Tummy Time - What every parent needs to know
- Mar 29
- 5 min read
Tummy time is often one of the hardest things to work on with a little one. Over the years I have tried so many strategies working as a pediatric PT and as a parent myself. First you need to know what actually is tummy time. Many mistake tummy time as any time on their stomachs which isn't necessarily true. It is considered tummy time only when our little ones are playing and actively trying to lift their heads. Sleeping or resting with their head down on a surface is not considered tummy time.
Practice optimally starts as a newborn with parent supervision. Many parents avoid this position because it is difficult for their little ones. However, you can start practicing the day you get home from the hospital. The American Academy of Pediatrics recommends to work up to 15-30 minutes a day by the time they are 7 weeks. Ideally an hour a day by the time they are 4 months. This can seem daunting especially if they hate this position but tummy time is important for many reasons.
Tummy time is a base skill that helps with the next skills your child will learn. Think of it as addition and subtraction in math, you need it to make it easier for the more complex problems. Tummy time not only works on strength, but also cognitive development, vision, spatial awareness, sensory input, can help with digestion/relieve gas, and helps prevent flattening of their heads. It isn't just about back and neck strength but about arm strength needed to catch themselves if they fall, to get in and out of sitting, crawling, and pulling to stand. If they enjoy sitting but hate tummy time, often you see delays in transitional skills and movements requiring their arms.
They aren't strong anywhere when they are first born so they often use suboptimal strategies that won't help them in the long run. You want to place them in the optimal position (see attached video) to strengthen the larger muscles made for endurance and this will get them tolerating and even liking tummy time faster. Many babies like to lift their arms off the floor bending them out to the side or at their side like Superman. Imagine if you were doing this lying on your stomach reading a book in bed. I don’t know about you but I would not last very long like that. I would want to be up on my elbows. The hard thing for them is that their shoulders and necks are not strong yet so using many muscles to lift their head with a full body extension pattern is easier for short periods.
Many find their babies do better in tummy time with placing a pillow or towel roll under their chest. If you want to work on tummy time and you know they just won't tolerate being on a flat surface anymore, you can try these options as a last resort but you always want to try without first. Imagine reading that book in bed and having a pillow under your chest, it feels good because it is much less work. It allows you to relax and you don't have to work your body too much. It is strengthening you some but very little in comparison to not having it there. Remember, the faster we can strengthen specific muscles made for endurance, the sooner you will get them loving tummy time.
Here are the tips I recommend:
Try to get as many bouts a day as possible. Some days you will be more productive than others and that is ok. Just do your best! It was torturous for me hearing my kids cry and so I understand you don't want them crying all day. Use your judgement as a parent when they need a break or even if you need a break too.
After decades of trying different strategies as a pediatric PT and a parent, I found what tends to work the best. Each time you sit down with them or put them down, start out in tummy time. Once they start getting fussy, help them stay in the optimal position for 30 seconds. This is usually doable for everyone, your little one should be easily consolable after 30 more seconds of work and parents/caregivers usually can tolerate 30 seconds. Count out loud so they know you are attending to them and eventually they will learn that when you are done counting, they will get a break. At the beginning, it may be only 30 seconds. If you are with them, keep them in the optimal position the entire time. If you are not right next to them while supervising them, go over for 30 seconds when they start to get fussy to hold them in the optimal position and to let them know they are almost done. Remember, since you are only pushing them for 30 seconds, you have to do this as many times a day as possible. If they have been resting in your arms or on their backs for 15-20 minutes or so, give them another bout of tummy time, even if it is only for 30 seconds. Their wake windows are often small so this is a way to optimize the time when they are awake.
Starting out by getting a lot of practice on your lap when you are sitting down with them. You can also put them on your chest up no their elbows when you are lying down. Ideally you would be lying down and not just leaning back in sitting on the couch. Leaning back is easier but better than nothing. Remember, The sooner they strengthen their shoulders and the more time practicing on a flat surface, the faster they will enjoy tummy time.
Note: if you don't have a place to put them down on the floor safely due to location, siblings, pets, etc, remember their crib, bassinet, portable crib, etc. are great places to play and can be used not just for sleeping. The bed and couch is suboptimal for safety reasons. You would be surprised how many babies fall off the bed when parents are right there with them.
Check out the video on how to place them in the optimal position!
DISCLAIMER: The information contained in this blog is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition or treatment and before undertaking new activities. Never disregard professional medical advice or delay in seeking it because of something you have read or viewed in this blog.