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Tummy Time
On the Back to Sleep, on the Stomach for Play
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Por Rae Pica, Children's Movement Specialist
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 (AAP) 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 worked. 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 AAP's campaign title: Tummy to Play.
The Flip Side
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
such as 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 exacerbates
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.
Balancing out “Back to Sleep”
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.
Tips for Tummy Time
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 but
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 also can 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 AAP 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 nursing support pillow
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!"
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