Talking about tummy time

I get such a kick out of receiving photos of my special little patients. This one in particular really made me smile. What a lovely photo. James is being the perfect model for why tummy time is so important but just look at the other people around him with tiny tots all on their tummies. There is a mom, a dad, a granny and a granddad. Spending quality time with babies and aiding in their development is something everyone can participate in.

 

What is tummy time?

Tummy time is exactly what it says. Your baby gets to spend time on his or her tummy. This is known as the prone position. The time one takes for this activity definitely depends on the baby’s age but the sooner you get started the better. The important thing about tummy time is that it is a supervised, awake activity.

 

Why is it important?

Imagine yourself on the beach, lying tummy down on your towel, reading a magazine. Think of all the muscles required to keep you there. Holding your head up against gravity, bearing weight on your arms, back flexibility, hands close together and eyes tracking the page. You don’t even think about it while you are chilling but all of this is exactly what is required from your baby to prepare that little body for rolling, sitting and crawling.

 

Let’s take a look at the photo of our little James and see exactly what I mean:

  1. His head is up- tummy time strengthens the neck muscles and gives the head control. This is vital for feeding, rolling, crawling and ultimately walking.
  2. He has beautiful head control- if a baby can control his or her head then visual development is also improved. With good head control your baby will be able to focus on an object and track its movement (much like you reading that magazine). James is focused on the red toy in the middle of the carpet and I have no doubt the movement of the bubbles are encouraging his eyes to track their every move.
  3. His weight is on his arms- this builds upper body strength. Being able to push up on the arms will allow baby to crawl and later on in life to do activities at school like sitting upright in a chair, climbing a jungle gym or swinging on monkey bars.
  4. He is experiencing different environments- Imagine perceiving the world from lying on your back. So much would be lost. When lying on the tummy, head up with a good 180⁰ view of the world there is just so much more to experience.
  5. He is developing on a sensory level- when babies are put down on their tummies it is usually on a mat with all sorts of toys and noise going on. This stimulates the child to experience different textures and sounds. James is experiencing shifting his weight and becoming aware of his body in space.
  6. He has a lovely round head- Since babies spend a lot of time on their backs this can affect the shape of their heads. The condition is known as plagiocephaly or flat head syndrome. It is not at all dangerous but is more a cosmetic concern. Tummy time takes the pressure off the back of the head and allows for a more normal round shape.

 

How long should tummy time be and what are we trying to achieve?

Tummy time should begin right after birth. Babies should spend 2 to 3 minutes, five or six times a day on their on their tummy and this can be gradually increased to roughly an hour to one and a half hours a day. It sounds like an awfully long time but very often it can be incorporated into the normal routine. Avoid tummy time just after a feed unless you are winding. The added pressure may aggravate reflux. Also choose a time when baby is alert and in a relaxed mood.

 

In the first two weeks:

  • Use tummy to tummy on mummy or daddy. This is a lovely way to bond and you probably do it naturally while relaxing on your bed or on the couch.
  • Lay baby over your lap to wind
  • Baby leopard in a tree. This is my own description. I see it often with the Dads who carry baby tummy down over their arm. It reminds me so much of a leopard lying on a thick branch with its four legs dangling down. This is a great position for tummy time
  • Turning baby onto the tummy once you have changed the nappy or while rubbing cream on.
  • Baby may also be propped onto his or her side using a rolled up towel or blanket for support.

 

By one month of age:

  • During tummy time baby is now able to move his or her head
  • Baby may attempt to hold the head up for a few seconds.
  • You may assist baby by lying him or her over a cushion with the arms over the edge. A rolled up towel, blanket or toweling nappy will also provide support when placed under the chest and armpits.

 

By two months of age:

  • By now most of the tummy time should be on the floor.
  • Use toys or a mirror to keep baby interested. Getting down face to face with baby is a lot of fun and you can interact beautifully like this.
  • Baby should spend at least one minute at a time on the floor.
  • Baby should be able to move his or her head to one side. It is really important that baby can turn to either side with ease. If baby favours one side it may be an indication that baby has a stiff neck and this should be investigated further.

 

By three months of age:

  • By now baby should be spending an hour a day doing tummy time. This is broken up but if baby is stimulated then 5 to 10 minutes at a time should be manageable.
  • Baby should be able to hold his or her head up at 45 to 90⁰. Looking into a mirror or following a fun toy becomes so much more fun. It is also important for visual tracking necessary later in life for reading.
  • If you do happen to have a large exercise ball then you may lie baby on the ball, well supported and moving baby back and forth. This is great for teaching baby about where their body is in space and helps baby to hold its head up.

 

By four months of age:

  • Baby should be pushing up on the forearms so that his or her chest is off the floor. The head control should be such that baby can keep his or her head at 90⁰.
  • Tummy time is way more fun now as you are able to interact with toys, tracking of your voice and for longer periods of time.

 

By five months of age:

  • This is an exciting time for baby. They start pushing up on their hands and are able to reach for toys
  • From this new position baby is likely to learn to roll over if they haven’t already done so. With this new range of movement and strength, tummy time is way more fun time than work time.

 

By six months of age and older

  • You did it!!! Baby probably enjoys tummy time more than anything because there is just so much more to do.
  • Baby can roll onto his or her back and then over again.
  • You will probably see baby reaching for toys in all different directions and baby certainly makes a plan to get to a toy placed just out of reach. Baby will probably turn him or herself in little circles.

 

Conclusion

As with anything related to development we as medical practitioners can give you a guideline on the norms and what can be achieved. Every baby is different and may develop at a different pace. What I do want to encourage is for parents and caregivers to make tummy time a part of the daily routine. This may sound strange, a little like diarising a break in your own day but with our hectic lifestyles tummy time may be forgotten. Babies spend a lot of time on their backs, sleeping, being in a car chair, lying on a change table or being pushed in a pram. Yes “back to sleep” is vital but tummy time plays a crucial role in the physical, visual and sensory development of your baby. Most babies fuss in the beginning and parents feel bad about tummy time. Please don’t. There is so much to be gained from tummy time. If you are at all concerned about your baby’s development speak to a physiotherapist, occupational therapists or join a group where you can participate in a variety of activities. Tummy time is fun time with so many advantages. Don’t wait to get started.