Expert Advice: Tummy Time


Everyone is aware that in 1994 the NICHD started the back to sleep campaign in order to attempt to reduce the incidence of SIDS. What most people don’t know is that at the same time they also began the “tummy to play” campaign. This means that since babies sleep on their backs, they need to be playing and resting on their tummies.

BENEFITS OF TUMMY TIME

Strengthening. It’s no surprise that tummy time is how babies gain strength throughout the neck and back. It’s hard work to lift and turn the head. Weight bearing through the arms increases stabilization through the shoulder blades and strengthens the arches of the hands which will help with grasp and handwriting later down the road. There is a correlation between the amount of time a baby spends on his/her belly and the ability to hit developmental milestones.

Sensory Input. The face, stomach, and hands are three of the most sensitive parts of the body. The skin is the most important organ in an infant. Babies gain tons of insight about their surroundings through the skin such as changes in temperature, textures, and pressure. They learn body awareness by pushing on something which pushes back on them (ie rubbing their feet together or kicking the floor). Since the back of the head, the back, and calves don't contain many sensory nerve endings babies will take in less information from their environment when lying on their backs.

Feeding. When the head is lifted in tummy time there is natural extension at the neck. Neck extension helps with mouth opening. Therefore when a baby plays on their belly there is wider mouth opening. In addition to mouth opening, there is increased tongue movement when on the stomach via input through the vagus nerve. The vagus nerve (controlling the autonomic nervous system so that a baby can breathe, obtain food, and maintain body temperature) is stimulated through movement of the tongue on the palate and there are branches that are stimulated through the ventral (front) part of the body as well. Better tongue movement + better vagal stimulation= better eating.

Emotional Regulation. The vagus nerve is in charge of the parasympathetic nervous system. This means that the nerve is responsible for calming you down when you’re in a state of fight or flight. Studies show that babies who have better vagal nerve have better emotional regulation. Since tummy time activates the vagus nerve, it will also help with emotional regulation (when in a calm state during play).

HOW TO DO TUMMY TIME

Skin to Skin

When a baby is born, tummy time means skin to skin. This means on an adults bare chest and baby in diaper. This way baby feels warmth, hears a heart beat, and is able to maintain a calm state. Baby will move their head back and forth while sleeping and be able to maintain their newborn flexion (curled up) comfortably.

Across the Lap

Across the lap is also a great place for tummy time. There, baby can begin to push up, move head back and forth, be burped, and maintain closeness to mom.

Babywearing

Babywearing is a controversial addition to tummy time. Baby will receive closeness and warmth from mom which keeps them in a calm state. Baby will be able to lift their head and move it back and forth which strengthens the neck. It is a good adjunct to use and developmentally better than using a stroller. However, they are not getting the same benefits of traditional tummy time in this method.

On the Mat

Lastly there is tummy time on the mat. All babies whether they are one week old or three months old will benefit from tummy time on a flat, horizontal surface. It is only in this position that they can stimulate the nerves in the brain and the muscles of the neck and back in the way that we want. Eye contact and engagement is key to tummy time play. Baby needs to be engaged with you in order to feel trust. This way baby will keep a calm state and also absorb and learn from tummy time rather than seeding them in to a state of fight or flight.

TUMMY TIME TIPS

Happy Baby

Keep baby happy. An unhappy baby will trigger the fight or flight response during which they cannot learn.

Start slow!

Tummy time on a mat can start with just one minute at a time. Gaining baby’s trust is key. When baby becomes upset, pick them up and soothe them, then try again.

Keep Going!

There is no amount of tummy time thats “too much”. Keep baby on the chest as much as is comfortable. Switch up tummy time throughout the day to on the lap, floor, chest. This gives them a variety of ways to use their neck and back and also keeps them happy and regulated.

Play Along!

Engage with baby. Singing, humming, and eye contact will help you get the most out of your tummy time.

WHEN TO TALK TO A PROFESSIONAL

Sometimes it is clear that your baby needs some extra help. Physical therapists and/or occupational therapists are both qualified to help with these issues. Here are some clues that your baby may benefit from some professional intervention:

If your baby has difficulty tolerating any form of tummy time including fussing and crying despite moving slowly and showing them trust.

If your baby is over one month old and cannot lift their head on the mat.

If your baby can only turn their head in one direction while in tummy time.

Remember, back to sleep means tummy to play!

Elizabeth Morel is the owner of Little Movers PT, Physical Therapy for mom and baby. She provides innovative hypopressive training for core and pelvic floor restoration. She also provides pediatric physical therapy and craniosacral therapy for babies with a specialty of breastfeeding support. You can find her at littlemoverspt.com , Facebook Little Movers PT and instagram @littlemoverspt

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