Open Accessibility Menu

Overcoming tummy time challenges

Published in Pediatrics, For the Health of It Author: Sue Peck, Pediatric Physical Therapist

In recent years, there has been a big push for babies to get tummy time, with more and more research showing the benefits it provides to a child's development. Tummy time improves hand and arm strength and shoulder stability. It helps with improving head control. Tummy time develops extension through the spine and prepares the body for sitting up. It prepares the hips for hands and knees positioning and crawling. It readies children to work and play and helps develop vision. There are also sensory benefits with weight bearing, weight shifts and reaching. With these vast benefits to typical baby development what can be done when your baby does not like being on his/her tummy?

There are many reasons why an infant may not like or tolerate tummy time. For a baby who spits up or has reflux, tummy time could be associated with a sour taste or burning in the back of the throat. One way to address this issue is to try tummy time 15-20 minutes before feeding time. Use of a wedge to elevate the upper body also will help to address this problem.

Arm and neck weakness can be another issue. This limits the baby’s ability to see anything but the floor, which is neither fun nor motivating. Use a rolled towel or Boppy pillow under the arms to prop the elbows under the shoulders. This will help with head elevation and will assist the infant to increase awareness of their environment. Being able to look around encourages that ongoing development of neck strength and head control. Get down on the infant’s level to encourage your baby to explore the environment. A baby mirror or book helps the infant focus on near objects, preparing vision for reading.

Poor vision can reduce a baby’s enjoyment of tummy time. Visual awareness helps an infant raise his/her head and look around. When a child lacks vision or has poor vision, other stimuli are needed to motivate a child to raise his/her head. Your light touch on the child's cheek or chin with encouraging talk could help to promote head elevation and accommodate for poor vision.

An alternative option for tummy time is for you to rest the infant on your chest while seated in a recliner. This allows for bonding as well as for the infant's vision to be directed at the best prize ─ a face.

Use of an exercise ball for tummy time can also be effective. Place the baby on his/her tummy over the ball, maintaining hold on the baby at all times. The ball can be rocked back, forward and sideways for calming. The baby also can be gently bounced without leaving the surface of the ball. If the ball is rolled forward, the arms will take more weight and provide extra strengthening for the neck. If the ball is rolled back, more weight will go to the tummy, pelvis and upper thighs. Using an exercise ball can be a fun alternative to typical tummy time.

The "Back to Sleep" campaign has saved many lives since it was initiated in 1992, though it may have caused some parents to have concern for placing babies on their tummy. What needs to be emphasized is "back to sleep...tummy to play." Both of these positions are needed for the overall health and wellness of an infant. There are many options to help an infant achieve tummy time goals. If you are struggling with tummy time for your child, speak to your provider about further interventions such as physical and occupational therapy evaluations. These specialists will be able to evaluate your child's needs, provide intervention and a home program to help your child grow happy and healthy.