You’ve surely been told by your doctor to always put your baby on his back when he sleeps. But what you might not realize is how important it is for your little one to spend supervised time on his belly while awake.
In 1922, the American Academy of Pediatrics’ Back to Sleep program successfully decreased the incidence of Sudden Infant Death Syndrome (SIDS) in the United States by 40 percent by encouraging parents to put their babies to sleep on their backs. Around the same time, a number of infant carriers that doubled as both car seats and carriers became widely used. The combination of these events greatly impacted childhood development today in unforeseen ways. According to the American Physical Therapy Association, many physical therapists noticed an increase in motor delay in infants who spend too much time on their backs while awake.
As a physical therapist, an important goal of mine is to educate parents on the importance of supervised "tummy time" while babies are awake. Tummy time has several important benefits:
- It allows babies to strengthen and stretch muscles that are important for developing basic valuable motor skills such as crawling, standing, sitting, and walking.
- In stomach-lying, infants start to use the muscles of the backside of their body, the extensor muscles. These are muscles that typically are weak in children with developmental delay or cerebral palsy.
- It facilitates visual development as your baby learns to move its head to look at objects and track movement.
- It also helps prevent neck muscle tightening, or torticollis, and the development of flat areas on the back of the baby's head, or plagiocephaly.
It is important for a baby’s development to have supervised tummy time and constant repositioning throughout the day to maximize its developmental potential. Ideally, babies should be placed on their tummies after every nap, diaper change and feeding, starting with a one to two minute session. Ultimately, you should aim for your baby to spend half of its waking time throughout the day on its tummy, with your supervision. Babies need a minimum of one hour cumulative supervised tummy time per day to acquire good head control, trunk strength, and gross motor skills.
The sooner a baby spends time on its tummy, the more comfortable this position will be as he or she continues to develop. If a baby is not used to spending time on its tummy, the baby may not enjoy it at first. Try introducing small amounts of tummy time to slowly build up his tolerance.
Here are some suggested supervised tummy activities:
- Use a small Boppy pillow or towel roll under baby’s chest and arms at first if the baby is fussy.
- If your baby cries when put on its tummy on the floor, try placing the baby on your chest or across your lap instead. You can also try to raise one of your legs higher to make it easier for him to lift his head.
- Get on the floor and play with your baby. Provide toys and distractions to keep the baby occupied.
- Carry your child tummy-down in a "football hold" with one arm supporting the trunk and one arm between their legs. This will work the neck and trunk muscles and take pressure off of the head.
- As your child gets a little older, try propping your baby up on his elbows and forearms.
- Reduce the amount of time your child spends in infant carriers, seats, walking aids or baby bouncers. These items limit free movement and often cause development of compensatory movements.
Shevy Friedman, DPT is a pediatric physical therapist who provides top-quality physical therapy services to infants, children, and adolescents. Her training is strongly based in Neuro-Developmental Techniques (NDT), Kinesotaping application, Wheelchair and equipment management, and Cuevas MEDEK Exercises (CME I).
