Your Guide to Tummy Time

Your Guide to Tummy Time

Your new baby will spend a lot of time on their back: sleeping in the crib, riding in a car seat, and cuddling in your arms. Tummy time plays a critical role in your infant’s development, and our guide to tummy time will help you understand how to do it safely.

What Is Tummy Time?

Tummy time is simply placing your baby on their stomach to play—an activity that’s important to their physical development and is recommended by the American Academy of Pediatrics (AAP). This time spent on the belly helps strengthen head, neck, shoulder, arm, and core muscles, and eventually, helps them learn to push up, which is a precursor to rolling, sitting, and crawling. It's a foundational exercise that supports gross motor skill development from the earliest days.

Why Do Babies Need Tummy Time?

In 1994, the AAP introduced its “Back to Sleep” public awareness campaign, which recommended that babies should always be placed on their backs to sleep, and never on their sides or bellies. “Back to Sleep” was hugely successful; the incidence of Sudden Infant Death Syndrome was cut in half. One consequence of the new guidelines, however, was that babies were spending almost all their time on their backs, and pediatricians began documenting higher rates of torticollis (baby’s head always tilting to one side) and positional plagiocephaly (a flat spot on the back of the head). Torticollis, characterized by tight neck muscles, can limit a baby's ability to turn their head fully, while plagiocephaly results from consistent pressure on one part of the skull. In response, the APP began recommending tummy time to prevent these conditions and delayed gross motor development. Regular tummy time counteracts the constant back-lying by encouraging babies to turn their heads in both directions, strengthening neck muscles evenly and reducing pressure on the back of the skull.

When Should You Start Tummy Time?

The AAP recommends starting tummy with your newborn once your baby’s umbilical stump has fallen off (usually around the one week mark). However, some health professionals suggest you can begin very short sessions, even just a minute or two, before that, as long as the baby is full-term and healthy, often by laying the baby on your chest (skin-to-skin can be particularly soothing). Always check with your pediatrician for guidance specific to your baby. Remember, tummy time is for alert and awake babies, and always make sure you don’t leave your baby unattended. Never allow your baby to sleep on their tummy during these sessions, as this increases the risk of SIDS.

When Is the Best Time to Do Tummy Time?

It’s best to avoid tummy time after feeding—placing your baby on their belly creates pressure on the abdomen and can lead to spitting up. Instead, try tummy time when your baby is especially alert, following a nap or diaper change. Many parents find success incorporating it into a routine, perhaps after every diaper change or when the baby first wakes up and is most content. This consistency can help your baby get used to the activity.

How Long Should Tummy Time Last?

When starting tummy time with your newborn, aim for quick 1-2 minute sessions, 2 or 3 times a day. Be sure to be on the watch for signs that your baby is getting fatigued. If your baby begins crying or resting their face on your tummy time surface, it’s time to take a break. As your baby gets older and builds muscle strength, gradually increase the length of time, up to about 20 minutes a day. The goal is to accumulate this time throughout the day, rather than one single long session initially. For instance, by 3-4 months of age, aim for a total of at least 20-30 minutes of tummy time spread across several sessions daily. Some experts suggest aiming for closer to an hour of accumulated tummy time by this age if the baby tolerates it well. You can continue to do tummy time in intervals, or in a single stretch (depending on your baby’s tolerance).

How to Do Tummy Time Safely and Effectively

Beyond just placing your baby on their stomach, there are ways to ensure tummy time is both safe and beneficial:

• Choose a firm, flat surface: A play mat on the floor or a blanket spread out is ideal. Avoid soft surfaces like beds, sofas, or pillows where a baby could accidentally bury their face, which poses a suffocation risk.
• Clear the area: Ensure there are no loose blankets, pillows, or small toys nearby that could cover your baby’s face or become a choking hazard.
• Always supervise: Never leave your baby unattended during tummy time, not even for a second. Stay close and watch for signs of distress or fatigue.
• Get down on their level: Lie down facing your baby. This encourages them to lift their head and make eye contact, making the experience more interactive and engaging.
• Start slowly: Especially with newborns, keep sessions very short. If your baby fusses, it's okay to stop and try again later. The goal is positive association.
• Vary the view: Change the direction your baby faces during tummy time sessions to encourage even muscle development and prevent a preference for turning their head only one way.

