,” she said.
That reaction isn’t uncommon.
“My in-laws think we’re crazy,” said Carpenter.
Still, there is a lot more acceptance now than there was 26 years ago when Laurie Boucke was using the method with her third son.
Boucke, who has written three books on EC, including the 500-page “Infant Potty Training,” said that until recently, she and other EC mothers were ridiculed.
The change came Oct. 9 when The New York Times ran a front-page story about EC. Since then, Time and People have run articles and news stations across the country have featured families like the Ratners.
While EC seems new here, it has actually been around for hundreds of years and is still common in many countries where disposable diapers are either too expensive or aren’t part of the culture.
The Internet is also helping to educate people about EC and is providing support for mothers who may not encounter anyone else using the method.
Maryland has its own YahooGroup with more than 50 active members.
“I think being on the Yahoo list is really helpful because I don’t have any friends who are doing this,” Carpenter said.
There seem to be a lot of reasons that EC parents meet with negative reactions, but most of them stem from misconceptions about the process.
Although the primary EC organization is DiaperFreeBaby, it “doesn’t mean that you have to ditch diapers and never touch them,” Ratner said.
She often puts Liam in absorbent cotton pants or cloth diapers. Carpenter, on the other hand, said that she has always kept Grace in disposable diapers as a back up.
Dr. T. Barry Brazelton, one of the nation’s most prominent pediatricians and author of “Toilet Training: The Brazelton Way” said he doesn’t see any harm in parents using EC. But he worries that the strong emphasis on communication may put more pressure on an already stressed working mother who may feel guilty about not being with her children full time.
“Women need to understand that there are lots of ways to communicate with a baby and this is only one of them,” Brazelton said.
Ratner and Boucke both love EC, but agree parents shouldn’t feel pressured. They both emphasize that EC can fit into any schedule and is not just for stay-at-home moms.
“You can still do this in the mornings and evenings when you are home,” Boucke said.
Ratner said she and other practitioners have had ups and downs with EC, periods where their children have used the toilet most of the time and times when most of it has ended up in diapers.
“It’s not about catching all of his eliminations,” Ratner said, it’s about communication.
Just in the last month Grace’s communication has become more direct, Carpenter said. She has started to use the word “poo-poo” and now can clearly indicate when she needs to be taken to the bathroom.
Grace’s milestone may be evidence of proponents’ claim that the practice helps reduce conflict as children reach the age when they are ready to learn to use the toilet independently.
Although Dr. Mark Wolraich, editor of the American Academy of Pediatrics’ “Guide to Toilet Training,” said he thinks EC is more of a conditioning exercise than training, he said they might be right.
“It actually may be easier to toilet train them when they are ready,” he said.
Toilet training would be a dream come true for Reli Ofman of Rockville who said she has been blown away by the cost of diapers for her infant triplets.
Ofman is a teacher at AISH’s preschool who popped in and out of Ratner’s meeting looking astonished by the process she was hearing about for the first time.
Many of her questions were those of a serious skeptic, but after watching Liam’s toilet success, Ofman ran back in to the room and exclaimed she was sold.
As the meeting broke up, she was trying to figure out the earliest time Ratner could come to her house and help her and her nanny get started using EC.