Tackling Tummy Time

 

Tummy time is an integral part of your child’s development. Tummy time helps develop your child’s neck muscles, which allows them to have head and neck control. It is also an essential building block for other gross motor development.  Tummy time can help decrease the risk of developing torticollis or plagiocephaly. Additionally, tummy time helps to develop your child’s visual and vestibular systems and strengthen their core.

Tummy time should be done early and often. You can start once you are home from the hospital. Begin with just 1 minute a day, 2-3 times throughout the day. Start increasing both the duration and frequency as your child ages. A good rule of thumb is to work up to a total of 1 hour per day of tummy time by the time your baby reaches 6 months old. This can be broken up into several segments.

Tummy time will look different as your baby grows and develops. Tummy time should ALWAYS be supervised. As your baby grows, there are some progressions you should expect to see during tummy time. At 1-2 months they should be briefly lifting their head and you may see them turn it to a side.  At 3-4 months, babies should be raising their head to 45-90 degrees and pushing up onto their elbows. At 5-6 months, babies will push onto their hands, pivot in a circle, lift their head to 90 degrees and roll from back to belly and belly to back. Use the checklist at the end of this article to monitor your baby’s progress.

Tummy Time Basics

• During the first month, alternate which side you place your child’s head to. This will help decrease the risk of developing torticollis or plagiocephaly.

• Once your baby can lift their own head in tummy time, help them gain stability by gently tucking their arms for them, so their elbows are positioned under their shoulders.

• Avoid tummy time for at least 30 minutes after feeding

• Save tummy time for when your baby is happy and calm

• Tummy time should always be supervised

• Tummy time should be done during awake times. Babies should be placed on back for sleep.

Tummy Time Alternatives

• Tummy to Chest positioning

  • Lay on the floor or bed slightly reclined. Place baby on your chest facing you.

• Inclined tummy time

  • Position baby over a boppy pillow, towel roll or wedge

  • This upright position can be easier for some babies to tolerate and makes tummy time more enjoyable, while still working those essential muscles

• Tummy troubles (Reflux, GI issues, G-tube)

  • Tummy time over your leg with belly in space between legs to decrease pressure on their abdomen

  • Use incline position mentioned above to minimize reflux

  • Wait at least 30 minutes after a feed to try tummy time

  • Use G-tube Tummy Time pillow

• Tummy time on stability ball

  • Place baby on tummy over ball.

  • Start in upright position and slowly lower over future sessions as they start to tolerate better.

Tummy Time Tips

These items can help keep your child calm and engaged throughout tummy time.

• Contrast cards or activity mats.

  • A baby’s vision is much different than ours. The black and white contrast catches their eye.

• Boppy pillow

  • Place chest on boppy to create a slight incline which can improve tolerance

• Rattles or light up toys to keep your child engaged

  • Position slightly above eye level to encourage lifting of the head

• Face to face

  • Get on eye level in front of child

  • Smile, make silly faces and engage

  • Often babies will respond better to faces than toys or other devices.

• Mirrors

  • For younger babies place just in front to entertain in tummy time.

  • As they get older, lift just above eye level to encourage raising their head

Tummy time concerns

If any of these describe your baby, contact your pediatrician or a pediatric physical therapist for an evaluation and more individualized tips to help them succeed and progress towards their milestones:

• Not tolerating tummy time even with alternatives

• Not being able to raise head in tummy time at 4 months old

• Keeping head tilted or rotated towards one side

• Flat spot on back of head (can be one side or both sides)

 

Tummy Time Checklist

Tummy time will look different as your child grows and develops. This checklist is a guide you can use to monitor your child’s progress. If you are noticing delays talk to your pediatrician and/or seek out a referral from a pediatric physical therapist.

1-2 Months Old

• Briefly lifts head 1-2 seconds.

• Lifts head and turn to head to the side.

3-4 Months Old

•  Begin to tuck their arms on their own.

•  Pushes up onto their elbows

•  Holds their head up well at a 45–90-degree angle

•  Follows toys and people as the move

5-6 Months Old

• Lifts head up to 90 degrees

•  Pushing onto their hands

•  Pivots in circle

•  Rolling from back to belly and belly to back

 

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Kimmy Krupack PT, DPT is a Doctor of Physical Therapy currently practicing at Chit Chat Pediatric Therapy in Vidalia, Georgia. In the past, she has worked in the NICU, Pediatric Acute Setting as well as Hospital based pediatric outpatient clinics. Her passion is working with developmental delay and torticollis, but she treats a variety of conditions.  You can connect with Kimmy on Instagram @chitchatpediatrictherapy or @kimmy.peds.pt