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Reposition and roll ‘em over: Tummy time matters
February 09, 2021
Reposition and roll ‘em over: Tummy time matters

How tummy time can help your baby

From day one, babies learn how to use their bodies through daily time on their tummies. Tummy time helps them strengthen muscles and master skills like lifting their head and turning over. These basic skills prepare them for sitting, crawling, walking and other milestones they’ll achieve as they get older.

Occupational therapist Andrea L. Johnson explains more about why tummy time is an important developmental milestone and what to expect.

Why do babies need tummy time?

In the first six months of life, babies spend a lot of time on their backs. They sleep approximately 15 to 16 hours each day and the American Academy of Pediatrics recommends they’re placed on their back for sleep for important safety reasons. (The Back to Sleep program was established in the early ‘90s and has decreased cases of sudden infant death syndrome by 40 percent in the United States.) Babies also spend additional time in a back-like posture in positioning devices such as car seats, swings, strollers and bouncer seats. These keep babies safe, provide a way for parents to bring them along to see the world and encourage playtime, but they also add to the amount of time babies spend on their backs.

A baby can develop flatness on the back or side of the head, sometimes leading to an uneven facial appearance, if they spend excessive time on their back. Difficulty turning their head to one side or keeping their neck and head straight due to muscle tightness/weakness is another common issue (called torticollis) and one of several related developmental concerns. Positioning devices prevent a baby from moving for long periods of time, which is also a concern. Babies need to move their neck, spine, upper back and arms to develop strength and motor skills.

This is where tummy time comes in. Repositioning— simply moving a baby into positions where they aren’t on their back and can move their bodies more freely—counteracts time spent on their back, helps minimize head-shape concerns and supports physical development. Tummy time is ideal for this. ANY activity that keeps a baby from lying flat on their back against a hard, supporting surface is considered tummy time. It can be accomplished any time you position your baby on their belly, whether it’s during play time, part of their care routine or when they’re being held or carried.

Tummy timeline: When to start tummy time and how much belly time should my baby get?

Tummy time should always be closely supervised and should never be difficult or unpleasant with extensive crying. Babies should do as much as they can tolerate, so when your baby is awake, position them on their tummy as frequently as possible. Here are some general guidelines for the minimum amount of tummy time recommended each day (this can be chunked into smaller time periods) and the physical skills or milestones you may see at different ages/stages.

 

Newborn

1-2 months

2-4 months

4-6 months

Daily tummy time recommended

2 to 3
3 minute sessions

2 to 3

3-5 minute sessions

45 minutes to 1 ½ hours

At least 1-2 hours

What you might see

 

Table adapted from CanDoKiddo.com

Head/neck

Cheek is down 

when baby is on their tummy and it takes a great effort for baby to briefly lift head.

 

Arms/legs  

Arms are bent inward with hands positioned near shoulders. Knees are bent under hips and some leg movements may be beginning.

Head/neck 

Baby may lift head to 45 degrees briefly and turn head to place opposite cheek down.

 

Arms/legs

Arms begin to move away from body and hands will begin to press downward to begin pushing shoulders/top of chest slightly off the surface. Legs begin to straighten.

Head/neck  

Baby may lift head

45-90 degrees without bobbing, turn head to look both directions and look down with chest lifted.

 

Arms/legs

Baby may lift arms and legs off the floor, sometimes rocking and appearing to fly like “Superman.” Baby may start to press down on forearms to lift upper chest.

Head/neck

Neck muscles and head control should be strong and steady by 6 months.

 

Arms/legs 

Tummy time is active with baby beginning to reach for objects and roll from belly to side. Baby may begin to lift upper chest from the floor by straightening their arms causing backwards pushing and semi-circular movements (pivoting).

 

Tummy time ideas and activities

tummy timeWhen carrying:

  • Hold your baby against your chest facing away from you and support their trunk. This position encourages them to watch the activities in the room by turning their head and allows them to work on holding their head up. As they get better at holding their head up, support their trunk and lean them forward to play the airplane game – watching them “fly!”
  • Carry your baby facing away from you on their right side like a football, then switch and carry them on their left side. Switching sides helps develop muscles on both sides of the neck.

When playing:

  • Lie on your back and hold your baby on your chest facing you. This will encourage your baby to lift their head to look at you.
  • Place your baby on your lap, tummy down, and raise one of your legs higher than the other. This assists the baby in lifting their head.
  • Put a small towel or blanket under your baby’s arms to support their chest when they’re on their tummy for playtime. Place a toy where they’ll need to lift their head to see.

When providing care:

  • Towel dry your baby on their belly and massage them while they’re in this position.
  • After a diaper change, roll them onto their belly for a little supervised playtime before you pick them up.
  • Try placing your baby tummy down over your lap when burping.

Tummy time is a great opportunity to interact and bond too. Enjoy this time together and find ways to make these moments fun.

Learn more about your baby’s developmental milestones and how our therapists can help if you have concerns.

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