Do you have any of these questions?
A month old baby's job is to turn his or her head from side to side - when on the tummy and when on the back.
"Good" handling habits can prevent:
- Flat heads and neck problems
- Developmental delays from too much time in one position
- Fussiness, constipation, and spitting up
"Good" play will help babies develop the muscle strength and coordination needed for:
- Preschool success with paper, pencils, and crayons
- Good balance when walking and jumping
- Good eye tracking for reading
- Good focus and attention skills
Information of this page will help parents understand the importance of good positioning from Day #1.
(A Tummy Time Brochure in English and Spanish)
The Baby Development Information brochure is designed for new parents. It is in a question and answer format to help parents understand the importance of varying infant play positions including time flat on the tummy, on the side, and on the back. "Tummy Time" is the term referring to the placement of a baby, who is awake and attended, on the tummy to exercise the neck and back muscles.
This brochure was developed by Ms. Jennings during a research project published in 2005 with Xavier University, Cincinnati, Ohio.
Why do tummy time?
"Tummy Time" is the foundation of all normal development. It is especially important for babies to gain strength from the head to the feet. Pushing on the hands and forearms helps the hands open to be able to manipulate toys. Tummy play helps to build the muscles needed for rolling over and crawling, both very valuable milestones that impact preschool readiness.
When a baby does not practice lifting the head up every day during tummy time, neck strength will not develop as fast as the head grows. Tummy time should start Day #1 reclined on the parents chest.
When the Back To Sleep policy was adopted in 1992, it was intended for SLEEPING babies. AWAKE babies truly need the tummy position. Sleep position should be on back until approximately 6 months when the baby can change positions independently.
How Best to Do Tummy Time
Week 1 Position: Baby is inclined on the parent's chest.
Week 2-Week 8 Position: Flat on the belly attended by the caregiver at all times.
Schedule in TT at least 7 times a day for 15 sec to 1 minute each: after each diaper change, before each feeding, before or after each nap
It is common sense that babies will only tolerate tummy time for very short times in the beginning. Trying to leave a baby for a 15 minute interval will cause intense crying. They feel just like any adult would feel if someone told them to get down and do 50 pushups!
New parents need to know that babies who are always reclined in car seats or bouncers frequently develop misshapen skulls. Research says that almost 48% of babies develop a flat spot. This is not normal. Research now indicates that babies that get adequate Tummy Time are less likely to develop flat spots on the back of the head, or stiff necks that may require therapy or helmets. Prevention of these positioning problems is always better than trying to fix them later on.
We don't know exactly what bad things can develop from flat spots, but I have treated enough babies and preschoolers with both gross motor and cognitive delays related to early positioning that I can strongly say: Let's Stop the Flat Spots!
How to prevent?
Supervised Tummy Time regularly scheduled after every nap, diaper change, and before every feeding for 15 sec to 1 minute will help the baby gain head control.
What is head control?
Head control is the baby's ability to turn her head either direction to orient to a noisy toy or brightly colored stimulus
By 1 month when lying on her back
By 2 months when lying on her belly, weight on the elbows
This is hard work at first. Mom will see that the baby is trying, by watching her eyes move in the direction toward the noise. Some babies like soft musical toys, others like crackling cellophane. Some even like loud rattling toys. It is good to have the TV and radio off for this play time activity.
The eyes will want to be horizontal to the surface, so the baby will try to tip his head back. At first it is just good to have the chin off the mat and be able to lift and turn both directions.
A note of warning: Babies are people first. Tummy time should always be done in short bursts of time as the baby can tolerate. To leave a baby on the belly and expect him to lift his head for many minutes can cause a muscle strain in the neck that will require physical therapy immediately.
New parents also need to know that research indicates that babies with a strong preference to one side (have their head to one side) are more apt to develop a neck problem called torticollis or wry neck. This positional preference also can develop into a flat spot on the back of the head.
How: Optimal Positioning
1. If bottle feeding, switch sides each feeding.
2. Change the baby's position in the bed, top for naps and bottom for nighttime.
3. Change direction on the diaper changing table each change.
4. Limit sit/reclining equipment to transportation only times for the first few months. This eliminates gravity pulling the chin to the shoulder. Babies are best laid flat for at least the first 2 months.
And of course, if holding a baby upright against the shoulder, always support the head.
Please click the links below to download each PDF item:
- Baby Development Information Brochure
- Baby Development Information Brochure - Spanish (Desarrollo del bebe)
Pictorial Milestone Chart for Baby Development
Companion sheet for Road to Success CD
APTA Press Release on Tummy Time (TummyTime.pdf; 84kb)
Babyhood Road To Success.pdf (Babyhood-Road-To-Success.pdf; 1.5MB)
A Baby Developmental PDF demonstrating why and how a baby develops as they do normally. This is a PDF to teach parents the long term effects of early appropriate play with their baby.
Beverly Stokes. "Amazing Babies: Essential Movement for Your Baby in the First Year". Ontario. Move Alive Media. 2002
Roxanne Small, PT, "Building Babies Better, Developing a Solid Foundation for Your Child" Victoria, British Columbia, Canada, Trafford Publishing, 2005 ISBN 1-4120-6233-0
Baby with stuck neck muscles caused pain. -- Please fix my baby