by Eliana Cutler, Hand to Hold’s Occupational Therapy Intern, occupational therapy student and doctoral candidate at Midwestern University’s College of Health Sciences.
Tummy time is a great way to interact with your baby while helping them improve strength, mobility, and also preventing flattening of the head. How do you participate in tummy time with your NICU baby and why is it important?
What is tummy time?
Tummy time is when an awake infant lies on their stomach and plays with toys, themselves or a caregiver. It is the main form of physical activity recommended for infants zero to six months of age, by the World Health Organization and the American Academy of Pediatrics.
Why is tummy time important?
Having tummy time each day with your child benefits your child’s fine motor, gross motor, problem-solving and socio-emotional development. Research from the American Academy of Pediatrics (2020) found that tummy time:
- Strengthens the head, neck and upper body muscles
- Improves ability to reach
- Improves head control
- Prevents flattening of the head
- Improves ability to move arms in different positions (e.g., bringing hands to mouth)
- Improves ability to move legs in different positions (e.g., kicking)
- Improves ability to roll
- Improves ability to crawl
- Develops ability to turn head and look when being talked to
- Reduces Body Mass Index (BMI)
Ideas for participating in tummy time
Tummy time should be fun! Here are just a few ways you can participate in tummy time with your baby.
- Lay your baby on their stomach on a baby blanket
- Incorporate blankets with various colors and textures to engage baby’s interest
- Lie on your stomach next to or facing your baby and sing, make funny faces, or play music
- Place a mirror in your baby’s line of sight to distract them and let them see different facial expressions
- Place padding or a rolled up towel under your baby’s chest area and armpits to help ease the strain on their muscles and make it easier for them to push through their arms to hold their body up
- Move rattles or puppets around in front of your baby to encourage them to look at the toys as you move them and help your baby practice following objects with their eyes
- Practice holding and grasping items to help them start to develop control of their hands. Eventually, they learn how to pick up items by curling the top of their fingers in a raking motion to bring an item closer.
How long should tummy time be?
The American Academy of Pediatrics recommends 3 to 5 minutes, two or three times a day, gradually increasing as your baby enjoys the activity. While there is no concrete rule of thumb for how long tummy time should be, try to aim for 10 minutes a day for each month’s adjusted age. For example, a baby who is two months adjusted should have approximately 20 minutes of tummy time a day.
Keep in mind that tummy time is a real workout for your baby’s muscles, so it is important not to overdo it! Look for cues that your baby is ready to stop, like crying or resting their head on the floor.
When should you do tummy time?
Have tummy time when your child is alert and awake after a nap. If your baby is crying or resting their head on the floor, they may be trying to tell you that they are tired. In that case, end tummy time and try again later.
Since tummy time is considered any time your baby is on their stomach, you can even start in the NICU during kangaroo care as your baby lies on your chest. Once you are at home, tummy time can be done at natural points throughout your day. This can be as simple as having your child lay on your chest as you lie or sit, or lying your baby on their stomach after a diaper change or bath time.
Tummy time is hard work for your baby’s muscles, so incorporating toys or games into the activity can help distract or entertain them, just like you may listen to music when you work out. If your child is not interested in playing with toys yet, that’s okay! You can try to get at your baby’s eye level and make funny faces or give them a mirror to look at themselves. Eventually you can move to toys with flashing lights or sounds to make tummy time more fun.
Here are great resources to check out about tummy time:
Tummy Time Tip Sheet – American Occupational Therapy Association
Download the Hand to Hold app, a safe and inviting place to connect with Hand to Hold’s NICU Parent Support Team and other NICU parents to find support whenever and wherever you need it. Learn more.