Tummy Time

Our parents didn’t have to think about “tummy time” for us. They often placed us to sleep on our tummies. As babies, we hung around in our playpens both faceup and facedown. And it was not at all unusual for us to be lying on our tummies on the living room carpet or the backyard lawn.

But, like so much in our rapidly-changing world, many things about raising a baby are different today. Where tummy time is concerned, specifically, things began to change when, in 1992, the American Academy of Pediatrics released its Back to Sleep policy. With this campaign, the organization advised that babies be placed to sleep on their backs to reduce the occurrence of sudden infant death syndrome (SIDS).

Fortunately, it helped. Since then, prone sleeping has decreased from more than 70 percent to about 20 percent in the United States. And the SIDS mortality rate has decreased by more than 50 percent.

Unfortunately, other problems have arisen in the wake of babies sleeping in a supine position, as parents seem to be less aware of the second half of the campaign title: Tummy to Play.

Because babies are now spending so much time on their backs, many are experiencing “flat head syndrome;” weak arm, neck, shoulder, and trunk muscles; and delays in developmental milestones like rolling over, crawling, pulling up to stand, and walking. The estimated 60 waking hours a week babies are spending in things (what a colleague calls “containerized”) further exacerbate some of these problems.

Of course, nobody wants their child to go through life with a flat head! And lack of upper torso strength could result in difficulties with gross (large-muscle) and fine (small-muscle) control. The former is needed for physical activity and athletics and the latter for such tasks as writing and keyboarding. Also, although babies do eventually master most or all developmental milestones, babies who don’t spend time on their tummies may spend less time crawling. This could mean eventual difficulty crossing the midline of the body – the invisible, vertical line that runs from the head to the toes and divides the body into left and right sides. In some cases, children unable to cross the midline – and there seem to be more of them in schools every year – have problems with reading and writing.

The good news is that something as simple as tummy time can lessen or eliminate all of these potential problems. Pediatricians advise that even five minutes of tummy time a day have a positive effect on head shape. When you place your baby facedown, curiosity induces her to attempt lifting her head and pushing up on her arms, strengthening the upper torso. (When she’s on her back, she has no compelling reason to make the effort!) And crawling is a cross-lateral experience (the left arm and right leg move simultaneously, and vice versa), so children who spend time practicing this motor skill generally have no problem crossing the body’s midline. Also, babies who spend time facedown tend to reach their motor milestones earlier than babies who don’t.

What do you do, however, if yours is one of the many babies who simply doesn’t enjoy being on the tummy?

First, it’s important to acclimate your infant to this position as early in life as possible. Right from the start, following a nap or diaper change, two to three times a day, you should place him on his tummy for a brief play period. You can gradually increase the length of these periods as your baby becomes used to them. Also, whenever possible, lie on your back and place your baby facedown on your chest. This not only helps him adapt to this position; it will also give him a reason to lift his head: to look at you!

But even if you didn’t begin tummy time the day you brought her home from the hospital, it’s not too late to start! Following are some suggestions for making tummy time a fun time.

• Get “down and dirty” with baby. Lie side by side with your baby and have a “conversation!” Coo and sing and make funny sounds. There’s no one else’s voice he’d rather hear. When your baby is ready to start lifting his head, you can also lie head-to-head with him. He’ll eventually lift his head and push up on his arms because he wants to look at you. You can make it worth his effort by making his favorite funny faces!
• Tempt her with a toy. Place a favorite toy or stuffed animal just out of your baby’s reach and encourage her to get it! Mirrors and rattles work well, too.
• Circle the wagons. The American Academy of Pediatrics recommends placing toys in a circle around the baby. Reaching in different directions helps develop the muscles needed to roll over, scoot, and crawl.
• Give him a lift. If all else fails and your baby still fusses while facedown, place a pillow or a “boppy” under his chest, with his arms in front of him. Or lay him across your lap, raising one of your legs to create a slight incline. This will make it easier for him to see what’s going on around him and should stop the fussing. Then, as he develops upper body strength, he’ll no longer need the lift.
• Remember: The policy is “Back to Sleep. Tummy to Play!”