Does Tummy Time Have to Be on the Floor?

Tummy time is typically done on the floor, but it doesn’t necessarily have to be. The main goal of tummy time is to provide babies with an opportunity to strengthen their muscles and develop their motor skills, so as long as the baby is safely supervised and positioned correctly, tummy time can be done on different surfaces. For example, tummy time can also be done on a parent’s chest or lap while the parent is sitting or reclining. This can be a great way to bond with the baby while also providing them with the benefits of tummy time. This position, sometimes called "tummy-to-tummy" or "tummy-to-chest," is often better tolerated by very young infants as they feel secure and can see your face. Some parents also choose to use special tummy time cushions or pillows that can provide additional support and comfort for the baby during tummy time. These products are designed to elevate the baby slightly off the floor while still allowing them to engage in tummy time activities. If using a prop like a rolled-up towel or a Boppy-style pillow, place it under your baby's chest and armpits, ensuring their arms are forward. This can make it a bit easier for them to lift their head and chest initially. However, always supervise closely and ensure the prop doesn't push their face into the floor or obstruct their airway. However, it’s important to keep in mind that safety should always be the top priority during tummy time. No matter where it’s done, tummy time should always be done under supervision and on a safe and comfortable surface to prevent any accidents or injuries.

What Are the Benefits of Tummy Time?

Tummy time is one of your baby’s first exercises, and helps your baby master foundational skills required to roll over, sit up, crawl, and eventually walk. It develops head, neck, and core strength, and is important for visual and sensory development. Other big time benefits include:

• Prevention of positional plagiocephaly (flat head syndrome). By encouraging active head movement and reducing time spent with pressure on one spot.
• Promotes sensory development and allows your baby to experience different physical movements. This includes the development of the vestibular system (related to balance) as they learn to shift their weight and the proprioceptive system (awareness of body position) as they push against a surface. They also experience different textures against their skin.
• Creates early interaction and engagement with your baby, and is a great activity for bonding.
• Strengthens the back, shoulders, and arms, which are crucial for pushing up, reaching, and eventually for more complex movements like crawling.
• Can aid in relieving gas: The gentle pressure on the tummy can sometimes help move gas along, providing relief for some babies.
• Improves visual tracking: As babies lift their heads, they begin to scan their environment, which helps develop their ability to track objects with their eyes.

Will Tummy Time Help Encourage Your Baby’s Milestones?

Tummy time is an important activity that helps babies develop their muscles, motor skills, and overall physical strength. By regularly practicing tummy time, babies can gain the strength and coordination needed to reach important milestones such as rolling over, crawling, and sitting up. During tummy time, babies learn to lift their heads and strengthen the muscles in their neck, shoulders, arms, and torso. These muscles are important for developing the gross motor skills needed for crawling, sitting, and eventually walking. Specifically, tummy time helps develop head control (lifting the head to 45 degrees, then 90 degrees), allows them to bear weight on their forearms and then hands, and eventually to pivot and push themselves backward or forward, all essential steps before crawling. Tummy time can also help with the development of fine motor skills, as babies use their hands and fingers to explore and play with toys during tummy time. This can improve their hand-eye coordination and dexterity. When they push up on their hands, they are also developing strength and stability in their wrists and fingers, which will be important for later skills like self-feeding and writing. Playing with your baby during tummy time also encourages social-emotional milestones, such as smiling and making eye contact. Reading and singing during tummy time will expose your baby to a variety of sounds, which are the building blocks of expressive and receptive language.

What Should You Do if Your Baby Hates Tummy Time?

