When does your baby have a conditioned dialling up with the bottle and what to do about it?

This page belongs to collection of short articles and videos in plain language, called When baby cries a lot in the first few months of life. Together, these articles and videos will give you a brief and simple summary of the Possums 5-domain approach to the crying baby. For comprehensive information on this topic, please consider reading The discontented little baby book.

What is meant by conditioned dialling up with the bottle?

Conditioned dialling up at the bottle is a common but distressing problem. By ‘conditioned’, this means a habit which has developed over time. By dialling up, I’m referring to the dial on the baby’s sympathetic nervous system.

A baby has a conditioned dialling up at the bottle when they repeatedly begin to fuss, or become agitated, either when starting to have a bottle or during the feed. The baby quickly signals distress in response to small or invisible frustrations.

The baby reacts like this, not because they don’t like to feed, but because they have such a powerful and biological longing for feeds but they have developed a habit of becoming very tense when they either see the bottle or are sucking from the bottle. This is not your fault. But the aim now is to re-teach your baby that drinking milk from the bottle is a lovely, satisfying, cuddly experience.

It’s important to have the support of your local GP or other suitably qualified health professional when your baby has a conditioned dialling up with the bottle. This health professional can monitor your baby’s weight for you, so that you don’t have to worry about it in between weighs.

What to do if your baby has a conditioned dialling up with the bottle?

Try to focus on creating enjoyable, no-pressure opportunities for baby to feed whenever you can.

When your baby has a conditioned dialling up, it’s important that your baby doesn’t feel pressured to take milk from the bottle. This is easy to say, and very hard to do when you might be feeling under great pressure to make sure your baby gains weight.

It’s also very important to address positional instability with bottle-feeding when we have a baby with conditioned dialling up, and to watch your baby’s communications closely and respond during feeds. We call this 'paced bottle-feeding'.

You can watch a video of Renee Keogh demonstrating how to do paced bottle-feeding here.

To help change the conditioned dialling up, we need to offer the bottle frequently and flexibly if it is your baby’s only means of feeding, which might mean more than every couple of hours if your baby is under six months of age - really just whenever the baby is dialled down and it seems a good time for you both to try, or when the baby is showing signs or cues that something is needed by beginning to dial up. This takes the pressure off any one particular feed.

The feeds might seem to be brief and small, but the most important thing is that the feed is settled and happy. You may be discarding a lot more formula than you've done previously, but this is the best way to repair a conditioned dialling up with the bottle. As long as an exclusively formula-fed baby isn’t taking a lot more than the recommended daily volumes as a pattern week after week, this is the best approach.

It’s important to grow enjoyment and happy interactions during feeding. Never feel you have to empty the bottle – let your baby be your guide.

Babies who have a conditioned dialling up with the bottle needs lots of rich and changing sensory motor nourishment. Rich sensory motor nourishment keeps babies dialled down overall, which in turn helps make time at the bottle dialled down too. If they are not wanting the bottle, offer your baby a change of environment (most easily achieved by stepping outside the home, if you can).

Acknowledgements

I'm grateful to Professor Sophie Havighurst, Ros June, and Caroline Ma at Mindful, The University of Melbourne, for their feedback on the articles and videos in When baby cries a lot in the first few months of life. They helped me keep the language plain and the concepts as accessible as possible, for this brief and simple version of the Possums 5-domain approach to the crying baby.

Recommended resources

Frequent flexible bottle feeds help make sleep easy if you're not direct breastfeeding and baby is under five months of age

Feeding your bottle fed baby to sleep doesn't cause bad habits

What is sensory motor nourishment and why does it help with baby sleep?