Ahhh, tummy time. If you’ve spent any amount of time around babies or grown-ups who care for them in the last few years, then I’m sure you’ve heard at least a little about this topic. Tummy time — as the name clearly indicates — is time awake that a baby spends on his, um, tummy. This trendy title is apparently a fairly recent addition to the vocabulary of American parents, as very few adults of my parents’ generation (parents who raised kids in the 80’s) seem to be familiar with it. This makes sense, since it wasn’t until the early 90’s that the “Back to Sleep” campaign was launched and, suddenly, babies nationwide found themselves on their backs for much of their early days, causing them to miss out on all that time that used to be spent lying on their tummies.
Tummy time is important because the skills learned while on the tummy are essential for later development. Think about it, most of the big milestones in the first year of life involve the prone position in one form or another (e.g., lifting and turning the head, rolling, pushing the chest off the ground, getting up to hands and knees, scooting, crawling). Tummy time also gives the back of baby’s head a break in an effort to prevent flat spots from forming (something called “positional plagiocephaly”). And, as an occupational therapist, I should mention that tummy time also contributes to the strength and skills needed in the upper body and hands for school-age tasks such as handwriting. Yes, it starts that early!
I remember when we took our son to his one-week checkup and, at the end of his appointment, his pediatrician told us that we could go ahead and start giving him tummy time every day. I knew what tummy time was (you put them on their tummy, duh!), but I didn’t really know what to do because he HATED being on his tummy. He has wanted to move ever since day one, and being on his tummy that early on just reminded him that he wasn’t yet old enough or strong enough to crawl. He would cry and squawk and moan, and it just didn’t seem like putting him flat on the ground was the right thing to do at that time. But I didn’t know what else to do.
Then, when my son was two and a half months old, I started taking him to a parent/infant education class offered through our local community college taught by child development specialist Laura Sobell (learn more about Laura and her amazing work at calmbaby.com). I am so thankful for everything I learned in that class, especially when it came to helping my little one actually enjoy tummy time! Who would’ve thought? Some of what you will find below is inspired by what I learned in that class. However, the majority of the details and graded progression from beginning to end are taken from my own experience as both a parent and a therapist.
Many sources I’ve read seem to recommend that parents try to give their babies about 30-60 minutes of tummy time each day, whether that’s in one chunk or spread throughout the day in much smaller portions. Pediatric physical therapist Wendi McKenna states that by about 3 months of age, babies should get at least 90 minutes a day of tummy time. Research has shown that, at four months of age, babies who spend at least 80 minutes per day playing on their tummy while awake are able to more successfully reach motor milestones involving the prone, supine (laying on the back), and sitting positions than those who spend less time playing on their tummy. Although 80-90 minutes sounds like a lot, it’s really not very much time throughout the course of a day, if you think about it! However, rather than shooting for a concrete number of minutes spent forcing your baby to lie flat on the ground (which will likely end with crying and screaming, like it did with mine), your baby can instead proceed through the steps listed below in order to build up the strength and stamina needed to be able to independently lay and play on her tummy and actually enjoy it!
Here is a general guideline: start each step a few times a day, a few minutes a day, building up to the final step.
Try not to let your baby cry during tummy time (though some grunting is normal when they are exerting themselves to try to “crawl” and move), and do your best to engage him by getting down to eye level and talking or singing to him. Always supervise your baby during tummy time to make sure he is secure and safe. And, as mentioned previously, take these “steps” as suggestions rather than rigid requirements…let your baby (and your intuition) be your guide.
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So, without further ado, I give you…
7 STEPS TO INDEPENDENT TUMMY TIME
1. Baby is held up to adult’s shoulder while being burped or carried.
This is, of course, one of the most common first positions in which people hold babies so, CONGRATS!, if you’re reading this post then you’ve likely already accomplished step one. This really is the first step to helping a baby learn to be comfortable in prone. The higher up on your shoulder you hold the baby, the more strength required to keep that head up and steady. While carrying baby up on your shoulder does not fit the definition of tummy time (and should not be considered a replacement for tummy time), it’s a great first step in helping baby ease into working on head control, in the context of the bigger picture.
2. Baby lies with tummy down on adult’s tummy/chest while sleeping or playing. As with step one, this is also a very common practice among parents and caregivers of new babies. And — might I add — one of the sweetest and most memorable practices that occur during those early days and weeks of bonding. My first postpartum tears (tears of joy!) were shed while my baby nuzzled and napped on me in this position when he was about a week old. Oh how I miss those days! If your baby is not yet comfortable being horizontal on your tummy (which he probably won’t be while awake), you can simply adjust how far you lean back/lay down while he rests on you. Now’s the time to kick back in your recliner chair or prop yourself with some pillows on the couch to get yourself into just the right position — anything for the baby, right?
3. Baby lies with tummy down or sideways across adult’s arms while playing or being carried. This one takes some practice, but the easiest way to accomplish this position is to place one forearm between baby’s legs up to the chest area, and then bring the other forearm down between the shoulder and ear that are closest to your own body. Confused?
Picture what it would be like to hold her horizontal with her back to you, and then “roll” her forward to her tummy while still holding her in the air. (As a bonus, this can also be a great position for calming down babies who are fussy or gassy.) You can practice with a baby doll or while standing in front of a mirror if you’re still feeling unsure. Once you get the hang of it, have some fun with it and turn on some music so you can dance with your baby while carrying her in this position! I’m a fan of any kids’ station on Pandora. Some favorites on my Pandora account include “Raffi”, “VeggieTales”, “Yo Gabba Gabba!”, “Nursery Rhymes Radio”, and “Elizabeth Mitchell”. You can move baby fast and slow, up and down, round and round…however she likes to move! Just make sure to stop for a few seconds every minute or so in order to allow her body to really register the movements (the body gets used to the continuous movements and sort of “stops” feeling it if it goes on and on at the same pace and rhythm for long enough).You can also try a variation of this hold by playing “super baby” with your little one!
