If there's a baby in your care who simply can’t bear tummy time, then read on. Although we all know it’s an important part of supporting development, the truth is that lots of babies just don’t want anything to do with being on their tummy.

Why is tummy time such a big issue?

We really don’t know why some babies don’t like being on their tummy.

But it could be because:
  1. Young babies don’t have good head control until they’re a couple of months old. Lying on their tummy may be genuinely uncomfortable for a baby who doesn’t have the muscle strength to move into another position.
  2. It’s common for babies to “face plant” onto the floor when they don’t have enough head control to keep their head upright. Try doing this once or twice yourself and you’ll understand why it’s not something you’ll want to repeat!
  3. When lying on their tummy, babies can’t see much. Little people are hard wired to seek stimulation and if the only thing they can see is the mat they’re lying on, then boredom may be an issue.
Why is tummy time such a “thing”

In years gone by most babies slept on their tummy. Even in maternity hospitals, the recommendation from health professionals was to settle babies on their front with their head to one side. But research into Sudden Infant Death Syndrome, now known by its correct title of Sudden Unexplained Death in Infancy (SUDI), has formed some very clear recommendations about safe sleeping positions. Tummy sleeping is a risk factor for SUDI and back sleeping has been proven to be the safest sleeping position for young babies.

When babies slept on their tummy they had enough exposure to tummy time and didn’t need as much opportunity to practice – they were getting it anyway. But back sleeping recommendations have meant that babies don’t get as much time overall on their tummy.

Can I just forget about tummy time?

For the sake of peace you’re probably tempted to, but evidence has shown that it’s worth persevering. The benefits of tummy time are so clear that even though a baby may protest, it’s still worth encouraging them.

Babies will build their upper body strength through lots of practice being on their front. Keep tummy time to short sessions while they are still learning what it’s all about. Don’t expect them to lie on the floor and be happy for long periods of time. In the early stages, just a couple of minutes at a time is enough.

Just remember

With time and practice a baby’s tolerance for being on their tummy will increase. They’ll become stronger and more able to control their body movements. Like any form of exercise, practice makes perfect.

Does it really matter if a baby doesn’t have tummy time?

Babies who mostly lie on their back can develop a flat head - the official name for this is positional plagiocephaly. Because a baby’s skull bones are soft, the weight and pressure of their head on the same areas can cause flattening. Plagiocephaly doesn’t affect brain growth or development but it can be unsightly and limit a baby’s head movements because they tend to “default” to the same position every time they are placed on their back.

Plagiocephaly can also lead to a shortening of a baby’s neck muscles on one side because of limited side to side head movement.

How much tummy time do babies REALLY need?

From birth, babies benefit from having some tummy time every day. When they are awake and being supervised is ideal. Experiment with different times of the day to see what a baby prefers. Try to avoid periods when they are hungry, tired or cranky. Ideally, tummy time is fun.

Top tips for tummy time success
  • Be sensitive to a baby’s cues when they’re having tummy time. They’ll let you know when they want to be picked up, or are happy to keep going.
  • Feel confident that you’re doing the right thing. Although a baby may seem to know what they want, you know what they need and tummy time is a good habit.
  • Offer a baby tummy time after their bath when they’re lying on a towel or change mat.
  • The early morning is often a good time for babies to be at their most alert and happy.
  • Give the baby a back and head massage when they’re having tummy time.
  • Talk gently to the baby when they’re on their tummy so they feel safe and secure.
  • Place some bright toys around so the baby can focus on them.
  • Hold the baby so they’re lying across your lap. Keep at least one hand on them so they’re safe.
  • Make sure the baby is dressed in comfortable clothing so their movements aren’t restricted.
  • Position a pillow on the floor so the baby can lie semi-upright. Then they won’t have to lift their head so high to look outwards.
  • Lie on the floor on your own tummy and place your baby in front of you. If they can see your face they’ll feel more secure.
  • Hold the baby so they’re facing outwards. This will help to build their upper body strength, head control and will prevent pressure on their head.
  • Don’t leave a baby lying in their pram for too long. If they’re too young to roll over and reposition themselves they’re likely to become uncomfortable.
References

http://raisingchildren.net.au/articles/sudden_unexpected_death_in_infancy_(sudi),_sids_and_fatal_sleep_accidents.html

http://www.rch.org.au/kidsinfo/fact_sheets/plagiocephaly_misshapen_head

https://rednose.com.au

This article was written for Sleep Smart by Jane Barry, midwife and child health nurse.

For more information on Babies and Sleep, please refer to our Guide to Settlings Infants course. This course also comes as part of our convenient 3-course Infant Bundle.