The Importance of Tummy Time and How to Make it Less Miserable
Tummy time, or what therapists call spending time in a "prone" position, helps to build a foundation for so many essential developmental skills. Many parents have heard this phrase or read that they should be having tummy time with their infant, but perhaps many do not understand why, which is why I chose to write this article. I will help you understand the importance of tummy time and then guide you in fun ways to engage with your child in this position!
In 1992 the American Academy of Pediatric's began it's "Back to Sleep" Campaign, recommending back or side sleeping for newborns to decrease the risk of SIDS. With this campaign came babies spending way too much time on their backs and not enough time on their tummies. Infants that spend too much time on their backs are more prone to motor delays and positional plagiocephaly deformities (flattened head). In recent years primary care providers have seen a dramatic increase (around 600%) in referrals for babies with misshapen heads! Because parents now have so many convenient car-seats and carriers, many which click right into infant strollers and swings, babies end up spending way too much time in one position, which denies them opportunities for motor learning.
I cannot stress enough how important tummy time is for motor learning and strengthening. Having both newborns and older children positioned in prone helps build head and neck control, strengthens the scapula and shoulder region for more stability of the shoulder girdle and increases trunk extension for good back strength. It allows children the opportunity to weight bear on their forearms which builds good proximal (near the spine) stability of the scapula and shoulder region (which is an essential building block for wrist stability and finger strength and the entire gamit of grasp and fine motor skills). It also helps newborns build strength in the muscle groups that will help them to roll over and to crawl. Have I convinced you yet that tummy time is important?? That was a joke. But seriously, I am going to summarize below.
Tummy Time
builds strong head and neck control
builds scapula strength and shoulder stability
builds strength in forearms and hands through weight bearing
prevents plagiocephaly deformities or flat spots
builds strong proximal muscles which stabilize shoulder and forearm for better fine motor skills
prepares babies to crawl and roll
helps facilitate trunk extension and back strength
contributes to overall muscle tone
How much time you ask? Aim for about half of the babies awake time! For newborns, every time you change their diaper, give them 2-5 minutes of tummy time. Remember, the more opportunities given in the prone position, the more strength and stability the child will build and comfortable the child will feel with this position. Babies who spend more time on the tummies usually reach major milestones like rolling, crawling and sitting before other babies. Many babies are fussy during tummy time. Luckily, there are a lot of ways to make it more comfortable and enjoyable for them. The best way to make them more comfortable in prone is to have them spend more time in it so that they can easily lift their head off the ground. It makes them upset when they are too weak to lift their heads up because they feel like they are stuck and they get frustrated. If your infant is really fussy during tummy time, try rolling up a small towel or wash cloth and placing it under his/her chest or placing them on a small incline. This will give them a little edge on the situation. They won't have to use their entire back and shoulders but will mostly start to at least lift their heads. Slowly decrease the towel or incline as the baby becomes stronger and more comfortable. Always make sure you are using a stable, hard surface like a floor with a blanket vs a bed which is very soft and less stable. Another easy prone position for newborns who are beginning in tummy time is to place them on your chest while you lay on a slight incline. Same concept, but even better because you get to spend face-to-face time engaging with your child. After a while your child may just be worn out from working out so hard, give them a break! Let them lay on their side or back for a while, they just did major exercise!
*babies who are not able to roll over easily should always be supervised during tummy time
Tummy time is also important for toddlers and older children. We therapist use tummy time so much with our older kiddos. Many children who have fine motor delays or difficulty with handwriting show underlying weakness in their proximal muscle groups (neck, scapula and shoulder regions). Children with poor proximal stability or low muscle tone get fatigued very quickly with handwriting or they have weaker grasps on their writing utensils. In order to have strong fingers and develop very fine muscle movements of the hand needed for handwriting, you must first have a stable shoulder girdle. My suggestion for these kids, tummy time! Have your child play a board game with you on their belly or color a picture while laying down. Trust me, they will be getting a workout while doing so!
