Wednesday, March 9, 2011

Tummy Time: 10 Things You Need to Know

By Marilee Hartling, RN, MFT
Did you know that Pediatricians and physical therapists are concerned that babies are spending too much time on their backs when they are awake? Parents are encouraged to get their babies to spend at least 30 minutes a day on their tummies while they are awake. We call this "Tummy Time". Parents sometimes forget how important it is to have their infants spend time on their tummies!  However, it's often difficult to get babies to play in this position. Babies generally resist "Tummy Time" and may protest loudly when parents turn them over. Babies who have not been put on their tummies from the very beginning may experience this as an unfamiliar position and babies don't particularly like positions that are unfamiliar.
 The Top Ten Reasons for your Baby 
to do "Tummy Time"
l. "Tummy Time" gets babies off of their backs and provides a break for the posterior occipital area (back of the head). This lessens the chance that your baby will develop positional plagiocephaly (a flat or asymmetrical head), which might require helmet therapy.

2. "Tummy Time" lessens the chance that your baby will develop acquired torticollis which involves neck muscle shortening when a baby's head maintains primarily one position. Sometimes babies may need some physical therapy for a while to correct this condition.

3. "Tummy Time" promotes the development of strong head and neck muscles by allowing your baby the chance to hold his head up against gravity. This paves the way for your baby to push up, roll over, sit up, and crawl later. "Tummy Time" is related to faster achievement of these developmental milestones.

4. "Tummy Time" is great for stretching and giving the abdominal organs a sort of "massage" which then stimulates normal bowel functioning and can help to eliminate baby gas.

5. "Tummy Time" enhances posture and coordination.

6. "Tummy Time" helps to develop your baby's visual system including tracking.
As your baby lifts his head while on his tummy he looks to both sides. This helps the coordination of 2 eyes together as he follows movement and looks for interesting toys positioned in front of him.

7. "Tummy Time" helps to develop your baby's throat and mouth area muscles as your baby looks up and moves his head. These are some of the muscles needed for speech and language development later.

8. "Tummy Time" reduces any tightness in the head and neck muscles. For your baby's brain and nervous system to function at their best the head and neck muscles need to be as free as possible from tightness.

9. "Tummy Time" helps babies to develop both near and far vision. We call this "visual organization" which begins while they are on their tummies. "Visual organization" is especially important later on when your baby grows and finally goes to school. He will need this organization as his eyes switch back and forth from blackboard to desk.

10. "Tummy Time" simply promotes good health and prevents problems related to motor development and learning later. Prevention of problems is always better and easier than trying to fix problems after they happen.
Learn how to get your baby to LOVE "Tummy Time".  We will give you ideas and activities you can utilize at home, some of which we will actually practice during the workshop, to make sure your baby gets enough "Tummy Time" throughout the day. Our "Tummy Time" activities are enjoyable for both babies and parents. You and your baby will have fun! For more information about "Tummy Time” or to ask questions about the content in this blog, contact: 


Nathan attends Marilee’s “Mommy & Me” group at the Hollywood Pump Station on Mondays.  He has been practicing "Tummy Time" in the group since he was one month old and really enjoys it!  So does his dad!! (picture used with permission)


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22 comments:

Teresa said...

At what age would u recommend starting tummy time for 30 min a day?

valerie gomez de la torre said...

This is a great list. But- it is very important to mention along with #2 the risk of your child sustaining a flat spot on their head called Plagiocephaly. This often results from external forces applied to the soft infant skull (laying too much on back, or sleeping in bouncy seat, swing or at seat).

Everyone should read this and share with friends. I wish I would have heard of this when I had a chance to fix my son's head without a helmet and therapy.

http://www.cranialtech.com/index.php?option=com_content&view=category&layout=blog&id=37&Itemid=28

Anonymous said...

