Baby Carter and his mom Kellie Garrett model tummy time in this fun how-to video hosted by Children’s Therapy TEAM OT Melissa Foster.
Make Tummy Time Great! by Melissa Foster, OTR/L
Kellie is one of several therapist friends of mine who has had a new baby recently. As therapists, we know that tummy time is extremely important for a baby’s development. But why exactly? It seems like “Tummy Time” kinda falls into the category of “Eating your veggies”. We all agree it is important. But we don’t necessarily like it. So we don’t necessarily do it. And though we hear that it is important, we are not even really sure why. So, this makes us even less likely to do it. Vicious cycle.
And even though we know that tummy time is important, babies don’t often like tummy time. And what parent wants to make their newborn cry? Isn’t it our job to comfort and snuggle her? That part can be tricky! So, today we will share the 411 on tummy time.
WHY IS TUMMY TIME SO IMPORTANT?
Again, as therapists, we know that tummy time is important for an infant’s overall development, but here are exactly all of the wonderful benefits of tummy time:
1. Strengthens neck & shoulder muscles. As the baby raises her head against gravity, even briefly, this helps her to develop the strength and coordination in her back and shoulder muscles. These muscles are necessary for her to later on roll, sit up, and crawl. Try it yourself. Place yourself in a hands/knees crawling position (quadruped) for 5 minutes while looking straight ahead. You will begin to feel the burn in your neck and shoulders, I promise! These are the exact muscles that your baby is working on, too!
2. Prevents flat spots on the back of your baby’s head. The medical term for this is positional plagiocephaly. A baby’s skull is made up of very soft moveable plates. This is what helps the baby’s head distend through the birth canal. Have you ever seen a “cone headed” newborn? Notice how the skull shifts back in a few days? You are seeing first hand how mobile the plates of a newborn’s skull really are!
As your baby grows and develops, these super soft plates of the skull begin to harden and fuse. If your baby is generally sleeping and playing in a single position, she will be at greater risk of developing a flat spot where her skull rests against the bed.
We all know that babies should be placed Back to Sleep to prevent SIDS (Sudden Infant Death Syndrome). However, babies should also work on Prone To Play (prone meaning being on their tummy), so that their heads are in different positions throughout the day. These different positions help to encourage proper brain/skull development and help to prevent flat spots from occurring.
3. Promotes gross motor milestones. This goes hand in hand with the strengthening point. While it is fantastic that the Back To Sleep campaign has dramatically reduced the incident of SIDS, it has also resulted in the increase of developmental delays (WebMD). Children who don’t get enough tummy time don’t get the gross motor practice that they need. Due to this lack of practice, these babies don’t develop the strength and coordination of their trunk, shoulder, and neck muscles. Without this strength/coordination, your baby will have more difficulty with head control, rolling, sitting up, crawling, and eventually walking. Tummy time now will help prevent crawling/walking delays later!
4. Promotes more sensory experiences. As a sensory-based occupational therapist, I hate that this one is rarely mentioned, but it is just common sense. If an infant is in one position all day, she will become very comfortable in that position. Too comfortable that is. Therefore, when you place her on her tummy, side, sitting, rolling, it will all feel like one wild roller coaster ride!
Your vestibular system is your body’s sensory system that tells you where your body is in relation to the ground/space. A roller coaster is a prime example for challenging your vestibular system. You are belted in and your body/arms/legs don’t individually move. HOWEVER, you definitely know that your body as a whole is flying through space!
Of course, tummy time can be scary for some infants, because their vestibular system is still immature. Encouraging your baby to feel happy and safe in a variety of positions will create a healthier vestibular system and help her learn that her body is safe in multiple positions and not solely on her back.
RULES FOR TUMMY TIME:
1. Tummy time is ONLY for when your baby is awake and alert. Tummy time is NOT for when the child is sleepy or napping.
2. Tummy time is ONLY for when YOU are awake and alert. True story, I was working with tummy time with my son when he was only 7 days old. He was laying on his tummy on my bed and I was bending down so I could make silly faces at him. My son was so mad at being on his tummy that he rolled over. This is definitely a supervised activity. We all need to be ready to catch the little ones!
3. Feel free to be brief. It is really hard for new mommies and daddies to hear babies cry. Again, it is our job to love and snuggle them! Feel free to start with even just 10-20 seconds at a time. As your baby slowly learns that this position is safe and won’t actually hurt her, she will be able to tolerate longer and longer periods of time.
4. Start early! When your baby was in the womb, she was actually upside down! And, unless her mama was on bed rest, your baby was used to moving into a variety of positions as her mama laid down, sat, walked, etc. Therefore, your baby’s body is used to being in different positions at birth. Now I am NOT saying that it is OK to turn an infant upside down. But, my point is that infants have been moving around in different positions in utero, let’s keep that going out of utero!
5. Slowly extend the time. The Mayo Clinic suggests that you want to aim for 20 minutes of tummy time per session by the time your baby is 3-4 months old. This will help ensure that your baby is able to meet her rolling then “army crawling” developmental milestones that emerge around this age.
