Tummy time: how to start and make it easier

Tummy time is your baby lying on their front while they are awake and someone is watching. The NICHD’s Safe to Sleep campaign says most babies can start a day or two after birth, and the AAP suggests starting the day your baby comes home from the hospital.

It does not need a mat, a schedule or a plan. It needs a baby, a clear patch of floor or a willing adult, and someone paying attention.

Why it helps

Babies sleep on their backs, and the rest of the day has to make up for it. The NICHD describes tummy time as a way to build strength in the neck, shoulders and arms, which babies later use to sit up, crawl and walk. It also helps with motor skills, meaning control over the muscles that move the body.

The second reason is the shape of the head. Babies who spend a lot of time on their backs can develop a flat spot on the back of the head. The AAP notes that this usually rounds out as babies grow and sit up, and both the AAP and the NICHD list tummy time as one way to help prevent it.

One thing tummy time is not: the NICHD is clear that it does not directly lower the risk of SIDS. Back sleeping does that job. Tummy time is about growing and moving.

The AAP adds that playing on the tummy is how babies get ready to slide on their bellies and, eventually, crawl.

Ways to start (on your chest, on the floor)

On your chest. The AAP’s gentlest version: lie on your back and put your baby tummy-down on your chest. Your face is the most interesting thing in the room, so they lift their head and push with their arms to look at you. This counts, and it is often the version a newborn tolerates best.

On the floor. The NICHD suggests a blanket on a clear area of floor. A rolled-up towel under your baby’s arms gives a little support while their neck is still finding its strength.

With something to look at. The NICHD suggests a toy within your baby’s reach, or a trusted person sitting in front of them. The AAP also suggests arranging toys in a circle around your baby, which invites the reaching, pivoting and scooting that come before rolling and crawling.

With a helper. The AAP mentions a supervised older child playing with the baby while they are on their tummy. Siblings are often better entertainment than any toy.

Fitting it into the day

Both the NICHD and the AAP suggest building tummy time around moments that already happen: after a diaper change, or when your baby wakes from a nap. Changes and wake-ups come round many times a day, so tummy time comes round with them, short at first and longer as your baby grows and starts to enjoy it.

The rest of the awake day helps too. The NICHD suggests holding your baby upright, sometimes called cuddle time, and limiting the stretches spent in car seats, bouncers, swings and carriers, where the back of the head rests against a surface. The AAP suggests varying your baby’s position while they are awake and switching sides when feeding.

At night, the same sources suggest alternating which end of the crib your baby’s feet point to, so they turn their head a different way to see the room.

In Priya’s house, tummy time happens after every morning change. Sam does the after-lunch one, and Jo has claimed the after-nap one, mostly because Trisha laughs at her.

When your baby protests

Some babies do not like it at first. The AAP says so plainly, and suggests putting yourself or a toy within your baby’s reach. With time, it says, they come to enjoy it.

A few ways to make the protest shorter, all drawn from the NICHD and the AAP:

• Start on your chest rather than the floor. Being close to you is a better deal than being face-down on a blanket.
• Get in front of them. The NICHD suggests a trusted person sitting in front of your baby, and a familiar face changes the view entirely.
• Keep it short. Both sources describe starting with short goes and letting them grow as your baby does. A short go that ends before the crying is still tummy time.
• Try it after a diaper change or a nap, when both the NICHD and the AAP suggest it.

Grumbling is not failure. It is a small person doing something hard with their neck.

Back to sleep, tummy to play

The AAP’s phrase sums up the whole thing: backs are for sleeping, fronts are for playing.

Tummy time is always awake and always watched. The AAP’s safe sleep advice is that babies go on their backs for every sleep, naps included, on a firm surface that is not inclined, with soft objects and loose bedding kept out of the sleep area. If your baby gets drowsy during tummy time, that is the moment to move them onto their back in their own sleep space.

Anyone who puts your baby down needs to know both halves: the back for sleep and the tummy for play, with someone watching.

Sources

• Benefits of Tummy Time — Safe to Sleep, NICHD (NIH)
• Back to Sleep, Tummy to Play: Give Your Baby a Safe, Strong Start — HealthyChildren.org (American Academy of Pediatrics)

This is educational information from public sources, not a replacement for advice from your child’s healthcare professional.

In Withya, Care shows when the last nap ended, so whoever is on next can see how the day has gone.