An example of baby dialling up because of an unstable position at the breast

The little one in the photo on this page is looking worried! He's starting to dial up at the breast and he certainly doesn't seem to be fitting well into his mother's body. He's experiencing positional instability (that is, he is in an unstable position or an unstable fit and hold), and it's also very likely that his mother is experiencing the painful effects of nipple and breast tissue drag. Hopefully once you've worked through the basics of Breastfeeding Stripped Bare, you'll be able to see what's going on for them, and what might help!

If baby is restless, or fussing and fretting, or starting to cry at the breast, we call this 'dialling up' at the breast, that is, a dialling up of the baby's sympathetic nervous system (SNS). When our baby dials up, we often dial up too! You can find out more about this here.

• This dialling up of our own SNS in response to our baby's dialling up is normal, and biologically hardwired. We are likely to feel upset and worried and find ourselves having a lot of difficult thoughts like “I'll never be able to do this,” or “I'm a failure as a mother.” You can find out about the ways our brain changes after giving birth to a baby, and how to care for ourselves and manage difficult thoughts and feelings, starting here.

• When the baby dials up, he not only fusses, back arches and cries, he may also vomit or puke more often, due to the effects of the dialling up on the gut. This reflux or vomiting doesn't do her harm, or require treatment.

The gestalt method of fit and hold is a holistic way of helping our babies and ourselves dial down with breastfeeding, that is, have relaxed, enjoyable experiences while effectively feeding our babies from our bodies, without pain.

Selected references

Douglas PS, Keogh R. Gestalt breastfeeding: helping mothers and infants optimise positional stability and intra-oral breast tissue volume for effective, pain-free milk transfer. Journal of Human Lactation. 2017;33(3):509–518.

Douglas PS, Geddes DB. Practice-based interpretation of ultrasound studies leads the way to less pharmaceutical and surgical intervention for breastfeeding babies and more effective clinical support. Midwifery. 2018;58:145–155.

Douglas PS, Perrella SL, Geddes DT. A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series. BMC Pregnancy and Childbirth. 2022;22(1):94. DOI: 10.1186/s12884-12021-04363-12887.