6. Crying (briefly) won’t hurt. New mamas and daddies (and grandmas and grandpas!) HATE to hear a newborn cry. But, crying actually has value. It strengthens the baby’s diaphragm and breath support. Now, I would never say that you should make a baby cry on purpose. BUT, if your baby happens to cry for a minute or two as she gets used to Tummy Time, or until you find the position she likes best, then that is completely fine. She is just strengthening different muscles! And don’t we all feel like crying sometimes at the gym???
TIPS FOR TUMMY TIME:
So we have the “why” for tummy time, we have the “rules” for tummy time, now let’s get started! Here are a few options for tummy time positions to help set you and your baby up for success:
1. On your chest: Having your baby complete tummy time on your tummy is probably the best and easiest place to start. You may already be doing this! We often burp/snuggle babies by placing them on our chest/shoulder. You use this exact same position, but you just slowly put yourself in a more and more reclined position. This can be done with you laying on your back/reclined in bed, on the couch, or in a recliner. A word of caution about this position. Make sure that you don’t get too comfortable in this position and doze off! Once again, tummy time is to be used only when BOTH adult and baby are happy and awake.
2. On your lap: Again, as you are snuggling your baby in your arms, slowly bend over and lay her on her tummy across your lap instead. This can be done so gently and gradually that your baby may not even notice that you placed her on her tummy!
3. On therapy ball: This one is my favorite, and possibly the tummy time position most often used in the clinic. You simply sit on the ground while stabilizing the ball with your legs, and stabilizing your baby on her stomach on the ball with your arms. This places you and your baby directly face to face. This way you can sing, make silly faces, discuss local politics, whatever. Your baby will be much more interested in this position because she will get so much interaction with you!
4. On Boppy/bolster: For this position, you can place a Boppy pillow under your baby’s armpits, or simply roll up a towel to create a bolster and position her arms over the towel. However, in this position, you need to make sure that your baby’s head is positioned in front of the Boppy/bolster to make sure that her face is clear and she can still breathe freely. The advantage of this position is that it frees up your babies hands for movement rather than being tucked under her, and can also help encourage her to raise her head up and look around.
5. Superman: This one is only for parents with strong arms and quick reflexes! While you are walking, use both of your arms to securely hold your baby in a face down “superman” position while her side is against your torso. Again, this is a two hands only position! Many babies who like the infant swing may also like the swinging input that this “superman” position provides.
6. On floor/mat: Sometimes simple is best! Simply place your baby on a blanket on a firm surface such as…your floor. Everyone has a blanket and a floor, right? Now, this is the type of tummy time that babies will typically like the least. Everyone else is up in chairs or walking around, and here she is just lying on the floor. I would cry, too!
The main point with this position is for you to get on the floor WITH your child. Remember the supervision rule, right? And, your baby wants to see you, your face, your hair, your smile. She will tolerate this position much better if you are on the floor with her. Added bonus… If you lay on your own stomach with your elbows propped under your shoulders, you will be working your shoulder and back/neck extensor muscles as well! Win, win!
Another trick to this position is toys, and siblings, and pets, and anything else that might entertain your child. (Once again, infants need to be highly supervised around siblings and pets, especially). When my daughter was an infant, I would put her on her blanket on the floor for tummy time, then her 3 year old brother and I would proceed to build a Thomas train track all around her blanket. She LOVED watching me and brother build the track and LOVED watching the train going round and round! Get creative and see what your little one likes best!
BUT WAIT, THERE’S MORE!
Yes, yes tummy time is fantastic. But, you can do even more! Whenever I do therapy with a kiddo (or my own kiddos!), I LOVE it when an activity can work on more than skill at a time. Tummy time is no different! Once your baby learns to enjoy tummy time, here are a few bonuses that you can throw in!
1. Visual tracking: Add visual development and visual tracking skills into the mix. Simply take the toy that you were using to distract your baby, and slowly move it side to side so that she has to move her eyes and head to follow the toy. As you complete this task, make note if your baby consistently favors one side or the other, and discuss this with your pediatrician at your next visit.
2. Social skills: Babies love faces! Your face, her face, sister’s face, daddy’s face, you get the idea. Take advantage of this to work on social and language development. Many babies can start to mimic sticking out their tongue when they are only a couple weeks old! So get face to face with your baby and stick out your tongue! Make silly noises! Sing silly songs! If you feel completely ridiculous, you are probably doing it right!
3. Reaching skills: Once your baby feels even more comfortable with tummy time, throw in a bit of reaching. If you want a future NBA or MLB player on your hands, this activity is for you! While your baby is engaged in tummy time, simply place her favorite toys just within reach. The extra reaching skills will be a fantastic strengthening and eye-hand coordination combination as well!
Now for the DISCLAIMER: These tips and ideas are intended for “normally developing” infants. If your baby has certain medical conditions, tummy time positions may not be appropriate. As always discuss any concerns specific to your child with your child’s pediatrician or pediatric occupational or physical therapist.
Resources:
NIH: Safe To Sleep Campaign (downloaded March 2017)
https://www.nichd.nih.gov/sts/
Mayo Clinic: Infant/toddler health (downloaded March 2017)
http://www.mayoclinic.org/
WebMD: Newborn & Baby Health Care (downloaded March 2017)
http://www.webmd.boots.com/
American Occupational Therapy Association: Establishing Tummy Time Routines to Enhance Your Baby’s Development (Downloaded March 2017)
http://www.aota.org/About-
