All doctors and physiotherapists emphasize to parents that tummy time is crucial for infants. Even the World Health Organization recommends it. Nevertheless, not all babies like to spend time on their tummies. Why is it so important, and how to do it correctly? Here are some tips about tummy time everyone needs to know.
What is tummy time?
To put it simply, tummy time is when the infant is lying on their belly. Placing babies on their bellies is safe only while they are awake. Someone has to watch the baby, as they cannot fall asleep while being in this position. There is evidence that it is unsafe for babies to sleep in the prone position because of sudden infant death syndrome (SIDS).
Why is tummy time important?
In 1992, the American Academy of Pediatrics started a safe sleep campaign because of increasing cases of SIDS. On of the key recommendations was a supine sleeping position. While the number of SIDS cases has fallen, concerns have been raised for potential delays in infant physical development. Because of that, the tummy time recommendation appeared. A review of studies with more than 4,000 babies show that tummy time is associated with improved motor skills and development in children, including the ability to roll over, crawl, sit up, stand, and walk.
According to the literature, spending more than 30 minutes per day on the belly is associated with better infant head control, which means stronger shoulder and arm muscles. Additionally, there are some benefits of tummy time for a baby's head shape to avoid flat spots. While an infant spends time on their belly, the still-developing skull is not affected by pressure.
How to do tummy time
Here's a rough outline of how to start tummy time and work your way up to crawling:
- In the beginning, you can start tummy time by placing your baby on your chest.
- Start at the right time, after sleep but before feeding (lying on the stomach after eating can cause regurgitation).
- Use your voice and make facial expressions — your baby will be much more interested and try lifting their head up. Speak to your baby and hold eye contact will help strengthen your bond.
- You can try putting your baby on their belly while changing diapers for a few minutes to let them get used to the sensation.
- Try using an inflatable ball where you can gently position your baby for support but do not forget to hold the back firmly.
- As soon as your baby becomes accustomed to being on their tummy, start tummy time on the floor. You can use blankets for warmth and added coziness.
- When your baby is 3–4 months old, try bending their arms.
- Use toys and sensory cards to encourage your baby to turn their head.
- If your baby lifts their legs and rocks like a boat while lying on their tummy, gently press down on their bottom and legs with your hands so that only their shoulders lift.
- If your baby has fallen asleep on their tummy, gently lay them on their back and let them sleep.
- If your baby starts crying, try to talk or sing to them and check if they're in a comfortable position. If that doesn't work, stop tummy time and try again the next time your baby is in a better mood.
- When your baby has sufficient control over their head, place the toys further away and encourage your child to reach and crawl.
If the baby doesn't like tummy time
Ensure your baby's arms are in a comfortable position. Sometimes, they may get stuck, so you'll have to help adjust them. Additionally, provide your child with clothes that are comfortable and not too restrictive and have no zippers or buttons, as those pose a risk of getting caught on the skin. Lastly, help your baby turn their head to the side if they can't breathe properly and are crying because of that.
If your baby really doesn't like tummy time position, you can put them on their side. Use a blanket or towel to support them and prevent them from rolling. Do not forget that time on a parent's chest also counts as tummy time, so practice it as much as you can.
When to start tummy time
Pediatricians recommend starting tummy time as soon as possible and increasing the duration of tummy time each day. Usually, the best time to start is after hospital discharge, starting with three minutes while the baby is awake, for example, during diaper changes, a few times a day. It is normal for the infant to cry or want to sleep the first few times, but each day, the baby should be able to do tummy time longer and start to lift their head. Do not forget to watch the baby during tummy time, and do not let the baby sleep in the prone position.
Tummy time chart by age
The American Academy of Pediatrics recommends starting newborn tummy time from 3–5 minutes a few times per day and increasing time while working up to 15–30 minutes in total each day by seven weeks. It is important to note that this is only a guideline schedule — you can apply tummy time at longer intervals if your baby really likes it.
