By Dr Jane Williams 

There has recently been a spate of online blogs and articles espousing that babies do not need tummy time for healthy development and that they will ‘find their own way to their tummy’ naturally over time if left lying on their backs. While I totally agree with ‘natural’ development, I am very surprised that lying on the tummy is considered an ‘unnatural’ position. What baby in the animal kingdom lies on its back as the natural position? None. It’s not a position from which babies can move, plus it leaves them vulnerable to attack. Fortunately, human babies don’t have to worry about being attacked, but there are some concerns about reduced movement opportunities if too much time is spent lying on the back.  

While I also agree with the authors that many babies are restricted in their movement because of the containers most babies spend a great deal of time in – swaddling, carriers, bouncers, prams etc. rather than spending time being able to move freely on their backs, I suggest that this makes tummy time even more important in the first months of life.  

One article actually equates tummy time being so bad for baby that it’s like they have been anaesthetised in their muscles and are totally helpless! Claims like this are very concerning as there is NO scientific basis to this whatsoever. Babies’ muscles are in perfectly good condition, and they are certainly not anaesthetised… in fact, when lying on tummy, these muscles are activated so they develop strength and are able to support a baby’s head. Like all the muscles of a newborn baby’s body, these back and shoulder muscles need to learn to feel what it’s like to move and to develop strength.  

Why am I so concerned about babies missing out on essential tummy time? 

1. Tummy time is important for movement. The activation of the primitive reflexes that help babies move forward (commando crawl) is only possible when babies are on their tummies. They can dig their feet into the floor and push off, and reach forward with those arms (now strong from lying on the tummy and pushing up) to pull. There will be many babies who miss entirely the potential of commando creeping as the reflex is most strongly activated in the first 4 -5 months of life. Many back-lying babies will not have rolled over until well after this time. This means babies have reduced opportunities to crawl, and this impacts on how foundational wiring in the brain is established. These early patterns of movement actually play a very important role in later development.  
2. Tummy time helps a baby develop strength, naturally. Turning the head from side to side and lifting the head for short periods, gradually increases muscle strength and head control. Pushing up on the arms develops strength in the upper body and enables babies to control reach and improve hand-eye coordination skills. Being able to push feet against the mat develops strength in the muscles of the legs and feet.   
3. Babies who do not become mobile by 6 – 7 months are far more likely to be propped to sit by their parents as they become concerned by their baby’s lack of mobility. Propping a baby to sit reduces opportunities to crawl and move. In desperation, babies bottom shuffle along instead of crawl. The brain is evolutionarily set up to respond to certain movement experiences and crawling is one of those. Specific patterns of movement wire of the brain for later learning success.  There’s a heap of research that confirms the essential importance of movement to learning in the first years of life. Interestingly, a very large UK study of 62,000 children from birth to school-aged reported that babies who were crawling at 9 months of age are more likely to learn easily at school.  
4. Research 1 shows that infants who spent more time on their tummies, had higher scores on developmental tests than children who lay on their backs or watched screens.  

Your baby not enjoying tummy time?  

There will always be some babies that do not seem to like time on their tummies. But this has nothing to do with anaesthetised muscles, in fact, the reason is exactly the opposite. These babies are often uncomfortable, and may even feel pain due to an unnatural resistance from the muscles in the neck and shoulders. This resistance is usually a result of the birth process. Babies born premature or via a difficult, long labour, a very quick labour or a caesarian section (where babies are often pulled out by the head – the exact opposite movement of being pushed through the birth canal) are at greater risk of not enjoying tummy time. But rather than avoid tummy time, it’s time to see a well-trained paediatric physiotherapist or osteopath. They can help reduce the tension on these muscles through very gentle massage. At GymbaROO – KindyROO we have seen many, many babies over the years shift from disliking tummy time, to loving tummy time, just after one or two visits to the appropriate professional and with tummy time practise.  

Encouraging tummy time: 

As early as possible, lie baby on her tummy for several short periods of time each day to familiarise him/her with the position and then extend tummy time as they get stronger. Find ways to encourage them to lift their head and look up: 

• Lie baby on your chest so she can look at your face 
• Lie baby across your legs and stroke down his back; 
• Lie on the floor with her, sing songs and talk to him  
• Place a toy or mirror in front of her 
• Place a small rolled-up towel under her chest and arms to provide support  

So, there’s no question about it. Tummy time is natural, it’s important and it’s something every baby should do every day, right from birth.   

Dr Jane Williams is the Research and Education Director for Toddler Kindy GymbaROO -KindyROO   

 

1. Carson, V., et al., Longitudinal associations between infant movement behaviours and development. International Journal of Behavioral Nutrition & Physical Activity, 2022. 19(1): p. 1-15.