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Trouble Tolerating Tummy Time?

Did you know that it’s recommended to start tummy time as soon as the child is discharged from the hospital with the goal of tolerating 15-30 min a day by 7 weeks of age and tolerating 1 hour a day by 3 months of age?

Let’s start with why tummy time is important:

In 1992, the American Academy of Pediatrics started recommending that babies be placed on their backs to sleep to reduce the incidence of sudden infant death syndrome (SIDS). This is commonly referred to at the Back to Sleep campaign. While this greatly reduced the number of infant deaths, babies who slept on their backs were behind in meeting their motor milestones and had increased risk of head-shape abnormalities. To offset these drawbacks, pediatricians recommend pairing back to sleep with tummy time to play. Tummy time is used to increase a baby’s strength and reduce pressure on the back of the baby’s head. Tummy time is essentially a general term for a baby’s physical activity that is not on their back.

Yeah, I know it’s important, but your child HATES it:

You are NOT alone. Studies reveal that only about 30% of parents meet these recommendations. here are some tips from your APT-Chattanooga physical therapist to help improve your child’s tolerance to tummy time.

It’s a marathon, not a sprint. These time recommendations are NOT for one bout of tummy time. They are for TOTAL time over a 24-hour period. Babies will often work up to 2–5-minute bouts of tummy time several times throughout the day. You can try to pair it with another habit you already have established (like changing their diaper, burping, waking up from a nap) to remember to try it throughout the day.

See where you are. Start timing your child to see what they can tolerate over a 24-hour period at this moment. Often to start, this will often be a few seconds or minutes here or there. I like to pick a day of the week and just dedicate the timer on my phone to keep a running total throughout the day. I record this number in the notes section. Then, I time it again on the same day the next week to see if there are any changes.

Change your thinking (and position). Traditionally when parents think of tummy time, they picture a baby on the floor by themselves. We need to change this line of thinking. Tummy time is any physical activity by your baby when they are not on their back. This includes playing in side lying, laying over a caregiver’s lap on their bellies, being carried like an airplane or football, laying chest to chest, supported sitting, and so on. You are probably doing way more tummy time than you give yourself credit for.
Laying on a flat surface is the endgame. Most infants need to start on an elevated surface when playing on their tummies. This can be a Boppy, a towel roll, a caregiver’s chest, and so on. I like to start with laying chest to chest sitting upright in a chair that reclines. I slowly lower the back of the chair to see how close to horizontal the child will tolerate. I try to increase the time spent in this position before reclining more.

Make it fun! This is the time to break out those super fun toys to keep your child engaged. Try out different textures and colors of blankets or towels to engage their senses. Getting down on the floor so you’re face to face can also be helpful. Some children love looking at mirrors, books, or listening to music. We want this to be a positive experience; when they start getting frustrated, it’s time to end that session of tummy time. Half the battle is creating a more positive relationship with tummy time for both caregivers and babies.

Always supervise your baby during tummy time and be sure they are in a safe environment. It’s important to remember to make sure your baby is alert and awake during these activities. No napping at the gym. Some of these recommendations may not be appropriate for children who are medically compromised or complex. Please consult with your healthcare provider prior to implementing these recommendations at home.

–Virginia Golightly, PT, DPT