I completely disagree that tummy time is needed at all. Babies should be allowed to be on their tummies when they can get there themselves and/or be in that position comfortably. The reason a baby protests is not because it is an unfamiliar position, it is because they are uncomfortable. There are other ways to prevent flat spots, such as spending time wearing, carrying or holding your baby. Once a baby can roll onto his or her tummy, he or she will spend plenty of time there. There is no rush in pushing a baby to be in a position they find uncomfortable and placing unnecessary strain on the neck.

Anonymous said...

My pediatrician says that Tummy Time is overrated and to never force my daughter to be her tummy.

Anonymous said...

I agree with Anonymous, Tummy Time is not needed. Children should not be forced into positions they can not get to naturally. When a child is strong enough to turn over, then they should be allowed to do so. Everyone who is unsure of the benefits of allowing your baby to be on their back until they are physically strong enough to do Tummy time on their own should read Caring for Infants with Respect by Magda Gerber. This book explains it all.

Kate said...

I am an occupational therapist who has been working with babies for 30+ years and I fully support tummy time. When Magda Gerber was alive, babies were put on their tummies to sleep. In that position, they arched when they wanted to lift up their heads, they actively rolled out of the position themselves,and being on their tummies was a familiar place to be.
With the medically appropriate decision to put babies to sleep on their backs in order to prevent SIDS, babies became unfamiliar with being on their tummies. As a result, babies often have low tone in their abdominal and lower back muscles that is not healthy for their otherwise perfect little bodies.
I advocate for the slogan "Back to Sleep, Tummy to Play."
Dr. Kate Crowley, OTD, OTR/L

Marilee Hartling RN, MFT said...

@ Teresa- I recommend a minute or 2 of "Tummy Time" or as long as baby tolerates it once or twice a day beginning the first week. The goal is to gradually work up to 30 minutes a day by 3 months. The 30 minutes may be done in several sessions. Watch your baby's responses and if he begins to get fussy....stop and pick him up before he becomes upset. There are many ways to do "Tummy Time" which we demonstrate in our class. We have a "Tummy Time" dance that babies really enjoy doing with their parents which counts for 3 minutes of "Tummy Time". Some parents say they forget to do "Tummy Time". One way to help get into a routine is to give your baby 1 minute of "Tummy Time" after each diaper change. Your baby will come to expect it as part of his diaper changing routine. hope this helps. Marilee

Marilee hartling RN, MFT said...

@Valerie- good point! We will be going into greater depth at the workshop. how is your son doing now?-
Marilee

Marilee Hartling RN, MFT said...

@Anonymous #1- It is so great that we can have this discussion! I agree with you that it is important to wear, carry and hold your baby. The problem with waiting until your baby can turn over on his own, now days, is that we are noticing that babies are rolling over later and they are not liking to be on their tummies now because of "Back to Sleep". Years ago this was not a problem when babies slept on their tummies. There is an optimum window of time that we consider when we look at preventing skull shape differences in infants and when we look at development. We will discuss this in more depth in our workshop. We would welcome you attend!

Theof said...

Tummy time is really important. It's not about pushing your child, torturing your child or any other negative thing, it's about taking care of your child at an age when they need us the most.

Dr Aletta said...

Great article, Marilee. I will share this on my Facebook page.

Marilee Hartling RN said...

@anonymous #2-Thank you for your comments. I am not sure what you mean by "overrated". I do know that the American Academy of Pediatrics is recommending "Tummy Time" for babies for some of the reasons mentioned above. That being said I do agree that Tummy Time should not be forced. In our class we teach gentle ways to support babies during "Tummy Time" while they are learning that this position can be fun! When these techniques are used there is no discomfort or crying and babies learn to love doing "Tummy Time" with their parents. Feel free to come to our workshop and see for yourself. And thanks again for your input.

Marilee Hartling RN, MFT said...

