Baby-Led Movement: Tummy Time.
Three month prone, or “tummy time”, is maybe one of the most underrated developmental positions out there. This is the first milestone in a long line-up of milestones, big and small, that will encompass the first thirteen months of your baby’s life. Exciting, scary, and everything in between.
Let’s take a step back and break this pattern down bit by bit.
When do I start tummy time? You can, and should, start exposing your baby to being on the stomach as soon as possible. What that might look like as they’re super small can include laying on the belly on your chest, laying on their belly on a couch ottoman while you are eye-level, laying on a blanket-covered exercise ball, etc. In my home, we exposed our little guy to laying on his belly from day one. Just be sure to always monitor your baby in this position as they do not have control over their heads until around three months of age (and later if they were premature!).
Now I know what you’re about to say- “my baby HATES being on their tummy”. I get it, we don’t want to make our kids upset on purpose. What I urge you to understand is that babies don’t like things that confuse them- they like comfort and routine. For most human babies, that means being on their backs. However, they need to have stimulation from their bellies for proper inner ear development, shoulder development, neck muscle balance, and the list goes on.
I also want to add this little tidbit- babies will likely get more and more confused and frustrated the closer they are to mastering a milestone. For instance, when I see a two and a half month old on their belly and they get instantly angry, screaming, flailing, and so on, I can’t help but smile because that is their way of giving me an inside look at their brain. The brain is saying, “I know I should be getting my arms up and pushing my head up off of this table and I’m so close to doing it on my own but I’m not quite there yet”. Being upset in tummy time is actually a good thing.
Okay, so we talked about when to start and why most babies don’t love it. But why does this position matter, really?
This is the first time in baby’s life that baby will move with intention. Baby will pull the arms above the head, push down through both elbows, and lift the head up off of the ground in order to look around. This is a huge step! Anatomically, this position is vital for the thoracic spine (the mid-back). Having both elbows push into the ground activates the proper muscles around the shoulder blades, giving them perfect stability. This makes room for the mid-back to move upward toward the ceiling. This motion is subtle, especially in tiny babies, but this is what forms the mid-back curve in our spines. Have you ever seen someone with a really flat back or a dip down in their mid-back? That person did not get nearly enough time on their belly as a baby!
Okay, so it forms the curve in our mid-back and it also puts the shoulder blades into the correct position. What else can tummy time do?
Lifting the head up off of the ground is a very important skill for babies to obtain for safety. We want our littles to be able to intentionally move their heads toward or away from objects. Around this time in a baby’s life the risk for SIDS greatly decreases- coincidence? I don’t think so.
Now let’s chat about how to do tummy time properly with your baby. I love when babies spend time on the belly on someone’s chest, however, this isn’t promoting an ideal pattern. Often, the person the baby is laying on will be inclined to some degree, which robs the baby’s brain from being completely horizontal. Also, it’s really hard to have the baby get their arms up above the head while laying on top of someone. Now, don’t hear what I’m not saying- I still love having your baby lay on your chest. It just isn’t purely “tummy time”. As a pediatric developmental purist, I encourage you to lay your baby on the floor (supervised!) for this pattern…even if baby hates it.
Here are some tips that I often give my patients that are finding it hard to implement tummy time:
Set a timer. Once my little one was about two months old, his tolerance for tummy time went downhill fast! I would set a timer for five minutes every hour or so. It was easier for me to deal with his fussing if I could see a visual countdown.
No intervention. This is a tough one! This means no pillows under the chest (an absolute no-go for proper development), don’t help the arms get above the head, don’t start the arms above the head (start with arms down by the sides), and don’t pick the baby up as soon as the fussiness begins. The brain needs to be able to problem solve and you are providing your baby that opportunity when you let them get fussy for a little bit in this position.
Flat and firm surface. Try to use a space that is soft enough that it wouldn’t hurt if a baby face-planted, but also a space firm enough that the baby can move freely. In our home, a thin and dense blanket that doesn’t bunch up was our choice.
Remember, the best thing you can do for your babies is to put them on the floor.
Dr. Lauren Jordan
Now, before you go, I want to talk about something else really quickly- flat heads. I could write an entire blog about this (and I just might) but here is the breakdown: babies are born with a physiologic predilection. Meaning, they know one side of them exists and aren’t really aware of the other side. This is because the right and left hemispheres of the brain don’t connect until around five months of age (this is why intentional rolling is around that time- cool, right?). Anyway, all babies have a side that they know and love more than the other. Some babies, it’s super obvious and some it isn’t. Some babies love their predilection side so much that they favor it a lot more than the other- they sleep toward that side, face that side, etc. This is a perfect recipe for a flat spot. Plagiocephaly (aka flat head or flat spot on the head) is a normal occurrence of a predilection. Until they have tummy time, roll, and crawl I expect seeing flat spots on their tiny noggins. I’ll just be upfront with you- I don’t like helmets for littles and they are prescribed too often too prematurely in my professional opinion. The best thing you can do to correct a flat head is to increase tummy time.
Alright, one milestone down. I hope this helps you on your journey to increase tummy time for your baby! Remember, the best thing you can do for your babies is to put them on the floor.
