0 - 12 Weeks

Tummy time for your baby: advice from a pediatric OT

Baby reaching for toy.
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Pediatricians and child development experts agree: tummy time is important for your baby to build the muscles and coordination needed for major motor skills like sitting, crawling, and walking. 

Discover all you need to know from Rachel Coley, a pediatric occupational therapist at Lovevery:

What is tummy time?

Tummy time is the term for supervised time your baby spends playing on their stomach, or tummy. Tummy time is for babies who are awake and being watched, according to the American Academy of Pediatrics (AAP). Tummy time should be on a comfortable, firm surface with only baby-safe materials and objects within reach. 

It’s safest for your baby to sleep on their back, so they need to play belly-down when they’re awake. This position helps your baby strengthen their muscles, develop body awareness, reduce plagiocephaly, or head flattening, and more.

Tummy time can happen on an adult’s body, a play gym, an exercise ball, a yoga mat, a blanket on the floor … almost anywhere. 

When do I start to give my baby tummy time?

The AAP recommends tummy time for healthy, full-term babies at birth. Many newborns may like it best on your chest at first, especially until their umbilical cord stump has fallen off. 

The sooner you start placing your newborn on their belly, the better, says Rachel Coley, a pediatric occupational therapist at Lovevery and mother of three. “Your newborn’s reflexes make tummy time feel very natural,” she says. “Plus, babies who do tummy time early and often tend to enjoy it more later on.”

Learn more about why to start tummy time right away in this video with Coley:

How long and how often should you do tummy time?

How long your baby spends in tummy time each day depends on their age, how often they’re awake, how well they like tummy time, and the day’s events. 

For newborns, tummy time may be just a few minutes, a few times a day. It may not seem like much, but that’s a long time for your new baby ❤️

Once your baby is 1 month or older, Coley recommends offering at least 12 tummy time “reps,” or short sessions, a day. That’s roughly a minimum of three reps at each awake window in your baby’s day. 

Each rep might last one to two minutes, or longer. It should end when your baby starts to communicate that they need a break. They may fuss or start to cry. ⁠If they grunt, however, wait a moment. Some babies enjoy tummy time, and their noises may just be sounds of exertion.

Babies who get comfortable with tummy time early on may play happily in this position longer than you might expect. For others, tummy time is uncomfortable and they spend less time on their bellies as a result.

Ideal tummy time daily amounts by age

1–2 months15–30 minutes
3 months30–60 minutes
4 months and older60–90 minutes
Source: Lovevery’s”Baby’s Best Tummy Time” Parent Course

“Babies who struggle to find comfort in tummy time may never do more than 15 minutes a day, and that’s okay” says Coley. “I want families to focus on happy tummy time more than hitting a certain amount of time each day,” she says.

Don’t force tummy time if your baby is unhappy. Take a break, soothe them, then try again, says Coley. Keep attempting short reps throughout the day—you might be surprised how quickly they add up.

If your baby has multiple caregivers, let everyone know tummy time is an important part of your baby’s routine. Your baby will enjoy different faces and voices up close.

Activities and toys to help your baby enjoy tummy time

In photo: Rolling Bell from The Charmer Play Kit

Tummy time is a position for play, not an activity itself, says Coley. “You have to add something to tummy time to keep your baby engaged,” she says. Lovevery’s Looker, Charmer, and Senser Play Kits include several playthings your baby can explore belly-down.  

Before your baby can reach and grasp, most of their play is visual. Babies are drawn to high-contrast pictures, especially from birth to 14 weeks old. Check out these ways to entertain your baby with high-contrast images during tummy time. You can also show your baby photos or books of faces or get nose-to-nose with your baby yourself 😊

Bells, rattles, and other toys with sound can also pique your baby’s curiosity during tummy time. Once your baby is regularly lifting their head, help them work on turning it by rolling a black-and-white ball or rolling bell across their field of vision.

In photo: the Magic Tissue Box from The Senser Play Kit

Once your baby can manipulate, or reach and grasp toys, anything that’s safe to mouth is perfect for tummy time.

Check out a few of Coley’s favorite playthings for tummy time, plus some key tummy time takeaways, in this video:

What are the developmental benefits of tummy time?

One of the highly touted benefits of tummy time is muscle strengthening, but there are many more, says Coley. These include:

  • Stretching body from womb position
  • Triggering reflex to lift their head
  • Facilitating digestion
  • Supporting respiration
  • Helping with oral motor functions
  • Encouraging regulation
  • Reducing plagiocephaly, or head flattening

Tummy time also encourages body awareness and balance. As your baby moves in tummy time, their weight shifts. This teaches them to be aware of their body and how to move their muscles to change position, also known as their proprioception sense. Different tummy time positions give your baby the opportunity to move in new ways and to develop their vestibular sense, or sense of movement and balance.

