In my job as a pediatric physical therapist I often get to evaluate cute little babies. Some come to me because they have medical conditions like Down Syndrome or cerebral palsy and benefit from early intervention. Others are not meeting their developmental milestones in a timely fashion. Others have developed conditions like torticollis (tight neck) or plagiocephaly (flat head) that need to be treated. In all of these cases, at some point in the evaluation I will ask the parents, “How does your baby do with tummy time?” That’s when I often get The Look.
It’s a look that says to me, “Come on lady, we’re trying to survive here. I know that I should be doing more tummy time, but baby hates it and I just can’t handle one more thing at this point. I already feel bad that we have to be here, at therapy. Please don’t judge me.”
Tummy Time is one of those things that gets mentioned briefly in parenting classes and in doctors’ offices during well-child checks. It’s also one of those things that many moms love to hate, because it brings up images of their baby laying on the floor, face smashed down into his activity mat, getting more and more frustrated until he starts to wail. So although parents have heard Tummy Time is important, they don’t always understand why, and they often don’t do it as much as they hear that they should. (This is similar to how I don’t floss my teeth nearly as often as I tell my dentist I do, shhh…)
So why then do we health care professionals keep bringing up Tummy Time, and what does it really mean?
Basically, Tummy Time is a catchy catch-phrase that medical professionals have used to mean any activity where baby is positioned out of baby equipment in a way that she has to work to support her own head and neck and use her arms and shoulders. In this way baby gets to explore movement and what her body is able to do, and work towards milestones like rolling over, sitting up, and eventually crawling. Tummy Time should ideally start right away, even as early as 1 day old, and by 3 months old babies should be getting at least an hour of time per day where they are free from equipment and on their bellies in some way.
Adequate amounts of Tummy Time help to prevent conditions like plagiocephaly, because when babies spend too much time on their backs or in infant equipment like swings, carseats, and bouncers, the bones in their skulls can be molded to create a flattened area on the side or the back of the head. Over time, this can make it difficult for them to turn their heads off the flat spot, leading to tight neck muscles (torticollis), which can affect the development of motor skills and coordination later on.
So what are some things that can help a baby who is having trouble tolerating Tummy Time?
5 Tips to Make Tummy Time Pleasant and Manageable
Start small, even a few minutes at a time.
Try placing your baby on his belly on the changing table for 30 seconds after changing his diaper. Doing this several times a day will help him get used to the feeling of pressure on his belly and the need to lift up his head.
Get down on the floor with him!
Babies are more motivated to look at faces than toys or other distractions, so get down on the floor in front of him and let the goofy faces roll.
Think outside of the box in terms of positions.
Remember that any position where baby is not held by equipment and has to support his head can be considered “Tummy Time.” Lying on your chest, across your knees, or being held in a wrap or carrier all count.
Being slightly inclined takes some of the weight of gravity off of baby and can make the work of lifting his head slightly easier. A wedge shaped pillow, a large exercise ball, or just your legs can make an incline for baby to lie on where his head is higher than his pelvis. As he gets stronger you can make the incline less steep until you get to the floor.
Check in with your baby’s doctor.
If you are really concerned that your baby is not tolerating time on her stomach, or if you are concerned she is not meeting her milestones appropriately, talk to your baby’s primary care provider about your concerns. Early intervention can solve a lot of problems and keep small problems from becoming big problems.
What Tummy Time IS:
- Always supervised. Never leave your baby unattended on his tummy until he is crawling and getting in and out of positions by himself.
- Always while awake.
- Lying on a parent’s chest.
- Held up over a caregiver’s shoulder.
- Lying over a parent’s legs.
- Being worn in a wrap or carrier.
- Supported on a towel or pillow.
- Effective even a few minutes at a time.
What Tummy Time is NOT:
- A position for sleeping.
- Putting your baby down flat on the floor and letting him scream.
- Does not have to be long duration to be effective.
What things have YOU found to help your child become better at Tummy Time?