@anonymous #3-Thanks for weighing in on this. I know the book and I really like Magna Gerber's focus on respect for babies and her ideas about sensitive observation of the child in order to understand his needs. Although I value Magna's beliefs about allowing children to become "active participants" rather than "passive recipients" in many situations, I also think that there are some situations in which parents absolutely do need to intervene in order to provide babies with what they need to be healthy. I agree with Kate Crowley, above, that the low muscle tone in the lower back and abdomen that results when babies do not do "Tummy Time" is not healthy for their little bodies and it can mean delays in their development later on as well as other problems. Because we never force "Tummy Time", it can be quite enjoyable. When I watch parents holding their babies in the "Tummy Time" position and see the babies either smile or sometimes go off sleep as parents start to gently sway and dance with the music during our "Tummy Time Dance" I have a hard time understanding how anyone, including Magna Gerber,could think that this is a bad thing.

Maria Hunt said...

Great blog Marilee!! I do Tummy Time with Dylan at least once a day.

lizadooolittle said...

I agree with Valerie that this is a great list! I too had a baby with not only plagiocephaly, but also torticollis. Both my pediatrician, physical therapist and the infant specialist I saw at Cedars strongly recommended tummy time to help mover her past her torticollis and to help her get her off her back. I did "baby wearing" and even that wasn't enough. I think what's important to note and what I learned through my doctors and Marilee is there's more to tummy time then just putting babies on their tummies and watching them cry. As illustrated in the photo, the fit ball is a great way for tummy time. And if you sit in front of them or place them in front of a mirror they actually quite enjoy seeing the world from a different perspective. There are lots of fun ways to do tummy time and knowing what they are really helped my baby's development.

Marilee Hartling RN, MFT said...

@Maria-thanks for your comment, Maria. Dillon is a lucky baby!

Marilee Hartling RN, MF T said...

@Liza-Thanks for your comments. One of the myths about "Tummy Time" is that it has to be uncomfortable and that babies always cry when they do "Tummy Time". This is simply not true. Your comments support the idea that "Tummy Time" is good for babies and that it is something babies can learn to enjoy when you know how introduce it.

jill said...

Tummy time was a very special time for my son and I. I would lie down on my back and place him on my chest with his tummy down. He loved to look into my eyes and coo. He wasn't at all bothered by it. Tummy time doesn't suggest that you simply leave your child on his tummy to cry. You need to be more interactive with the baby than that.

My son is now a very happy and well adjusted two year old :) I actually miss those tummy time days!
Jill

Margaret said...

I can truly say that as a pediatric early intervention PT (for the past 20+ years), I would have at least 25% LESS referrals if tummy time was a regular practice with parents!
If a little one cries, then tummy time can be used a "little bit at a time". But most importantly, it is time well spent with mom and/or dad down on the floor looking into their little one's eyes and talking with them, engaging with them, playing with them...Find a comfortable place, if the floor is not realistic or comfotable use bed, on top of you,a soft comforter..the little one will tolerate and be able to do "more" tummy time with you if they see you and feel comfortable...
This tummy position is not only strenghtening for their neck and back musculature, but also for their upper bodies, i.e. their arms...to use to crawl, to creep on their hands and knees and eventually to support themselves in sitting...
The sensory experience of tummy time is also critical...to feel their bodies...the tactile, proprioceptive, vestibular input enables and promotes their own body awareness and ability to eventually MOVE their bodies in many ways...in their own way and their own time..
Before you know it, they will be walking, running and then graduating from college! :)

Jennifer said...

Marilee, excellent blog. As always, you are a wealth of information. In addition to the reasons you have listed here, I found through my own experiences that there are reasons other than medical to promote tummy time. 1) It offered quality time for my son and I to bond. 2) Once he became accustomed to it and could hold up his head, it offered my baby some independence, as opposed to being prone on his back when I set him down. 3) It gave my son and I a way to break up the schedule of the day and occasionally try something new. In particular, my son really liked laying with his stomach on the boppy, that way his hands were free to play.

Molly Russell said...

Merilee, you really helped me with Charlie and his tummy time (in addition to myriad other things). Your insights into the benefits of this and many other things are invaluable and I'm so glad that we have you as a resource! Thank you for the great information!

Itsallforkids said...

Can you please tell me at what age would you recommend starting tummy time for 30 min a day? Tummy Time