About conditioned dialling up in babies and toddlers and how to prevent it

This article is part of a collection inside The Possums Sleep Program called Deeper Dive, which explores the complex scientific, historical and social contexts in which families and their babies or toddlers live and sleep. You don't need to read Deeper Dive articles to be helped by The Possums Sleep Program.

What is a conditioned dialling up in a baby or toddler?

It's common for babies and toddlers to develop what I have called a conditioned dialling up. To understand conditioned dialling up, I suggest first taking a look at the pages about dialling up in our babies here and in toddlers here.

A conditioned dialling up is a learned response, you might say of fear or distress, to a particular stimulus. For our babies and toddlers, certain objects or events can become linked with very upset feelings, which they remember, particularly if it is a repeated experience.

This happens because the baby or toddler brain is bursting with new neural connections. The baby or toddler brain is a great flourishing of neural synapses. New neural pathways are laid down at an astonishing rate. Nothing equivalent to this great flourishing (and also from toddlerhood, pruning) of neural synapses happens in the brain throughout the rest of the lifespan. This is why little ones learn from the environment and their interactions with other humans at a stupendous rate.

But your baby or toddler might also quickly learn that a particular thing or event makes her feel distressed (dials her up). So the minute she sees that distressing object, or the minute she knows that particular distressing activity is approaching, she dials up in anticipation. She has become sensitised to a particular stimulus which she experiences as negative. Now, each time she encounters that particular stimulus, her sympathetic nervous system and hypothalamic-pituitary-adrenal axis activate or dial up, communicating to you that she is distressed.

Usually, a conditioned response can be unlearned, but first we need to identify what's going on. Often, in babies in particular, a conditioned dialling up is misdiagnosed as a medical condition, such as gut pain, reflux, allergy, lactose problems or tongue-tie. Also, a baby might regularly dial up in a particular situation, e.g. positional instability at the breast, and be misdiagnosed with one of these medical conditions without necessarily having a conditioned dialling up.

• You can find out about gut pain in babies here and toddlers here.

• You can find out about reflux in babies here.

• You can find out about allergy in babies here and toddlers here.

• You can find out about lactose problems in newborns and young breastfed babies here.

• You can find various articles about tongue-tie in the Free Resources, starting here.

You can find out how this concept of conditioned dialling up is novel and unique to the Possums or NDC programs, including The Possums Sleep Program, leading to new ways of thinking about a range of problems faced by parents with babies or toddlers, here.

What can babies or toddlers learn a conditioned dialling up in response to?

Many things can become a conditioned stimulus for babies and toddlers, which cause them to dial up in a conditioned or habitual way.

Conditioned dialling up may become a serious problem in babies, requiring assessment by your local GP. You might also, in collaboration with your GP, seek the help of NDC Accredited Practitioner.

Some common examples for babies

• The breast (very distressing for mothers). You can find out what to do here. The underlying issue is often unidentified positional instability. You can read more about dealing with positional instability in the section on the gestalt method of fit and hold in breastfeeding, starting here.

• The bottle (also very distressing for parents). You can find out about this here.

• Waking up alone. You can find out about this here.

• The bassinet or cot. You can find out about this here.

• The pram. You can find out about this here.

• The car capsule or car seat. You can find out about this here.

• Tummy time. You can find out about this here.

• The high chair. You can find out how to avoid this here.

• Parental use of a spoon to deliver solids. You can find out how to avoid this here.

Some examples for toddlers

There will be many times when, as the parent, you need to be in charge with toddlers, and continue on with things that your toddler doesn't like. But it's still useful to understand what a conditioned dialling up in a toddler might look like, and how to avoid it if you can. It doesn't help though, and often makes things much worse, to persist once your toddler has developed a true conditioned dialling up.

• Waking up alone. You can find out about this here.

• The cot. You can find out about this here.

• The high chair. You can find out about this here.

• The car seat.

How can you prevent a conditioned dialling up?

The way to prevent a conditioned dialling up is to respond to your baby's communications, or respond to your toddler's communications, as best you can. Babies in the first weeks and months of life are particularly neurologically sensitive. Quick but sensible responses work best on the whole in the first 16 weeks, getting in before the baby dials up much, as best you can.

As your baby matures, and then matures into toddlerhood, you will be increasingly relaxed about your responses, even as you maintain a sensible pattern of responsiveness and heart connection, overall. There are things you'll need to do that your little one won't like. But if you notice a pattern developing of persistent and growing distress in response to the situations I've detailed above, it helps to take steps to avoid a conditioned dialling up, by avoiding the particular situation or stimulus, and thinking creatively about the days.

Rich and changing sensory motor nourishment dials babies and toddlers down, and is a vital strategy in any situation of conditioned dialling up, sometimes with immediate effects but importantly, with effects evident over the days and weeks as you persistently provide rich environmental experiences.

How can you deal with a conditioned dialing up?

We do this by growing positive experiences in relation to the object or event whenever we can - and avoiding it or letting it go when we check it out, but find the child continues to dial up. If you follow the links above, you'll find a detailed discussion for each of the examples, as part of The Possums Sleep Program.

Selected references

Douglas PS. Pre-emptive intervention for Autism Spectrum Disorder: theoretical foundations and clinical translation. Frontiers in Integrative Neuroscience. 2019;13(66):doi.org/10.3389/fnint.2019.00066.

Douglas P, Miller Y, Bucetti A, Hill PS, Creedy D. Preliminary evaluation of a primary care intervention for cry-fuss behaviours in the first three to four months of life ("The Possums Approach"): effects on cry-fuss behaviours and maternal mood. Australian Journal of Primary Health. 2013; 18:332-338.

Douglas P. Diagnosing gastro-oesophageal reflux disease or lactose intolerance in babies who cry alot in the first few months overlooks feeding problems. J Paediatr Child Health. 2013;49(4):e252-e256.

Douglas PS, Hill PS. A neurobiological model for cry-fuss problems in the first three to four months of life. Med Hypotheses. 2013;81:816-822.

Douglas P, Mares R, Hill P. Interdisciplinary perspectives on the management of the unsettled baby: key strategies for improved outcomes. Australian Journal of Primary Health. 2012;18:332-338.

Douglas PS, Hill PS. The crying baby: what approach? Curr Opin Pediatr. 2011;23:523-529.

Douglas P, Hill P. Managing infants who cry excessively in the first few months of life. BMJ. 2011;343:d7772.

Douglas PS, Hill PS, Brodribb W. The unsettled baby: how complexity science helps. Arch Dis Child. 2011;96:793-797.

Douglas P, Hiscock H. The unsettled baby: crying out for an integrated, multidisciplinary, primary care intervention. Med J Aust. 2010;193:533-536.

Douglas PS. Crying Baby. Hecate. 2007;33(2):74-75.

Douglas PS. Excessive crying and gastro-oesophageal reflux disease in infants: misalignment of biology and culture. Med Hypotheses. 2005;64:887-898.