What is tummy time?

Simply put, tummy time is time your baby spends on their stomach while they are awake. Seems easy enough, right? As a pediatric physical therapist, I consider this topic the foundation for my profession. I enthusiastically proclaim the benefits of tummy time like a Southern Baptist preacher at church…or so I’ve been told by my patients’ parents.

In 1994, the “Back to Sleep” (now “Safe to Sleep”) campaign was launched – recommending infants sleep on their backs to reduce the risk of Sudden Infant Death Syndrome or SIDS. This National Institutes of Health campaign dramatically decreased the incidence of SIDS (over 50%), but also resulted in increased motor delays. A 2008 survey of 400 physical therapists found that two-thirds of those surveyed felt that they had seen an increase in motor delay over the prior six years.Benefits of tummy time

What does “Back to Sleep” have to do with motor delays? Because babies are spending so much time on their backs (12 – 16 hours in the early months), they are missing out on some fundamental development that used to happen on their bellies. So it’s up to parents to make sure those babies spent time face-down when they are awake.

The American Academy of Pediatrics (AAP) recommends placing babies on their backs to sleep and on their tummies to play when they are awake and alert. Starting with a few minutes from birth can have long-reaching impacts in many health- and development-related areas. Take a look:

1.  Head & Brain:

• Prevents cranial asymmetry (flat head/plagiocephaly) that can require helmeting
• Increases body spatial awareness
• Improves sensory integration (one benefit of this can be to decrease meltdowns due to overstimulation)
• Supports progress in cognition

2.  Eyes:

• Improves hand-eye coordination
• Supports visual motor depth perception

3.  Arms:

• Improves strength and ability to reach
• Helps prepare arms for crawling

4.  Tummy:

• Decreases gas, constipation and slows gastrointestinal (GI) motility

5.  Hands:

• Increases strength
• Supports independence

6.  Hips & Legs:

• Improves flexibility, strength and mobility
• Helps prepare legs for crawling

7.  Neck & Back:

• Prevents torticollis (atypical position of head and neck), which can require physical therapy
• Strengthens shoulder, back and neck (crucial to reach future gross motor milestones)
• Improves posture

Tummy time helps your baby crawl, grasp toys and eat?

Here are a few developmental skills babies acquire during the first year of life:

• Cooing & babbling
• Reaching and grasping a toy
• Rolling
• Eating
• Sitting up using abdominal muscles
• Crawling on all fours
• Walking

All of them have one thing in common. Can you guess what that is?

To be performed they all require strength of the muscles on the front side of the body, known as flexors (e.g., muscles of the hips, quadriceps, stomach, head/mouth and neck). Babies strengthen these muscles by pushing against gravity – the most effective way to do that is lying face down. Babies that don’t spend enough time on their bellies often have delays in areas ranging from talking and grasping to crawling and walking.

When to begin and how much time?

Tummy time can begin as soon as your little one comes home from the hospital. You can start by simply putting your baby on their tummy for a few minutes after every diaper change each day.

AAP recommends tummy time two to three times a day for three to five minutes each time from birth, with more time added gradually. The Mayo Clinic recommends about 20 minutes a day. Start slowly. Place your baby on his belly for a minute or two at a time, four or five times per day. The goal is to increase each tummy time session to 10 minutes, four or five times a day or more. Research shows that at four months of age, babies who spend at least 80 minutes per day awake on their tummy are more successful at reaching certain motor milestones than babies who get less tummy time.

Different tummy time positions

Although 80 minutes sounds like a lot, you’d be surprised how quickly tummy time adds up throughout the day. The BabySparks app includes several activities in tummy time position to make it more fun and engaging for your baby. You can also alternate different tummy time positions to help your baby adjust:

• Tummy to Tummy: Lie down and place baby on your chest or tummy, so that you’re face-to-face.
• Tummy Down Carry or Football Hold: Position one hand under the tummy and between the legs and carry baby facing down.
• Prone on Lap: Place baby face-down across your lap.
• Eye to Eye: Bend down so you are level with baby. Offer additional support by placing a rolled-up blanket under baby’s chest and shoulders.

Every minute that your baby spends on their tummy will make a difference. If you have done plenty of tummy time with baby, but are concerned they are not meeting their milestones, bring your concerns to the baby’s pediatrician or a health care provider.

Morgan Bryant, PT, DPT has a doctorate in physical therapy, and is the owner of Matrix Rehab, LLC, a wife, and mother of 2.