Can too little Tummy Time hurt your baby? - Cape Cod Healthcare

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Published on June 29, 2021

Can too little Tummy Time hurt your baby?

Tummy Time

“Tummy time” for infants isn’t getting as much attention as it deserves, and a baby’s ability to roll, sit, and crawl on their hands and knees, and more can suffer as a result, according to the American Academy of Pediatrics (AAP). The Academy says the practice is as important as its “Back to Sleep” campaign, which recommends all infants be placed on their backs to sleep. The awareness campaign has contributed to a 40 percent decrease in sudden infant death syndrome (SIDS) in the United States since 1992.

However, there may be some downside to lying an infant on their back for too long. Subsequent research, including a new study in Pediatrics, shows that infants who sleep on their backs may be slower to achieve motor skills and have increased rates of brachycephaly and plagiocephaly (flat heads).

Physical therapist Lisa Eatough, PT, DPT, CEIS, who sees patients at Cape Cod Hospital Rehabilitation Center, said the answer is to make sure babies spend time—about an hour each day, and more as they get older—on their tummies while they are awake and being watched. 

“Tummy time,” also called “awake prone positioning,” is the foundation of gross motor development, and Eatough explained that tummy time is essential to counterbalance the effects of babies sleeping on their backs.

“Everyone needs to understand that ‘Back to Sleep’ and ‘Tummy Time’ are equally important,” she said, noting that parents remember to place babies on their backs to sleep for their safety, but many forget about the need for daily tummy time.

How It Benefits Babies

Eatough, who grew up on Cape Cod, is a Doctor of Physical Therapy and Certified Early Intervention Specialist who treats children from birth to age 3. As a pediatric clinical specialist, she has treated many infants who are otherwise healthy, but whose lack of tummy time delayed their development.

Young patients can be “stuck in sit” because of insufficient tummy time, she warned.

She explained that children who are “stuck in sit” are otherwise healthy 9 or 10-month-old babies who are not rolling over and aren’t trying to crawl on their hands and knees. “They have adequate strength, but no motor ability because they’ve never been motivated to roll over,” she said. “They have never learned important skills because someone has been picking them up, or they’ve been on their backs, or they’ve been in a piece of equipment (such as an ‘exersaucer’) all the time. They haven’t been given enough tummy time.”

For this reason, she said there is a huge urgency to educate people about tummy time.

The treatment for developmental delays such as this, in otherwise healthy children, is to introduce tummy time. Eatough said this gives children the opportunity to strengthen their necks, acquire neck control, start weight-bearing in their arms, and build musculature in their shoulder girdle.

“It’s much more difficult for children who are older to accept tummy time,” she said.

Tummy Time Tips

Eatough recommends these helpful ways to incorporate tummy time into your baby’s routine each day:

  • “Eye contact is super important,” she said. “Babies need to look at your face, and the only way to do this is by lying down; you can't be sitting next to the child. Place infants on your chest. Spread a blanket on the floor and lay down with the child. Use this time to interact and bond.”
  • The best time for tummy time is when the child is quietly content, she said. Try tummy time sessions when your baby is well rested, fed, and dry.
  • For older infants (versus newborn), she suggested placing high-contrast toys (red, white and black colors) and toys that include mirrors within your baby’s reach during tummy time. Eatough said these are the best toys to help children learn to play and interact with their surroundings.
  • “As your baby gets older, tummy time can last longer and take place more frequently throughout the day. Work up to more than an hour a day,” she said.
  • “Limit the amount of time your baby spends in car seats, swings and carriers, and don’t use exersaucers or door jumpers,” she said. “Exersaucers and door jumpers simply shouldn't be used at all.”

Since “back to sleep” was introduced, children have been rolling, sitting, and crawling on hands and knees later than generations before them, Eatough explained, while stressing that sleeping on their backs is still the safest thing for babies.

“I understand that many parents are deterred from placing their babies on their tummies because they are afraid it will hurt them. ‘Back to sleep’ has received strong emphasis. Reflux is another negative stimulus. If babies throw up when you put them on their bellies, you tend not to want to do it,” she said.

Babies who don’t have tummy time early in life can resist it later, and no one wants to have a crying baby, but Eatough emphasized parents should not give up or give in.