Tummy Time
6/6/2022
TUMMY TIME
Once you welcome your new baby to your family, your focus will be on feeding and caring for your newborn. Helping your newborn meet developmental milestones by providing opportunities to develop and practice new skills. Tummy time is an important exercise for your baby to incorporate into their daily routine with many benefits.
TUMMY TIME BENEFITS
Tummy time is an easy, do-anywhere exercise but has so many benefits that last for years to come and impact many areas of development. They include
- Building muscle to to help move, interact and engage with their environment including
- Neck muscles
- Shoulders muscles
- Arm muscles
- Wrist muscles
- Core muscles
- Hip flexors muscles
- Spine and back muscles
- Build balance and vestibular sense
- Help develop visual tracking
- Help stretch muscles
- Prevent flat spots on heads
- Promotes crawling
- Helps develop grip strength
- Develops body awareness
- Develops bilateral coordination
- Promotes language development by
- Strengthening muscles needed to move the mouth
- These muscles help us form words and sounds
- Help coordinate breathing and swallowing and breath support
- Increases babbling by help bring lips together to make bilabial (lip together) sounds like bababa
- Promotes oral motor skills for eating
- Builds strength for being upright which helps with eating, digesting, and eliminating food
- Promotes respiratory control needed to safely swallow
- Oral motor skills mimic gross motor skills
- When learning the bilateral coordination needed for crawling a baby is also learning to move food to the sides of their mouth
A study done by the World Health Organization found that 30 minutes of tummy time a day could result in gains in gross and fine motor development, problem solving, and social skills.
Of note, side lying is also important to add in to your baby's playtime. Side lying helps a baby learn to bring their hands to the midline, helps round out the ribcage for breathing, and helps keep the body flexed. It also helps prevent flat spots on your baby’s head.
HOW TO START
When Should You Start?
Babies should start tummy time by 1 weeks of age and continue to do tummy time through 6 months of age. After 6 months of age, babies may play on their belly but they often start working on sitting, vertical play, and crawling.
How Much Tummy Time?
Our goal is 30 minutes of tummy time a day. Do not try to do 30 minutes of tummy time right away! Most infants do not have that much awake time. Start with short 1 to 2 minute periods of time and increase as your baby tolerates tummy time and has longer awake periods. Even older babies tolerate 3-4 shorter periods of tummy a day instead of one longer period.
And remember, your baby needs playtime in a variety of positions, not just tummy time. They should have time to play on their back and sides. A baby should spend almost equal time on their backs, sides, and tummy every day.
Positions
We often think of tummy time as an activity that should be done flat on the floor. That is not the only position. We want your baby to be on their tummy but this can be done:
- On your chest
- Across your thighs
- Parallel on your thighs with your knees raised
- Being held in football hold
- On a mat on the floor
- On a tummy time pillow/mat8
- On a rolled blanket or towel*
- On a boppy pillow*
- On a bed*
- On the couch*
- On a stability/exercise ball*
A BABY SHOULD ALWAYS BE SUPERVISED DURING TUMMY TIME BUT ESPECIALLY WHEN ON A RAISED OR ELEVATED SURFACE ( *)
Troubleshooting
What if your baby hates tummy time? What can you do to help?
- Avoid doing tummy time right after a feed (a fully belly can result in an upset belly or spitting)
- Pick their happiest time of day to try tummy time
- Start early and do it as part of your post-bath or post diapering time of day
- Get on your baby’s level
- Put them in tummy time gently
- Sometimes placing a baby on their belly will activate startle reflexes to avoid this have them start on their back then slowly bring arms center and roll them gently and slowly onto their belly
- This will reduce startly as well as help their vestibular system
- This also help activate the muscles they will eventually need to roll back to front
- Make sure they are in a comfortable position
- Try an inclined position
- Try holding them
- Make sure their elbows are in line with the shoulders and not “splayed” out
- Get on your baby’s level
- Be face to face/eye to eye with your baby
- Make it interesting
- Show pictures
- Use a mirror
- Sing
- Talk
- Go outside
MILESTONES
What a baby can and should be doing in tummy time changes based on their age.
Under 2 months
For babies under 2 months of age, this is a time for exposure rather than success. Babies under one month of age will keep their head to the side and may try to switch sides but not lift their head. Babies between 1 and 2 month olds will try to lift their head WHILE tilted. When doing tummy time with this age group, place them in an inclined position and offer support under their arms. Without these accommodations, their naturally flexed hips push their head into the ground preventing them from lifting their head which will increase their frustration and limit their tolerance of tummy time.
3 to 4 months
3 month old babies can lift their head up without tilting. Their head may come up 45 to 90 degrees. They may also start pushing on their arms. A four month old baby will lift their head up 90 degrees and will keep their head centered. They may push up on their forearms. They will also be able to track a person, toy, or voice while their head is up.
5-6 months
Babies will start to push up on their hands with straight elbows between 5 and 6 months. They will start to reach for toys and may start pushing on their arms to pivot around.
Swimming or Superman
The swimming/superman reflex is a normal reflex that starts between 3 to 6 months. During tummy time, a baby will raise their arms and legs and draw their arms back. Swimming happens during this time of development because the back muscles are stronger and easier to use than the core muscles. When activated, they pull up the head and legs. This muscle development is normal but as your baby works on rolling and sitting they will even out the strength by increasing their core strength. So ‘swimming” during tummy time is ok, but shouldn’t be the only thing a baby does during tummy time. They should also be bearing weight on their forearms and hands as well as tucking and working on rolling.
Too much “swimming” results in asymmetrical strength: over-developed back muscles and weak core muscles. When this happens a baby will be unable to roll, will not be able to bring their arms across their body, and when placed in a sit position will repeatedly fling or arch backwards.
If your baby is “swimming” too much, there are a few exercises to work on. Making sure they are getting time to play on their back and sides can help. Work on building their arm strength. You can do this by holding them in a sit or “all fours” position and having them lean forward to put weight on their arms and reach out for toys. Also working on rolling, both directions, can help increase core strength.
Your child's develop is a wonder to watch but can also leave you with concerns and questions. If you are worried about your baby's development or have any questions about tummy time, please do not hesitate to discuss these concerns with your provider.
Children’s Health Care of Newburyport, Massachusetts and Haverhill, Massachusetts is a pediatric healthcare practice providing care for families across the North Shore, Merrimack Valley, southern New Hampshire, and the Seacoast regions. The Children’s Health Care team includes pediatricians and pediatric nurse practitioners who provide comprehensive pediatric health care for children, including newborns, toddlers, school aged children, adolescents, and young adults. Our child-centered and family-focused approach covers preventative and urgent care, immunizations, and specialist referrals. Our services include an on-site pediatric nutritionist, special needs care coordinator, and social workers. We also have walk-in appointments available at all of our locations for acute sick visits. Please visit chcmass.com where you will find information about our pediatric doctors, nurse practitioners, as well as our hours and services.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.