Rachel Coberly, Child Development Specialist
I often hear from parents that their baby doesn't like tummy time or doesn't like it anymore. With parents encouraged to keep their little ones on their tummies 30 - 60 minutes throughout each day, this can feel very stressful. There are so many factors that may contribute to this, like physical discomfort (they are strengthening their muscles after all!), and even that the recommended sleeping position for infants is on their backs. In fact, since the inception of the Back to Sleep campaign in 1994, SIDS has decreased by 40% in the US. However, an unintended consequence is that infants nowadays miss daily opportunities to get used to time on their tummies and all those extra minutes each time they would have woken up still on their tummies. Obviously, we'll take a reduction in SIDS over more challenging tummy time routines any day, but it's helpful to have this in mind--especially when our own parents or grandparents say they didn't have this problem when they were a new parent.
Another factor I think worth diving into is understanding why the baby seems to get so frustrated, why as soon we start to transition them onto their tummy, they begin to fuss or cry or roll to their backs.
Again, there are lots of reasons for why our complicated tiny humans do what they do, but try this yourself or just imagine...
- Lay on the floor in a prone position (aka on your tummy) and scope out the world around you. You can keep your head turned to one side or prop yourself up on your elbows or hands... the view doesn't get much better.
- Now imagine items of interest to you just out of reach... very disappointing.
- So now let's say you got that favorite toy, but you're still stuck in prone until help arrives, and you’re barely able to play or explore... I'd be pretty fussy too!
Now, of course a newborn is not going through the same thought process that you just did, but it won't take long before they do! As a developmental specialist, I am constantly curiously looking at the whole child, including all areas of development. Additionally, I find that trying to see the world from their point of view goes a long way in understanding, empathizing, and responding to them effectively... oh, and to alleviate our own stress!
Even if we are focusing on just one area, like their gross motor skills, primarily when thinking about tummy time, it's imperative to take into account where they are and what they are needing in relation to their fine motor, social, communication, self-help, and especially in this scenario, their cognitive skills.
We know that babies’ brains develop at a rapid pace, literally doubling in size by the time they turn one. Around three months old, they can watch our faces intently, follow moving objects, recognize familiar objects and people, and even enjoy playing with people. They may also cry when it stops. By about six months, they may start to respond to their own name, distinguish emotions by tone of voice, find a partially hidden object, and work to get objects that are out of reach. Interestingly, even though we see that cognitively babies can identify what they want around them by this time, we don't actually expect an infant to have the gross and fine motor skills to be successful in getting to those objects or moving into a position that makes exploring them enjoyable.
When working with parents, I like to demonstrate this by pointing out the ways that their baby is becoming more inquisitive and interested in what is going on around them and how they are able to focus on people and objects in their environment. Also, we notice that they are even able to reach and grasp and explore using their hands and mouths. When on their tummies, their world view is limited and exploring toys is more limited, but when they are on their backs or we assist them in a sitting position, babies often calm down quickly.
The good news is that when they are finally able to move around on their bellies to get to what they want, usually the fussing decreases and they want to stay in tummy time longer. Nevertheless, I often find that babies become happiest when they can "put it all together." By this I mean that a baby can lay on their tummy, see something they want, maneuver or crawl to get to it, push themselves up into sitting independently, and play with it. Next steps would include being able to transition from sitting to tummy again and then start the flow over. Another variation may mean that they roll themselves over to their back to play rather than moving into sitting. Yet another example would be that they could move themselves to a nearby loved one to be picked up, or even start to climb onto them. Regardless, they have newfound freedom, and their cognitive abilities are no longer being hindered significantly by their physical abilities.
This is a lot to accomplish, however, and until they are capable and coordinated, tummy time may not be their favorite routine. Moreover, I like to think about the fact that they are advancing cognitively, and now we get to help them and wait for their gross motor skills catch up.
So, what can you do to help?
- Keep them entertained and distracted to increase the amount of time they are able to tolerate on their tummies. Ideas:
- Lay on the floor with them. If this is not possible, cautiously* provide tummy time in an elevated location, like on a bed or tabletop with blankets... somewhere where you can get closer to being face-to-face with them. *Safety first! Keep one hand on your little one at all times and remember that even if they are not able to roll or move around much yet, it's likely to happen when you aren't expecting it!
- Use a mirror for them to look at when playing. I like to have one that is big enough for them to see their face (and yours) easily and that I can move around - like to place upright to encourage them to keep their head up longer (and to use upright even higher when we are practicing sitting to encourage them to keep their head and back up longer.)
- Place toys all around them, not just directly in front - I prefer toys with different textures, crinkle toys, toys that are easy to grab like ring toys, cause and effect toys, books, and even real-life photos. (Infants enjoy looking at real images! You can use either those you have or photos you cut from magazines (just watch them from going into the mouth - you can even consider laminating them and round the corners)
- Make the environment more visually motivating by using a solid colored surface to make the toys pop. Infant's eyes are still developing, and they may not be able to distinguish a colorful toy on a busy surface. Also, high contrast toys are easiest for newborns to see and track - hence why you find stores selling those simple black and white patterned toys and books.
- Change up their surface
- On your tummy or chest with you leaned or laid back (great for newborns!)
- On your lap
- On the floor, tummy time mat, or yoga mat with blankets
- Cautiously* on a more cushioned surface like on cushions/pillows on the floor, a mattress, or a couch (*Safety first! Keep one hand on your little one at all times and remember that even if they are not able to roll or move around yet, it's likely to happen when you aren't expecting it!)
- Change up their vantage points by propping them up on an incline using a rolled towel or blanket or a firm pillow like a nursing pillow. Try to position this under their chest where they can either bear weight onto their elbows or hands in front of or directly onto the roll/pillow.
- Limit or avoid devices that hold your baby in a position they can't hold on their own yet (i.e. jumpers, walkers, exersaucers)
- Guided gross motor strategies - this includes physically helping them into a supported position or transition we would expect them to do on their own one day, creating motor memory and strengthening. (Come to my Floor Time Strategies for Babies class or sign up for an at-home private session!)