4. Baby lies with tummy down on exercise ball, beach ball, big pillow, or adult’s shins. This is a great one because
you can vary the angle at which your baby is positioned, thus determining how easy or difficult it is. A greater incline will be more comfortable for a baby who is just beginning tummy time (kind of like being up against an adult’s shoulder as a newborn), whereas a more flat position right on top of the ball, pillow, or shins will be more challenging and appropriate for those who are further along in the process. Once you get your baby into a position on the ball that is comfortable for both him and yourself, you can begin to slowly roll him forward and backward, making sure that you keep a good grip on him and that he is okay with how far and fast you are moving him. While you can certainly place your hands on baby’s hips and position yourself behind him as you roll, it’s even better if you can place yourself where he can see you so that he knows where you are and can interact with you. We did this one a lot in our parent-infant class and it was so great to see babies tolerating tummy time way better than when on the floor! If you don’t have an exercise ball, you can use a big pillow instead, placing baby’s chest at the bottom edge of the pillow and propping him uphill from there so that he is at an incline similar to if he was placed on a ball. Learn more about how to use an exercise ball to help your baby enjoy tummy time by reading THIS POST.
If you really want to get hands-on you can lay on your back, bend your hips and knees at 90 degree angles, and place baby on your shins as you hold onto him and vary the angle at which he is positioned (this one is best for taller people, who have longer shins than us short folks). The more bent your knees (i.e., the smaller the angle), the more inclined baby will be and, thus, the more comfortable he will be as he’s starting out. You can turn it into a game by putting him on your shins and playing “elevator” as you slowly move him up and down as you sing or talk or do whatever you must in order to make it fun!
5. Baby lies with tummy down across adult’s legs, with adult either sitting in a chair or on the ground (leg position can vary). Believe it or not, I first discovered this position as I desperately tried to soothe my son during his colicky months as a newborn (so glad those days are behind us!). Boy, am I glad that my mother showed me this trick — prone across her legs while supporting his head (which gets turned to the side), rubbing or patting his back, and maybe even offering him a pacifier. Worked like a charm when she used it on him. It wasn’t until my baby was several months old that I discovered this position could actually be used as a means of introducing tummy time. My favorite was to sit on the floor with my legs extended so that he could start to put his arms out in front of him on the floor. This transitions nicely into step six…
6. Baby lies with tummy down and upper chest positioned over a rolled-up towel on the floor with arms over the towel. You can also position the baby so her upper chest is over your leg instead of a towel, or you can sit on the ground with your legs in a diamond shape (so the soles of your feet are touching each other) and position her facing away from you so her chest is over the part where your feet come together. You can place a toy, book, mirror, or even another person in front of her in order to make this position more interactive. Some people also choose to use a Boppy pillow at this point to assist their little one with tummy time, but I personally was never able to get my baby to enjoy this position with a Boppy — all he wanted to do was use his feet to push himself forward, which led to him pushing his head straight down into the ground as he curled forward around the pillow! I think we ended up kind of skipping over this step because he just wanted too badly to crawl, and this position just frustrated him. Do what works for your baby…she’ll let you know if she likes it or not!
7. Baby independently lies with tummy down on the floor. Tada! Keep playing and challenging him and, before you know it, he’ll be pushing his little chest off the ground and getting ready to roll! (Check out this video to see a discovery I made with my little one when he was 3 1/2 months old that helped him learn how to instantly push up while on his tummy. It’s actually pretty amazing.)
Here are two easy-to-understand videos I’ve found on YouTube for those of you who are visual like me and like to see what you’re doing before you do it. A quick rant: I hate how “professionals” make it seem like it’s normal for babies to love tummy time and that it should be an easy thing for them to do. It’s not! There, I said it. Keeping that in mind, here they are: Five Essential Tummy Time Moves and Therapy Ball to Promote Tummy Time. (Note that I am not officially endorsing or affiliated with the companies who produced these videos, but I do find them incredibly helpful.)
And here is a really helpful book by Pediatric OT, Dr. Anne Zachry. It’s called Retro Baby and it’s filled with tips and activities to help your baby with things like tummy time, rolling, sitting, crawling, and beyond. You can read my review of Retro Baby by clicking here, or you can just head straight to Amazon to see it for yourself.
Best of luck in your tummy time endeavors!
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In addition to being mama to two sweet little boys and wife to a crazy awesome husband, Christie is a Registered & Licensed Occupational Therapist (OTR/L). She holds a B.A. in Psychology with a Minor in Education from the University of California Los Angeles (UCLA...Go Bruins!), and an M.A. in Occupational Therapy from the University of Southern California (USC OT). She has experience working as a pediatric OT in early intervention (birth to 3), clinic-based, and school-based settings. Her mission with MamaOT.com is to encourage, educate, and empower those who care for children. Christie loves that she gets to PLAY when she goes to work, is hopelessly addicted to Kettle Corn, and is known for being able to turn virtually anything into a therapeutic tool or activity, from empty food containers to laundry and everything in between. Learn more about Christie and what inspired her to become an OT.
Occupational therapy (OT) is a holistic profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities, also known as “occupations”. Some OTs help people diagnosed with disability, injury, or disease. Others help prevent disability, injury, or disease. Because of occupational therapy, people of all ages are able to say, "I can!" no matter what their struggle. Isn't that amazing?!
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