If your baby hates tummy time, you’re not alone. We talked to the experts to find out why pediatricians recommend it, and the answers to the most-common tummy time questions, and when to start tummy time.
Tummy time is the activity of placing your newborn baby on its stomach when he’s awake and supervised, according to the American Academy of Pediatricians. The AAP views this time as important as putting your baby on her back to sleep.
When to start tummy time
All infants, unless instructed by a pediatrician, should be doing some form of tummy time as soon as they get home from the hospital, says Catherine Workman, M.D., developmental pediatrician at Hassenfeld Children's Hospital at NYU Langone in Manhattan. “It doesn’t have to be a long amount of time at once, particularly at the beginning,” she says. “Start with just three to five minutes at a time and work up.”
Isn’t putting an infant on its tummy dangerous?
It’s complicated. In 1992, the AAP launched its Back to Sleep campaign, announcing what many pediatricians had believed for years: Putting a baby to sleep on his stomach was dangerous. The AAP recommended all babies sleep on their backs until the age of 1. Back to Sleep led to a dramatic reduction in the amount of SIDS deaths but an increase in anxiety in parents about baby being on his stomach. A 1995 study in the Journal of Pediatric Medicine found that a quarter of parents never put their babies on their front to play due to fear of SIDS. However, tummy time for newborns is perfectly safe as long as he is awake and supervised.
What are the benefits of tummy time?
After the Back to Sleep campaign, doctors and physiotherapists began to notice it was taking babies a little longer to reach some developmental milestones such as sitting up, rolling over, and crawling. Studies also showed an increase in the number of babies with a condition called plagiocephaly, or flat spots on their head, caused by spending most of their time lying on their backs.
After concerns were raised in 2003, the AAP made the recommendation that all babies should be placed on their tummies as much as possible when they are awake, and the term tummy time was officially born. The AAP then coined the phrase Back to Sleep, Tummy to Play.
“Tummy time sets you up for strengthening and coordination,” says Amanda Math, MPT, C-SIPT, physical therapist and co-owner of Jumping Jax Speech, Physical and Occupational Therapy, which has locations in Manhattan and Westchester County. Math treats babies and young children with developmental delays and is passionate about the benefits of daily tummy time. “When you strengthen those head-neck muscles, upper back muscles, and shoulder muscles early on, you’re going to start to get some head control, which points you in the direction of achieving all of your early developmental milestones.”
How often do I do it?
Whenever your infant isn’t feeding or sleeping, look for opportunities to put her on her stomach (under your supervision). The key is to start early, do it for frequent, short periods of time, and build up time gradually. “By four or five months you want them on their tummy for forty minutes to an hour a day cumulatively,” Math says.
My baby is so busy sleeping, eating, and napping; how do I fit tummy time in?
A common misconception is tummy time is a specific activity that’s scheduled every day at a set time. In fact, the best way to approach it is to build it into whatever you're doing with your baby during the day (and night!). Any time baby is leaning on his stomach counts.
My baby screams so much, what do I do?
Remember the old parenting adage: this too shall pass. “As the baby gets stronger, they will like the time more,” Dr. Workman says. “Kids eventually learn to roll over. Once they’re rolling over on their own it’s less of an issue, so it’s a time-limited problem.”
When your baby gets upset during tummy time, it can be hard to distinguish between minor discomfort and distress, but you know your baby best. Math recommends watching for central nervous system reactions such as his face turning red, or he’s holding his breath. A bit of frustration and discomfort at the beginning is normal, but don’t push a distressed baby. Pick him up and try again another time.
“Get down on their level, get down on your tummy yourself,” she says. “It’s hard when we put them down and they sense that we’re far away from them. Modified positions are great to help, and then you just do whatever you can. You sing songs, you’re silly, you move that rattle, and just do your best to encourage it because it really sets them up to be in the best developmental position.”
My baby has reflux, do I still have to do it?
As a mother of two babies who suffered from severe reflux, I can still remember how difficult tummy time was. Lying down flat caused them to throw up and cry in pain, sometimes at the same time! Dr. Workman recommends having tummy time after a nap so a long period has passed since the last feed, or doing it just after you give medication if applicable. Math suggests using modified positions like using a bolster or on a caregiver’s chest as more reflux-friendly versions.
My mom friend says her pediatrician told her not to force it if her baby hates it, but mine says it’s essential. Who is right?
Although most experts recommend tummy time, there are some who view it as unnecessary and suggest parents instead let their babies reach their milestones in their own time. Studies suggest the delays in development are transient and resolve by 18 months. Michel Cohen, M.D., is a pediatrician with more than 25 years of experience and is founder of Tribeca Pediatrics, which has 24 locations across the city. He is known for the low-intervention approach that has made him extremely popular with New York parents. His view? We should be letting babies develop their own muscles at their own pace. “Why are we tampering with nature?” he says. “Babies are meant to develop by themselves.” He points out that tummy time can even create more stress for parents: “The baby can end up liking it,” he says. “And they have a problem because now you have a two-month-old who likes being on his belly.”
In his popular 2004 parenting book, The New Basics: A-Z Baby and Childcare for the Modern Parent, his simple, yet controversial, advice is, if baby hates it then skip it. “Since there’s no need to strengthen any specific muscle group, I advise you not to act as Lucy’s personal trainer. Skip the tummy time and tickle her tummy so she’ll exercise her giggling muscles instead.”
As with everything in parenting, deciding what’s right for your child is a personal decision made between you and your pediatrician.
Tummy Time Hacks
Catherine Workman, M.D., developmental pediatrician at Hassenfeld Children's Hospital at NYU Langone suggests making tummy time fun: “Pair it with something they like, so it’s more enjoyable for the parent and the child.” Here are seven ideas to make baby's tummy time more fun for your infant—and you:
The Diaper Change Massage
After a diaper change, flip your baby over for a few minutes on the changing mat (but stay close to avoid falls). If she’s fussy, give her a massage to distract her.
The Caregiver Crawl
Tummy time isn’t just about the playmat. Lying on a caregiver’s chest is cozy and counts toward his daily minutes. Just make sure your baby is supporting himself on his own stomach. You can vary the incline by sitting or lying down yourself.
I Spy Me!:
“A lot of babies respond really well to mirror play,” Dr. Workman says. Using a non-breakable baby mirror so baby can see herself while she’s on her tummy can be a fun distraction. “All babies want to do is stare at the other baby in the room because they don’t realize that it’s them,” says Math.
Math recommends using a bolster made from a rolled-up towel or a breast-feeding pillow to help prop up reluctant tummy timers. “Prop them on their stomachs so they’re weight baring a little bit on their hands and their forearms, but their head is upright,” she says.
Instead of burping your baby over your shoulder, try laying him down gently across your knees (making sure to support his head and neck). Lots of babies love it because the pressure helps them with gas, and they’re close to you.
Dr. Workman suggests alternating the type of sensory material the baby is lying on. Use a fluffy blanket one day, a crinkly one the next, and seek out baby mats with lots of different sensory sensations. “Maybe they like a certain type of blanket than another,” she says. “Finding what it is that the baby enjoys can make it more palatable.”
Get out of the chair
Avoid the tendency to always have your baby in a seat or stroller when he’s awake and not being held. Wherever possible put him down on his tummy to play.