For a lot of little ones, tummy time can feel more like torture time, especially before they’ve developed the necessary muscle strength in their head and neck to prevent face-planting. To make tummy time more fun, try:

• Introducing tummy time by placing your baby stomach down on your chest while you’re reclined. Make silly faces and funny noises, and lift your baby off their bellies airplane style for a mini break.
• Learning your baby’s schedule and planning for tummy time during their least fussy periods, like after naps.
• Doing tummy time in different rooms, so your baby gets new and exciting views.
• Adding a mirror or high-contrast toys and illustrations.
• Using a rolled-up receiving blanket or a small nursing pillow under their chest and armpits (with arms forward) to give them a little lift, making it easier to see around. Ensure this support doesn't push their face down.
• Trying different positions like the "lap lay," where you place your baby tummy-down across your lap. You can gently rub their back or talk to them.
• The "football hold" or "colic carry" also counts as a form of tummy time, as the baby is engaging their neck and back muscles. Carry your baby face down along your forearm, supporting their head in your hand.
• Singing songs or talking animatedly to distract and engage them.
• Incorporating gentle touch or massage on their back and shoulders during the session. Remember, there’s no reason to force tummy time if your baby is screaming or crying. Take a break, and try again later. Consistency with short, positive sessions is more effective than infrequent, stressful long ones.

When Should You Stop Doing Tummy Time?

For babies under two months old, remember to keep it simple: short 1-2 minute sessions 2-3 times a day. As your baby grows, you’ll probably start to notice that tummy time involves less fussing, and it’s easier to build to a daily tummy time goal of twenty minutes. At four months, start gradually increasing the amount of daily tummy time to sixty minutes, until your child begins to crawl. Once your baby is rolling proficiently both ways (tummy to back and back to tummy) and spends a good portion of their awake time off their back exploring (e.g., sitting up, attempting to crawl), dedicated "tummy time" sessions become less critical. They will naturally get the benefits by moving and playing. However, continue to encourage floor play in various positions. Most babies will naturally outgrow the need for structured tummy time sessions once they are mobile, typically between 6-9 months old when they are crawling and exploring independently.

What Kind of Toys Should You Use for Tummy Time?

When it comes to tummy time, it’s important to choose toys that are safe, engaging, and appropriate for your baby’s age and developmental stage. Here are some ideas for toys that can be used during tummy time:

• Soft toys: Soft, plush toys that are easy to grasp and hold can be a great option for tummy time. Look for toys with different textures and colors to provide sensory stimulation and keep your baby engaged.
• Mirrors: Babies love to look at their own reflections, so a small (unbreakable, baby-safe) mirror can be a great addition to tummy time. Place the mirror within reach and encourage your baby to look at themselves and reach out to touch the mirror.
• Rattles: Rattles or other toys that make noise can be a fun way to engage your baby during tummy time. Look for toys that are easy to grasp and manipulate, and that make different sounds when shaken.
• Play mats: Play mats with different textures, colors, and patterns can provide a soft and safe surface for tummy time. Some play mats also have attached toys or features like crinkly fabric or squeakers to keep your baby entertained.
• Activity gyms: Activity gyms are designed specifically for tummy time and provide a variety of toys and features for babies to explore. Look for activity gyms with different textures, colors, and toys that can be easily grasped and played with.
• Board books: Propping open a sturdy board book with bright, contrasting images can give your baby something interesting to focus on.
• Water play mats (sealed): These provide a unique sensory experience as the baby pushes on the water and watches items float inside.
• Textured balls: Lightweight balls with different textures can encourage reaching and Pushing. Toys rich in sensory input with varying textures and sounds will engage your baby and encourage them to explore. Because your baby’s vision is still developing—it starts improving between 2-4 months—black and white images are most likely to capture their attention. As their vision matures, they will appreciate brighter colors too.

When to Consult Your Pediatrician

While most babies will gradually adapt to tummy time with patience and varied approaches, there are times when it's wise to consult your pediatrician:

• If your baby consistently cries or seems distressed during every attempt at tummy time, despite trying various techniques and keeping sessions short.
• If you notice your baby always tilts their head to one side or seems to have difficulty turning their head in both directions (which could indicate torticollis).
• If your baby is not meeting age-appropriate motor milestones, such as lacking head control by 3-4 months or not attempting to push up.
• If you have any concerns about your baby's muscle tone (either too floppy or too stiff).
• If you notice significant flattening on one side or the back of your baby's head. Your pediatrician can assess your baby's development, rule out any underlying issues, and provide personalized advice or referrals if needed, perhaps to a pediatric physical therapist.

Finding What’s Right for You

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