What if my baby hates tummy time?

Try these strategies to help your baby get more comfortable with tummy time. 

Use the football hold. Hold your baby belly down in your arms, with the bulk of their head and abdomen resting on your forearm. This position is sometimes called the football hold. 

You might walk around or stand in front of a mirror while holding your baby in the football hold and talking or singing to them. Feel free to gently sway or bounce, too, while noticing your baby’s cues about whether they like this movement. 

Place your baby on an incline. Raising your baby’s shoulders higher than their hips makes tummy time easier, which may be just what they need as they’re building strength and getting used to tummy time. Try positioning your baby on a nursing pillow, a folded blanket or towel, or a firm throw pillow. 

Try a location besides the floor. Some babies prefer tummy time on a table or an exercise ball where they can get a different view of the room. Check out “4 ideas for no-floor, less fussy tummy time“. 

Give your baby something really interesting to look at. Some ideas include: your face, a shiny mixing bowl, you pouring water into a shallow container, complex black-and-white images, and a favorite book or toy.

Most importantly, focus on the brief period that your baby is content in tummy time, says Coley. When they get upset, roll them out of tummy time and soothe them. The key for babies who don’t sustain long periods on their tummy is increasing the frequency. Offer your baby lots of short rounds on their tummy whenever they’re awake and it’s practical. 

When can we stop doing tummy time? 

At some point, often between 6 and 8 months, tummy time becomes a transitional position from the floor to sitting or from the floor to crawling. Once your baby becomes mobile, tummy time will naturally fade into a position they hold briefly on their way to another position. Until they’re getting out of tummy time on their own without simply rolling to their back, your baby will continue to benefit from it. 

Learn more about when to stop in this video from Lovevery’s“Baby’s Best Tummy Time” course:

How to do tummy time safely

Tummy time can start in the first hours and days of life for most healthy, full-term babies. Coley recommends following these best practices for the early days and beyond. 

  • Always stay with your baby during tummy time. 
  • Newborns can do tummy time on the floor but many prefer to stay closer to familiar caregivers.  holding them on your chest or lap is a perfect way to spend tummy time.
  • If your baby is tired or falls asleep, move them to a firm, flat surface free of blankets and place them on their back. Your baby is always safest sleeping on their back.
  • Do tummy time on a warm, dry, firm surface such as The Play Gym, a carpet, or blanket. A soft bed or pillow can press against their mouth and nose and restrict their breathing.
  • Wait 20 minutes after your baby has eaten to lower the chance they’ll spit up during tummy time. The position has been shown to be good for digestion overall, so don’t take some spitting up as a reason to avoid tummy time. 
  • Be sure to do tummy time where there is no risk of a fall. Even newborns can reflexively roll from their belly to their back without warning.  
  • Keep only baby-safe materials and objects near your baby during tummy time. Your baby will soon reach for whatever is close to them, so keep glass, heavy objects that could fall, and flimsy plastics far out of reach.
  • Don’t hesitate to ask your pediatrician for tummy time guidance. 

5 tips for newborn tummy time

In photo: Complex Black & White Card Set from The Looker Play Kit
  1. Try reclining slightly and putting your baby (belly down) on your chest—a semi-upright position may make tummy time more comfortable and sustainable for both of you. 
  2. Your baby doesn’t have to lift their head to make tummy time worthwhile. Lying on their belly with their cheek resting on your chest or the floor still counts.
  3. Put your baby (belly down) across your lap and gently rub their back. Try holding a black-and-white image in their line of vision, then slowly moving it up to see if they follow it with their eyes.
  4. For tummy time on the floor, place your baby on their back, coo and make eye contact, then gently roll them onto their belly, arms tucked under their shoulders. To hold their interest, place a black-and-white rattle or image to the side where your baby is looking.
  5. If you notice your baby isn’t turning their head and putting their other cheek down during tummy time, you can gently rotate your baby’s head so it faces the other direction. This helps stretch the muscles on both sides of their neck and can prevent flat spots on their head.

A pediatric OT answers Lovevery parents’ tummy time questions

In the Lovevery App, experts answer parents’ developmental questions in the Ask & Learn section. Rachel Coley, a pediatric occupational therapist and mother of three, answered these questions from users.

What should I do if my 3-week-old just lays there sucking his hand instead of lifting his head in tummy time?

At this stage your little one has mastered the first goal of tummy time—comfort! Enjoy watching your baby looking with his brand new eyes and feeling his hand and mouth connect; both are important newborn sensory play and learning. 

