Strategies for Making Tummy Time Enjoyable
I was inspired to write this month’s post by a recent conversation with a fellow mom who’s daughter isn’t the biggest fan of tummy time, as well as by some other things I’ve seen on the internet recently saying that tummy time is cultural and not necessary… The former situation made me realize that not everyone knows that tummy time doesn’t need to be a forced or miserable experience for babies, and the latter just made me sad (because although “tummy time” may be defined by Western cultures, we do live in a Western culture, and there are absolutely benefits to it!)
For those who don’t know, tummy time is essentially time spent in the prone (belly-down) position for babies during waking or sleeping hours. This concept wasn’t really a thing before the “Back to Sleep” campaign in the 1990’s because so many babies slept on their bellies and were getting upwards of 16+ hours in the prone position during time spent sleeping. Some babies still sleep best on their bellies, but with societal pressures to keep them sleeping on their backs, parents need to make intentional time for prone play in order for babies to log the hours that provide the developmental benefits of this position. Other positions are still beneficial (back & side-lying play), but tummy time should not be neglected!
So, what are the benefits of tummy time and when should you start?!? Well, you can start day one! I don’t mean you have to put your brand new baby on the floor and expect them to enjoy it, but cuddle with them on your chest (during skin to skin), and that counts as early tummy time - don’t complicate it! The benefits of tummy time/prone play (I will use the terms interchangeably from this point forward) are vast. Some of these benefits include: interacting with the new world around them, establishing social connections with caregivers, building posterior chain/extensor strength (in the back) which lays the foundation for later postural control & core strength, development of visual motor & perceptual skills, upper extremity/shoulder girdle strengthening which lays the foundation for future fine motor skills, integration of primitive reflexes, early sensory integration (especially of the visual and vestibular senses - you can download my freebie on the sensory systems here!), prevention of flat spots and torticollis, and achievement of mini milestone skills that lead to the major milestones like sitting, crawling, standing, and walking.
One small caveat I want to address before I explain some strategies for helping your baby actually enjoy tummy time - because they should! - is that if a baby seems extra “strong” in their first few weeks of life while spending time in prone, that is likely a sign of excess total body tension and may need to be assessed by a developmental therapist to determine if that tension is negatively interfering with function. Seek support from a lactation consultant/IBCLC or pediatric occupational therapist or physical therapist if you suspect tension. A newborn should not be able to hold their head up or roll in the first few weeks of life, and if they can, it is likely tension helping them do so, not true strength. It’s the time spent in the prone position that builds the muscles and skills for holding the head up against gravity, rolling, and later milestones as well. Tension will impede the natural progression of these developmental milestones, and if you have concerns, it is always better to address them early on!
Here are some of the strategies I recommend to parents when they tell me their babies “just don’t enjoy tummy time” (because, yes, parents recognize that it is important, but nobody likes seeing their babies unhappy! And you don’t need to - it can be an enjoyable experience for all!) :
Like I said above, complete tummy time on a caregiver’s chest - either when the baby is sleeping or when they’re awake and you just want to snuggle the heck out of them :)
If you feel like your baby sleeps better on their belly, have a conversation with their pediatrician to discuss your options and follow your parent gut. There are measures you can take to ensure extra safety for belly sleepers, but I’m not providing any specific advice here on that. That’s a conversation for you and your child’s doctor, but I will say my daughter is a belly sleeper and she’s been a-okay :)
When they are on their bellies, prop their arms underneath them so they are resting on their elbows and not flat on the ground. This takes some of the workload off of their neck muscles that are trying to hold their heads up (so that they aren’t face-down; no one would enjoy that!). Doing this creates an opportunity for baby to use and strengthen other participatory muscles in the arms and chest to help them build overall strength which will serve as the foundation for being able to hold their head up for longer periods of time while completing prone play. At first, it may take the help from a caregiver to actively maintain their arm position beneath their chest by holding against their arms from the outside so that they do not splay them out and faceplant. Over time, you may just need to occasionally re-adjust their arms as a reminder instead of holding them for the entirety of tummy time. Helping them facilitate this position will help them have more space to move their head and be able to see more and interact more with their environment, leading to more enjoyment in prone play!
Complete tummy time on an incline surface in order to eliminate some of the challenge of working against gravity. This could be completed over a breastfeeding pillow, propapillar device, rolled towel, pillow, couch cushion, wedge cushion, etc. The more vertical they are, the easier it will be for them. You can progress this as your baby begins to tolerate tummy time more - by decreasing the incline and making the surface more horizontal than vertical; this will increase the difficulty and work different muscles at different angles!
Bring back your yoga ball that you (hopefully) spent then end of your pregnancy sitting on. This serves a similar purpose as the incline surfaces mentioned in the last bullet, but you can incorporate even more movements for the vestibular (movement) system by holding baby and moving them around in a variety of directions and making eye contact with them to make it fun.
Quality over quantity. It is far more impactful to do 1 minute of positive tummy time every wake window than it is to force your baby to be in the prone position for multiple minutes while they’re screaming. Keep it positive and when baby starts to fuss and stops enjoying playing on their bellies, roll them out of it and let them play on their side or back, or in any other position - or you can pick them up and transition to another activity. Whatever you choose to do, just ensure baby is content and happy because that will keep their nervous systems regulated and in a place where they are equipped to learn.
Similarly to the point above, be realistic about your expectations! We shouldn’t expect a one month old to tolerate 10 minutes of tummy time! They’ve only been earthside for a few weeks, they might only tolerate a few minutes of tummy time at once. If you try to aim for the number of minutes being equivalent to their number of months (1 minute at 1 month, for example), it might take some of the stress off of you - some babies might tolerate more, some might tolerate less; this is just a guideline. As they get older, you can gradually increase the amount of time, and work in these increments throughout their day. All of their tummy time doesn’t need to be completed at once or in one wake window - I’d actually advise against that. Switch it up a remember to keep those expectations realistic :)
And finally, KEEP IT SIMPLE. Don’t overcomplicate the situation! Babies don’t need much at all. They don’t need all the colorful toys, all the bells and whistles, or all the latest gadgets marketed towards enhancing tummy time… They really just need you :) Get on the floor with them, talk to them, read to them, sing to them, etc. Make it fun for them and it will be enjoyable for both of you! If you just set them down and don’t provide them without support, engagement, or stimulation of some sort, of course they won’t enjoy it!
If you ARE looking for “things” that can help you maximize learning/cognitive development during tummy time, I recommend using high contrast (white, black, and red) items for newborns to look at (they can see other colors as they get older), mirrors - because who wouldn’t like to look at their cute baby face?!, tactile mediums (crinkle books, different fabrics, bubble wrap, etc.), and books!
I hope these tips help to transform your floor time experience with your babies! Let me know how things are going :)
Here’s a picture of my daughter around 2.5 months old, propped up on her elbows during tummy time, looking at high contrast cards and a mirror, like I explained above - alongside her daddy for support and encouragement to build connection :)
