As occupational therapists, we are often asked why parents should place babies on their tummies?
Is it really that important?
Is it even safe?
When should I start letting my baby have tummy time?
How long should my baby stay in this position?
In order to answer these questions, we must know what ‘tummy time’ means.
Tummy time is the common term that is used to describe a baby’s position when they are placed in prone (on their stomach) while being awake.
1. Why parents should place babies on their tummies?
When a baby is placed in this position, they are forced to attempt to keep their head up against gravity by using their back, neck, gluteus muscles and even their stomach muscles. Eventually, they use their arms and hands to push up against gravity, further developing their arm and hand muscles. All these muscles are critical in facilitating rolling, sitting, crawling and even when the child starts to pull him or herself up against furniture.
When a baby’s strength in these muscles are not sufficient, we often see delays in the child reaching their milestone, skipping of milestones and muscle imbalances.
2. Is it really that important?
According to a study done in South Africa, namely; “Prone positioning and motor development in the first 6 weeks of life”, the following conclusion was made: “At 6-weeks of age there are significant differences between infants who spend 30 minutes and more per day in a prone position compared to infants who spend less than 30 minutes per day in a prone position, such as head control, turning off the head, weight displacement towards the thorax, active movement of the arms especially pushing up on the arms and position of the lower extremities.”¹
These researchers found that babies who spent more than 30 minutes on their tummies when awake showed much better head control, arm and hand motor development. The long-term effects of increased or decreased tummy time still need to be explored. There is also some indication that reduced tummy time restricts the baby in optimally exploring his/her environment, which can have an impact on their cognitive development.
3. Is it even safe?
Regarding the safety of tummy time, there is some reason to be cautious when placing a baby on their stomach.
Various studies have found that placing a baby in prone to sleep is suggested to increase the chances for Sudden Infant Death Syndrome (SIDS).
In a study published in JAMA Pediatrics, they found that babies who sleep on their backs (supine position), were at lower risk for SIDS². They also specifically mention that the risk for SIDS is increased for babies who are not accustomed to the prone/stomach position.
These dangers can be greatly reduced by constant monitoring when a baby is placed in this position and by making sure one only places the baby in this position when awake. This allows the baby to become accustomed to this position, and stronger when lying on his/her stomach while being monitored by his/her carer for safety.
4. How long should my baby stay in this position?
Deciding when and how long to place your baby on their stomach is quite a difficult question to answer. It depends a lot on your baby’s temperament, their physical abilities or disabilities and their level of arousal/energy.
You can start placing your baby on their stomach, while awake and receptive for short increments from the time you arrive home with your little bundle. You should use your baby as a guide on how long this should be. You do not have to force your baby to stay in this position if they are clearly upset or uncomfortable. Using the “tummy-to-tummy” method is also quite effective when practising tummy time with a smaller baby. This involves placing the baby on his/her stomach on your chest or stomach while you interact with him/her. Initially, you might place the baby on their stomach for 30 seconds at a time, a few times a day. This can eventually increase to 30 minutes or more of tummy time a day, divided into increments of 5 to 10 minutes, by 6 to 12 weeks of age. By this time, placing the baby on a harder surface with toys in front of him will help him/her further develop their motor skills.
However, always consider that these are general guidelines.
- Every child is different, let your child guide you in what is enough.
- You must also be sure that they are awake and able to breathe effectively and not burrowing their face against the material they are lying on.
- If you are concerned that they are not developing appropriately regarding motor or postural abilities, do not hesitate to visit your medical practitioner, occupational therapist or physiotherapist for an assessment.
Disclaimer: The information in this article should not be used as medical advice. Information on this site is intended for educational purposes only. D.O.T and Sibella van Wyk Occupational Therapist do not claim responsibility for any injuries that result from the educational information.
1. Russel DC, Kriel H, Joubert G, Goosen Y. Prone positioning and motor development in the first 6 weeks of life. South African Journal of Occupational Therapy. 2009, May;39(1):14.
2. Mitchell EA, Thach BT, Thompson JMD; et al. Changing Infants’ Sleep Position Increases Risk of Sudden Infant Death Syndrome. Arch Pediatr Adolesc Med. 1999;153(11):1136-1141. doi:10.1001/archpedi.153.11.1136.