Notice how this position is stretching his neck, chest, and hip muscles. Gently stroke your baby’s back and talk to him. Tummy time is about so much more than neck strengthening so don’t think for one second that cheek-down tummy time is a waste. Do make sure to very gently and slowly help him turn his head for cheek-down tummy time in each direction if you notice a head-turning preference. 

My 1-month-old spits up and is fussy after eating. I keep her upright and burp her well, but any time I try to do tummy time (even 30 to 60 minutes after eating), she cries and spits up. Any tips?

Tummy time can be tricky for babies with reflux, so it’s important to focus first on helping your 1-month-old reach the initial goal of tummy time: comfort. It can be easy to feel like your baby isn’t getting enough tummy time or doing enough in tummy time, but this first goal is critical.

I find that babies with extra physical discomfort from gastrointestinal issues, like reflux, can be more sensitive to position changes, physical separation from a caregiver’s body, and overstimulation. But with patience, repetition, and a lot of co-regulation, they can develop and strengthen their tolerance for these challenges. 

To co-regulate your daughter while she’s in tummy time, take some slow, deep breaths, and then speak to her in an even and gentle voice as you assume a pleasant facial expression, make eye contact with her, and touch her in ways that she finds soothing. Think of yourself as a flight attendant exuding calm during turbulence to help passengers regulate their responses. 

Believe it or not, tummy time has been found to reduce reflux, but I find it helpful to avoid putting pressure on the belly. To promote your daughter’s comfort, try holding and carrying her in tummy time with your hands positioned on her pelvis and upper rib cage or armpits. This eliminates pressure on her belly and allows you to offer tummy time at an incline, which can be more comfortable for babies. 

You can also experiment with tummy time over your lap, leg, or a nursing pillow, while keeping your baby’s belly free by supporting her weight on her upper chest or arms and her hips or folded legs. Placing her in tummy time on your chest while you sit slightly reclined can be a great option, as long as you have a burp cloth under her 😊

Most importantly, be responsive to your daughter as she learns to find comfort. There is no need to force tummy time while she’s crying. When she cries, help her gently out of the position and co-regulate, co-regulate, co-regulate. Once she’s soothed, try again. Frequent repetition, even if each instance results in only a few seconds on her tummy, helps your daughter learn to self-regulate and find comfort in tummy time. 

My baby is almost 3 months old. When we do tummy time, he rolls onto his back. How can I get him to strengthen his neck and shoulder muscles? 

If your baby is fussy and rolls out of tummy time, he may do better if you make it a little easier and more comfortable for him with some modifications. Try placing him on his tummy at an incline, with his shoulders higher than hips. This might be with his chest on a nursing pillow or rolled-up blanket or on your chest while you’re reclined. 

If he isn’t fussy and seems to be accidentally rolling out of tummy time, you can slowly roll him right back into it. This unintentional rolling commonly happens as babies begin to lift their heads higher in tummy time and then turn their head, resulting in a loss of balance. They are “falling backward” out of tummy time. This unintentional rolling provides valuable feedback for your baby that paves the way for their intentional rolling in future weeks. 

My 4-month-old still gets really upset in tummy time and can only stay there for a minute or two. Should I force it?

I bet your parental instincts are telling you the same answer I give parents—nope, don’t force it! But that doesn’t mean you don’t offer your baby tummy time every day. I teach parents responsive and respectful tummy time. This means that you don’t force tummy time on a crying baby. Crying babies don’t utilize ideal movement patterns and motor control in tummy time and they don’t benefit from stretching because their muscles are tightened in response to stress. Plus, their developmental learning of trust in caregivers and co-regulation isn’t supported. 

Learn more about what to do if your baby cries in tummy time in this video:

     

Is a tummy time pillow a help or a hindrance? My 3-month-old does so much better with the pillow, but I can’t help but worry that the pillow is doing most of the work.

While there isn’t a need to “worry,” I think your parental instincts are right on point. A pillow or any surface that elevates your baby’s shoulders higher than their hips is a modification that makes tummy time easier and helps many babies tolerate longer stretches of tummy time comfortably. But pillows also prevent your baby from being rolled with help into and out of tummy time, reduce the use of their arms for support, can block rolling, and more. 

For these reasons, I suggest putting your baby in tummy time in a variety of different places: on your chest, across your lap, over your forearm, on a pillow, on the floor or atop a rolled-up towel.  All these positions can help strengthen your baby’s muscles in different ways. Just know that your baby may have mastered the first tummy time goal—comfort—on a pillow incline but not on other surfaces. So be responsive to your baby’s cues that they need a break 😊

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Posted in: 0 - 12 Weeks, 3 - 4 Months, 5 - 6 Months, 7 - 8 Months, Tummy Time, Gross Motor, Rolling, Child Development

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