From a pediatric physiotherapy perspective
From the moment you share the happy news that you’re expecting a baby, the people in your life will be quick to offer you their best advice—what works, what they did “back in their day,” etc.—leaving you with so much advice (good or wacky) that it’s sometimes hard to make sense of it all. A hot-button topic is whether or not you should place the baby on their stomach. Here are our recommendations on the subject.
Why the fear?
You might wonder where the fear of placing the baby on their stomach comes from. It could be because many people associate the prone position with sudden infant death syndrome (which is why back sleeping is now recommended for all babies). In fact, it is strongly recommended to put your baby to sleep on their back to reduce the risk of sudden death. However, you should know that when the baby is awake, there is no risk of sudden death. Therefore, there is no need to worry about tummy time while your baby is awake.
When to start?
The answer is: from the first few days after birth. Many parents already do this without realizing it when they place their newborn belly-down during skin-to-skin contact. This is a great way for the baby to explore this position comfortably. The longer the adult lies on their back with their baby belly-down on their chest, the more the baby will strengthen their neck muscles as they try to straighten their head to look at their parent.
Why focus on the tummy?
The prone position is essential for symmetrical and balanced motor development. This is the starting position from which the child will begin to move, first by rolling over, then by crawling, and then by walking on all fours. It’s the foundation for development from 6 months onwards. In fact, at about 6 months, once the baby can put their feet in their mouth and is able to turn over from back to belly, then motor development on their back is complete. If, up until that point, they have not gotten used to being on their stomach, then they will refuse the stomach position and risk delaying their motor development by staying on their back. Tummy time also helps develop neck and shoulder muscle strength in a way that no other position can. It also gives the child a different view of the world.
What if my child doesn’t like tummy time?
In the first 3 months of their life, the idea is to have your child explore the position as often as possible in short sessions, depending on their tolerance. The goal is to make the tummy position their preferred position by the time they are 6 months old. As soon as the child starts to whine or cry, you may change their position. This is their way of telling us that they’ve worked hard enough for the moment. Our job as parents will be to try the tummy position again 5 minutes later and to wait again until the child signals that they’ve had enough. The important thing is the accumulation of all the short tummy time sessions that the child experiences during the day. It’s better to aim for many short sessions than for a few long ones.
To help your baby enjoy tummy time more, it’s recommended to place them on their back first and then to turn them onto their stomach, always keeping their body against the surface that they are lying on. This is much more comfortable and safer than picking them up and placing them directly on their stomach with their body hanging in mid-air. You can also place a mirror in front of them—no baby can resist another baby’s face! If they are younger than 3 months, you may put toys of contrasting colours (black and white) in front of them. You can also lie in front of them at their level, bring their elbows in front of their shoulders, and hold them in place. This will allow them to raise their head a little higher.
After 3-4 months, you will notice that they will be able to tolerate and enjoy longer tummy time sessions (often about 5-10 minutes or more). It’s a small effort we have to make as parents, but it will definitely pay off later on when you can watch your little darling play quietly on their tummy, giving you the chance to finally tackle that huge load of laundry that’s been sitting in the dryer for days!
Article written by Janie Chrétien, physiotherapist and pediatric physiotherapy expert
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