My oldest child hated tummy time. Miserable, she would flail on the floor and wail like a marooned walrus. Although she eventually learned to tolerate it for periods of time, she disliked time on her belly so much, she skipped the developmental milestone of flipping over from her back to her belly and went straight to sitting upright.
Babies spend a lot of time on their backs when they are young. In accordance with guidelines to prevent Sudden Infant Death Syndrome, babies are put to bed on their backs. But continual pressure on the back of an infant’s head when the baby is also awake leads to head flattening. Thus, current recommendations are to give your baby time on his belly when he is awake. But for some, tummy time is torture time. For those infants, Physical Therapist Deborah Stack gives us ideas on how to make tummy time tolerable.
Dr. Lai with Dr. Kardos
Physical therapists are sometimes enlisted to treat or prevent plagiocephaly (head flattening). Physical therapy for plagiocephaly is a combination of parent teaching, assessment of nursing positions, carseat and feeding seats, handling techniques for promotion of typical movement patterns, and facilitation of motor development. Much teaching revolves around different ways to incorporate tummy time into your family schedule. Remember…it is critical to keep weight off the flattened area for as many hours a day as possible. If needed, babies do best if referred to physical therapy by their doctors at two to four months of age. In fact, a 2008 research study1 showed a significant improvement in plagiocephaly for children referred to physical therapy versus children whose parents were provided with an instructional pamphlet.
How can you get started? Try these ways to do “tummy time” with your baby.
1. Belly to belly with your baby
Recline back comfortably in a chair with your child on your chest. Try to help your baby keep his forearms supported on your chest. Talk to your baby to encourage him to lift his head to look at your face.
Place your baby on a bed, couch, or other raised large area with her head near the edge of the surface. Get down so you can look your baby in the face and talk, sing, or make funny faces or sounds. Keep one hand on your baby’s buttocks so she does not roll or fall. Siblings love to be the entertainment!
3. Lap play
Place your baby across you lap with his chest on one leg and his thighs on the other. You can raise the leg nearer the baby’s head a bit to make it easier.
4. Airplane carry
Carry your baby face down as you walk. If your child is small enough, place your forearm under her belly with your hand supporting the upper chest. Younger infants will need their heads and chest supported, but as your baby gains strength in the neck and trunk muscles, less support is needed. Most babies really like this!
Progress tummy time as tolerated. Many babies can initially only handle 20 or 30 seconds at a time without becoming distressed. Within a few weeks, many children will be able to be on their tummies for 15 minutes or more.
Remember, babies should be placed on their backs to sleep, but while your infant is asleep, you can still tiptoe in and rotate your baby’s head gently away from the flat side.
Deborah Stack, PT, DPT, PCS
Dr. Stack has been a physical therapist for over 15 years and heads The Pediatric Therapy Center of Bucks County in Pennsylvania www.buckscountypeds.com. She holds both masters and doctoral degrees in physical therapy from Thomas Jefferson University.
Source cited:1 van Vlimmeren LA, van der Graaf Y, Boere-Boonekamp MM, et al. Effect of pediatric physical therapy on deformational plagiocephaly in children with positional preference: a randomized controlled trial. Arch Pediatr Adolesc Med. 2008;162:712-718..
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