Age | Tummy time |
---|---|
Newborn | 3 minutes 3 times per day |
First month | 4 minutes 3 times per day |
Second month | 5 minutes 3 times per day |
Third month | 10 minutes 3 times per day |
Fourth month and later | 1 or 2 hours in total per day |
When to stop tummy time
It is recommended to practice tummy time until the child starts crawling. In fact, babies never stop being on their tummies; they do it naturally and change positions all the time as soon as they are able to do it.
Benefits of tummy time
Tummy time is important and has a positive impact on an infant's health.
Physical development
A lot of studies show a positive association between tummy time and motor development. Infant gross motor development may be better if the baby spends time on their tummy while awake. This has been established by assessing infant development on a range of standardized scales. Longer tummy time is associated with better Alberta Infant Motor Scale (AIMS) scores. AIMS is widely used from birth till 18 months old, and it provides an assessment of infant motor development in four positions: prone, supine, sitting, and standing.
Cognitive and sensory development
The first months are crucial for cognitive development. Most research on tummy time finds benefits for motor development. In addition to this, there are some hypotheses that tummy time creates a multi-sensory experience because of the different angles for vision, hearing, and skin sensation if compared with the supine position.
Social and emotional growth
Engagement in tummy time has been shown to have a significant, positive impact on the various aspects of overall development. According to studies, longer tummy time is associated with better social interactions, problem-solving abilities, and communication.
Prevents flat spots
Plagiocephaly is a common condition where continuous pressure and the same position cause a flattened skull. Studies have investigated that newborn tummy time less than three times per day increases the risk of deformational plagiocephaly, as assessed at seven weeks of age. Researchers suggested that earlier achievement of motor milestones is one of the factors that may prevent infants from deformational plagiocephaly.
May help relieve colic symptoms
General research on tummy time suggests it benefits overall development, including strengthening muscles, which can potentially reduce gas buildup and relieve colic symptoms.
Tummy time is important for overall infant development and can help prevent a flattened skull. Start tummy time from the first days of life and be consistent — this should become part of your daily routine. If you have more questions or concerns about tummy time, ask your healthcare provider.
FAQ
Is tummy time better with or without a pillow?
The results are better if the baby is on a firm surface like the floor. Sometimes, if the baby is dissatisfied with tummy time, you can use a pillow or side position.
What happens if you don't do tummy time?
There is some risk of the skull flattening, known as plagiocephaly. The overall baby development may be delayed, and muscle hypotonia, i.e., weakness, may occur if the baby is in a supine position all the time.
Does babywearing count as tummy time?
Holding your baby can enrich tummy time, but it is not a substitute for tummy time sessions. Ensure that your baby has opportunities to spend time on their tummy on a firm surface.
Should I force tummy time?
You have to make it a regular part of the routine, but you shouldn't force it. If the baby is crying during tummy time and ancillary facilities do not help — end tummy time and try it later.
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Tummy time is helpful for children's motor, sensory, and social development, helps prevent flat spots, and sometimes helps to relieve colic.
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It is important to start tummy time early in life as well as include it in the baby's daily routine.
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Use your face and voice, toys and cards, and ensure a comfortable position for your baby.
9 resources
- Pediatrics. Evidence base for 2022 updated recommendations for a safe infant sleeping environment to reduce the risk of sleep-related infant deaths.
- Pediatrics. Effects of sleep position on infant motor development.
- Pediatrics. Tummy time and infant health outcomes: a systematic review.
- Pediatrics. Risk factors for deformational plagiocephaly at birth and at 7 weeks of age: a prospective cohort study.
- American Journal of Occupational Therapy. The relationship of infant sleep and play positioning to motor milestone achievement.
- Developmental Medicine & Child Neurology. Influence of supine sleep positioning on early motor milestone acquisition.
- Frontiers in Neurology. The Alberta Infant Motor Scale: a tool for the assessment of motor aspects of neurodevelopment in infancy and early childhood.
- Pediatrics International: Official Journal of the Japan Pediatric Society. Inability of infants to push up in the prone position and subsequent development.
- Infancy. Postural Position Constrains Multimodal Object Exploration in Infants.
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