Tummy Time Do’s and Don’ts for Newborns

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Introduction

Many first time parents or even parents with children may be concerned with sudden infant death syndrome (SIDS).

The annual number of SIDS cases has dropped since the American Academy of Pediatrics’ (AAP’s ) 1992 campaign to encourage parents to put babies to sleep on their backs, according to the CDC.

Benefits

However, this has lead to many babies spending a lot of time on their backs instead of their stomachs for “tummy time”. Lack of tummy time may be associated with delayed development including motor skills (crawling, rolling over), sensory systems, and meeting milestones.

Also, due to the increased time on their backs (and backs of their heads), baby’s can develop “flat spots” on the back of their head, also known as positional plagiocephaly.

Furthermore, tummy time can help to strengthen the neck, shoulder, back, and upper body muscles. Therefore, tummy time is an important activity that parents should engage their babies in frequently. Parents (even dad) can even start tummy time with newborns.

Here are some Do’s and Don’ts for Tummy Time for Newborns.

Precautions

• Consult with your health provider before beginning tummy time, especially if there may have been any complications in labor or birth. Otherwise, tummy time is generally considered to be fine for newborns.
• Be sure the baby is alert (awake) and not very drowsy.
• Always supervise babies when they are on their tummy.

Do’s

• Begin early.
  If parents are hesitant to place newborns on surfaces, they can promote tummy time “belly to belly” with the parent. The parent can recline on a couch, chair, or even lie flat on a bed (preferably skin to skin) with baby belly to belly.
• Follow a parental habit leading up to a family routine.
  Frequency is better than duration, especially with younger little ones. Although newborns are thought to not follow any routine such as for sleep, it’s not so much a routine (babies are kind of random) as a habit for the parents. This can be after the baby is done feeding after a burp, after a diaper change, or when the baby has that curious awake stare.
• Pay attention to the baby’s airway (breathing).
  This one is kind of obvious but some surfaces or materials can make tummy time riskier. Flatter and firmer surfaces work better. As always, keep plastic bags and similar hazards away from the baby. Your baby’s chin should always be positioned in front of the support/bolster so that the airway is not blocked.
• Position baby properly.
  Their chest is supported on a support/bolster, the neck is up (or has to room to go) in air, left and right sides of the body are equally distributed in weight – especially the arms. Be sure their arm is not “stuck” or caught under them and at risk for pulling on their shoulders.
• Dress baby appropriately.
  We like onesies and bodysuits. Keep in mind that the baby’s body makes contact with the surface and can cause friction when rubbing and moving. This is not so much a concern if you are doing “skin to skin” with the baby as it is with the baby on another surface.
• Promote vision and perception.
  Newborns have immature vision are continuing to develop their visual abilities (color, textures, distance, etc). The use of high contrast toys and bright colors will help this development.
• Promote facial recognition.
  Get down low or close to baby at eye level for the baby to recognize mom and dad.
• Consider props for positioning and comfort.
  With the use of pillows (e.g., boppy pillows are popular). Also, a towel rolled up like the letter “C” can be used in a pinch.
• Dress baby appropriately.
  Not too cold or not too warm. A baby that is too hot will be flushed at the ears and sweating at the neck. If you have a hardwood, marble, or similar type of floor and consider putting a towel down.
• Do file or trim baby’s nails.
  So you don’t get scratched. We like using a glass nail file for newborns that is gentler and less abrasive to the skin.
• Do incorporate the vestibular system (rocking, vibrations).
  Using an exercise ball, put the baby on while firmly supported with both hands. Rock baby back and forth, side to side, or use light jiggle bounces. Start slow. Babies often like these movements as they mimic the womb (or a nice car ride) similar to how the 4Moms MamaRoo Swing and Rocker works.
• Engage baby.
  With sights of your face, sounds of your voice, and touch to comfort baby. Sing, coo, that kind of thing. Involve the whole family!
• Continue to use “containers” and “constraints” as needed.
  Baby gear such as swings, bouncers, and other baby gear can be very useful. They have their place in helping parents while they do other things but save time for tummy time outside of these devices.

Don’ts

• Don’t forget to clean up first.
  Have a clean environment – vacuum, sweep, clean up the tummy time area before you begin.
• Don’t continue if baby becomes increasingly frustrated.
  Tummy time should be a therapeutic and enjoyable experience for the baby (and parents!)
• Don’t do it if baby is hungry (or too full).
  Baby will be happier doing tummy time after they are fed and had a chance to digest.
• Don’t forget to burp baby first.
  Or you’ll end up with a mess on you or the floor.
• Don’t expect all babies to be “pros” in the beginning.
  Some babies will like tummy time more than others. Gradually introduce tummy time (short times such a 1 minute) and increase gradually as babies tolerate this more.
• Don’t let your guard down.
  Pets, objects that could fall, electrical cords are things you should be aware of in the environment. Don’t step too far from the baby during tummy time and you should be within arms reach. Don’t leave the room or turn your back. Don’t leave the baby to get a delivery package. That kind of thing.
• Don’t stress about the time they can tolerate the activity.
  Start with several minutes working up to an hour daily.

Additional Information

Occupational therapists can work with newborns and their families to promote their participation in everyday activities (occupations). Tummy time is one such activity. Occupational therapists can work with parents to develop an individualized program to meet the family’s specific needs and address their concerns. Ask your pediatrician or school administrator for a recommendation, or look online to find an occupational therapist in your area.