There is an abundance of information on the importance of Tummy Time for babies and the developmental benefits it brings. Due to this wealth of information and the escalated health campaigns, mothers are becoming more aware of the need to place their babies on their tummies daily. Before the Back to Sleep campaign in the early 90s (to prevent Sudden Infant Death Syndrome SIDS)
babies were naturally placed on their tummies to sleep and therefore had ample Tummy Time. They became accustomed to this position from birth and had the opportunity to learn to lift their head and prop on their arms while on their tummy.
Importance of Tummy Time
When you place your baby on their tummy you are enabling them to practise and achieve important developmental mile stones. Tummy time helps motor development by strengthening their back muscles and allowing them to gain head and trunk control. It also helps develop perception, body awareness and sensory motor skills as well as a whole array of Sensory Integration systems that include vision, tactile and proprioception.
The focus in most literature, however, is on the importance to the motor development and the prevention of motor delay. Motor control develops in a cephalocaudal fashion. This means that a baby will gain head control first and then shoulder control, then the abdomen, and so on down to their feet. If babies don’t get the strengthening of the back and neck muscles that they need, it can lead to or exacerbate an early motor delay.
Early motor delays are increasingly being diagnosed with and estimated one in 40 babies diagnosed and 400,000 babies a year at risk (Smith, D. 2010). “Early motor delay” was used as a description within a wide range and variety of conditions from low muscle tone to cerebral palsy. Some of these early motor delays are present from birth, whilst others develop or worsen because the baby does not get enough tummy time. The positive thing is that most of the early motor delays are not so serious and with Occupational Therapy and Physiotherapy that involves a programme of tummy time, most children can catch up quickly.
When To Start Tummy Time.
Tummy Time can and should be started with a healthy new born baby. This will make it easier for the baby to accept and get used to being placed in this position. It is often not so practical as with a new born baby the main concerns are with feeding, sleeping, changing and bonding. Tummy time would therefore need to be centred on soothing and holding and would be for short periods of time (around a couple of minutes several times a day). After 3 weeks of age the baby will start to recognise faces and sounds and this makes Tummy time much easier as the length on her tummy can be extended with fun objects and faces to look at. The aim is to get around an hour total within a day by the end of three months.
Difficulties with Tummy Time.
Most babies will initially find being on their tummies uncomfortable or unusual, but they soon get used to it and eventually enjoy it as a natural play position. There are, however, a small minority of babies that just don’t seem to tolerate being on their tummies despite their mother following all the advice on “short bursts” and “making baby comfortable”. These tend to be babies that have colic, severe reflux, sensory processing difficulties as well as other dysfunctions. They are generally restless babies and will not sleep well or fall into a routine. Many of these babies will want to be held most of the time and have difficulty settling.
It is important to find a Tummy Time strategy that works for these babies and this will usually incorporate some form of Sensory Integration (SI) input. The input does largely depend on the difficulty or dysfunction that the baby has and this would need to be assessed by a Paediatric Occupational Therapist for an individual strategy. In more general terms, however, I have found that many Tummy Time difficulties can be overcome by using SI techniques that are calming and by giving vestibular input as well as propriocetive input. This basically means that gentle rocking/swaying and holding baby very close will calm them down a notch (this is also considering that they have been fed, changed and are not sleepy). For new born babies, carrying them extended along your arm, with your arm between their legs is an ideal way to very gently swing/rock them whilst holding them close to your body. They can also gradually be introduced to the Tummy Time position by laying them upright on your chest and then gradually inclining back a little each day until flat on the floor. Music is a very good distraction so it would be advisable to play some calming music in the background.
At the beginning of 4 months the baby should be pushing up on its forearms and lifting and holding its head up. Cause for concern is when the baby has some difficulty lifting its head, has stiff legs with little or no movement, pushes back with its head or turns its head to one side only.
There are some very good informative video clips on tummy time and its importance at the following link: www.pathwaysawareness.org/top/pathways-video-tummy-time-english-and-espanol1/