What Every Parent Needs to Know About: Tummy Time!
I have yet to meet a parent who has not heard of tummy time, but what defines tummy time?
Tummy time is any play where baby is able to explore movement on their stomach! Over the last few decades, many aspects of our society have evolved. One of the biggest changes is the introduction of “back to sleep,” with the AAP recommending babies be placed on their back for safe sleep. Additionally, many families today are more on-the-go with work, childcare, playgroups, activities, etc. This means many babies spend more time in car seats and strollers. Lastly, parents and families have access to a lot of new technology and equipment, which can be a wonderful tool but most of these items position baby on their back. Now, I do want to say that none of these are bad things, but some examples of how things change over time and a few of the reasons why we hear so much about tummy time.
What are the benefits of tummy time?
One of the principles of motor learning is variety. Babies need a variety of positions and experiences to learn new skills! And since babies born today in general spend more time on their backs, they need help from their caregivers to introduce a variety of positions! (This is also where I like to emphasize that term variety. Everyone talks about tummy time, but time to play and explore active movement on their back and playing in side-lying are also important!) Research shows us that babies under 6 months old who do tummy time more then once per day score higher on gross motor tests and achieve rolling, sitting, and crawling earlier then babies who do not play on their tummy. There are also findings that baby’s who do tummy time have improved communication and problem solving skills in the first 2 years of life. Another big concern for parents today is flat head syndrome (which I will do a whole separate post on!) and tummy time can support a round head shape since there is no pressure on the back of the skull.
When should I start tummy time?
I encourage parents to start tummy time from birth. Through years of working with babies I have seen that tummy time early and often leads to a positive tummy time experience for both baby and caregivers! And if you’re reading this and have not started tummy time with your baby don’t worry, you most likely are doing tummy time without even realizing it! For newborns I recommend focusing on holding your baby chest to chest as tummy time, and start to introduce other positions as you feel your baby is ready or by the time they are 6 weeks old.
Where can I do tummy time?
I’m glad you asked! Try your chest, lap, the changing table, the floor, on a wedge/pillow/blanket roll (If baby is not on the floor keep your hands on for safety at all times and once baby is trying to roll move all tummy time to the floor.)
What about baby wearing?
Wearing your baby chest to chest in a carrier does encourage activation of the extensor muscles (muscles along the back of the body,) but to a lesser degree then tummy time on the floor. Baby also has less freedom of movement in the carrier. I love babywearing, for myself and my clients. It is a great way to incorporate activation of the extensor muscles when you need your hands free (vs placing baby on their back in a swing for example,) and also is a great way to introduce tummy time to very young or very fussy babies. And there are lots of other benefits to babywearing! However, I do not consider babywearing a replacement for tummy time play where baby is working against gravity and exploring independent movement. So I recommend a mix of both!
But my baby hates tummy time?
I hear you, It can be so challenging to incorporate any activity that makes your baby upset. Try:
Start with connection! Do tummy time on your body and start with baby in an upright position (less work against gravity) then over time move towards a flatter position.
Start small! Roll your baby onto their tummy for 1-5 sec, then roll off and take a break. Focus on short, positive experiences on their tummy then slowly increase how often and how long they play on their tummy.
Find what engages your baby! Toys, mirrors, pets, sibling, the package of wipes are all fair game. Use a wall or elevated surface to bring the toy above eye level to encourage lifting their head.
Change the environment! Go to a new room, go outside etc for a new experience.
If baby always keeps their arms out to their side, help them tuck elbows under shoulders to learn and push through those forearms!
When should I seek support from a pediatric physical therapist?
Your baby is < 1 month old and holds their head up off the surface during tummy time (this is usually related to tension more then strength and for some babies can be related to torticollis or impact gross motor development)
Your baby is 3 months old and cannot lift their head during tummy time on a flat surface
Your baby is 4 months old and cannot tolerate 2 min of tummy time on a flat surface with minimal fussing
Your baby can only turn their head one direction (left/right) during tummy time
Your baby consistently leans their body to one side (left/right) during tummy time
You aren’t sure how to start or adapt tummy time because of your baby’s medical needs
Your baby is 8 months old and not moving during tummy time (scooting, pivoting in a circle, or crawling)
Your baby is 10 months and not crawling
Remember you are the expert on your child, If you have any concerns they are valid and we are here to support you!
Resources:
Hewitt L, Kerr E, Stanley RM, Okely AD. Tummy Time and Infant Health Outcomes: A Systematic Review. Pediatrics. 2020;145(6):e20192168. doi:10.1542/peds.2019-2168
Zhang Z, Predy M, Hesketh KD, Pritchard L, Carson V. Characteristics of tummy time and dose-response relationships with development in infants. Eur J Pediatr. 2023;182(1):113-121. doi:10.1007/s00431-022-04647-w