Tummy Time

by Anjali Fortna, PT, DPT

What is Tummy Time?

“Tummy time” is the time during the day that an infant spends on his or her tummy. Because it is typically recommended that a baby sleep flat on her back during all naps and overnight sleep, it is important to give baby time in other positions to help develop symmetry and strength in all
directions.

There are many benefits to tummy time that go beyond just changing position. Spending time on their stomachs is crucial to babies developing strong neck muscles to lift their heads against gravity, and begin to develop the ability to lift their heads to look at people or objects in their environment. In the womb, babies grow in a position of flexion, meaning their necks, backs, hips, knees — everything — are bent forward. Developing range of motion in the opposite direction, or extension, is an important part of developing strength and symmetry for everyday activities. Tummy time is a big part of this development. It even helps the spine develop its
shape and change from the completely flexed forward infant spine to the childhood and adulthood spine that has curves at the neck and low back. All of this develops by working against gravity.

Another big benefit of tummy time is the prevention of a flat back of the head. When babies spend too much time on their backs beyond just when they are sleeping, their soft heads can become flattened on the back (brachycephaly), or the sides (plagiocephaly). Changes in head shape can lead to shortened or tight neck muscles, asymmetrical preference for vision and motor development, and may even affect the way a bike helmet fits when a child gets older. Working tummy time into baby’s every day can help prevent irregular skeletal and gross motor development.

So how is tummy time done? Tummy time should always be supervised until the baby can confidently and consistently roll from tummy to back by himself. While some babies enjoy playing on their tummies, others immediately fuss and try to avoid this position. Babies who
have colic or reflux may especially resist tummy time. Ideally, babies should spend 60 minutes per day on their tummy. If the baby enjoys being on his stomach, this can be completed in large chunks of time with the baby flat on his stomach on the floor, with a toy or parent in front of him to encourage him to lift his head and work his muscles against gravity. If baby doesn’t like tummy time or becomes fussy easily, it can be done in shorter bouts of just a couple minutes at a time. Some parents choose to work in small amounts at regular intervals during the day, such as just after a diaper change.

If the baby does not tolerate being flat on her stomach at first, there are some alternative methods of working in tummy time. Some babies will tolerate being in a partially flat position on their stomachs, such as propped with their chest over a boppy pillow or small wedge. Other babies will tolerate lying on their stomachs against their parent’s chest while the parent leans back on the couch. These positions are still considered tummy time because the baby must use her extensor muscles on her back to lift her head and trunk against gravity.

Overall, tummy time should be a positive and playful part of the day to help baby develop strength, symmetry, and new ways to interact with her environment. If you have concerns about your baby’s tolerance of tummy time, movement preferences, or developing body, a pediatric physical therapist can help assess your baby’s motor development and come up with strategies to make tummy time a regular and fun part of the day!