Playing With Baby: Tummy Time
Playing is serious business. It's how your little one gears up for all those milestones you're waiting to chronicle in your baby book: rolling over, sitting up, and more. It gives him the tools he needs to make cognitive leaps too. "When a baby explores the world around him, he learns how things work, which is the foundation for the development of language as well as the understanding of math and science," says speech-language pathologist Rebecca Landa, Ph.D., director of the Center for Autism and Related Disorders at Kennedy Krieger Institute, in Baltimore. "He discovers how high he can stack blocks before they topple, how much pressure he has to put on something to make it move, and how that pressure relates to the size and weight of an object." When babies don't hit their milestones on time, physical or occupational therapists use early-intervention exercises to help them catch up. These little games can also help a child who's developing normally. "Babies who get these kinds of enrichment activities with caregivers tend to have more advanced motor, communication, and social skills," says Dr. Landa. This is how to help your baby make the most of his precious playtime.
Let him grab. While your infant is on his back, dangle toys of different shapes in front of him to see if he can grasp them and bring them to his mouth. At first, he'll probably just swat them. Move a toy higher, lower, and to the side. "Offer your baby a variety of kinds of objects so he learns how to approach them with his hand in the right position," says Dr. Landa. "Lying there, looking at a rattle, assessing the shape and figuring out how to put his fingers around it, grasp it, and bring it to his mouth may sound like a mundane thing, but it's a great accomplishment for a baby." Eventually he'll use these same skills to take books off a shelf.
Get down. Make sure your infant hangs out on her belly every day while she's awake -- even if she complains. "The reason a baby fusses on her tummy is because her muscles are weak," explains Dr. Landa. She needs tummy time to practice holding her head up, getting up on her elbows, and balancing on one elbow while she grabs a toy. Playing with toys while having to support her body weight with her arms requires different muscles and skills than playing with toys when she's on her back and reaching out into open air.
Stretch out. Starting at about 3 months, put your baby on his back, gently take his ankles in your hands, bend his knees, and then stretch his legs toward you to increase his flexibility and help him get a sense of where his legs are in space. You can make it more fun by saying "in" and "out," singing "Row, Row, Row Your Boat," and kissing his feet. As he gets stronger, he'll start pushing his legs out on his own.
Play ball. By 6 months, your baby should be able to sit on an inflatable exercise ball if you hold her securely on her hips. Tilt the ball slowly so that she has time to realize what's happening and shift her weight. This will strengthen her core muscles and help her improve her balance. As she gets stronger, you can move the ball a little faster and tilt her farther. Make it fun by bouncing her gently and singing rhymes. "If you do it on a regular basis using the same words, your baby will start to understand them," says Dr. Landa. "The rhythm of the music helps babies remember words."
Give him new things. While your baby is sitting up, either supported or on his own, hand him objects of different weights and shapes so he can learn to use his muscles to hold them. That child's ability to pick up toys, look at them, put them in his mouth, pass them from hand to hand, rotate them to get a different view, and bang them helps him learn enough about objects to eventually attach words to them.
Bring out the blocks. Babies who play with blocks not only have stronger fine motor skills but more advanced language, according to research by pediatrician Dimitri Christakis, M.D., director of the Center for Child Health, Behavior, and Development at Seattle Children's Research Institute. The physical act of playing with the blocks isn't as important as the conversations that occur as your baby is sorting and stacking and you're creating things together and explaining what they are, says Dr. Christakis.
Play it forward. Encourage your baby to belly crawl. Some babies skip this step and begin crawling on their hands and knees without their belly touching the floor. Either way, it helps a baby develop strength in the hips and trunk, which is necessary for standing, as well as in the muscles of the shoulder girdle, which will help her handwriting in the future, says Gay L. Girolami, Ph.D., clinical associate professor of physical therapy at University of Illinois at Chicago. Once your baby can get up on her hands and knees, place toys in front of her so that she has to support herself with one hand while she reaches for them. Then move the toys out to 11, 10, and then 9 o'clock. Do it on the other side too. "As your child reaches in different directions, she'll learn to shift her weight more to her shoulders and legs," explains Dr. Girolami. Soon she'll take off!
Reach for new heights. Put toys slightly out of reach -- on a sofa cushion on the floor, for example -- to encourage your baby to explore upward from a crawling position, suggests Dr. Girolami. You can gradually place objects even higher (on a low bookshelf or a sofa with the seat cushion removed).
Set up an obstacle course. Challenge your little one by blocking his path with a cushion, suggests Dr. Girolami. At first, he may scoot around it. Then set up a row of pillows so that he has to climb over them.
Help her squat. Once your baby can stand, place a small box about 8 inches away from her when she's at a coffee table or a sofa. Put a toy on the box and she'll have to squat to pick it up. After she's mastered that, place the toy on the floor. You can also move the box farther away from the sofa so that she'll have to turn and squat to reach the object. Do it in both directions and move the box farther and farther out, until she's turning 90 degrees. "This will encourage her to go from shuffling sideways along a sofa to walking forward," says Dr. Girolami.
Push off. Once your child can squat, stand, and cruise, he's probably ready to push one of those little toy shopping carts so he can practice walking independently. Dr. Girolami recommends weighing it down with a 5-pound bag of flour placed in a bag, so it doesn't go too fast.
Dealing with delays
There's a wide range of normal when it comes to motor milestones, and experts worry most about kids who have multiple delays. Missing a single motor milestone may simply mean that a child hasn't had a lot of experience with that particular skill.
Motor delays are especially worrisome for babies who have relatives with autism. "Other problems may develop later, like communication and social delays," says Dr. Landa. According to her research, 6-month-olds at high risk for autism often flop their head back when being pulled up to sit -- and babies who did this were more likely to eventually be diagnosed with autism or a social or communication delay.
4-6 months Roll from tummy to back
5-6 months Roll from back to tummy
6-7 months Sit independently
By 8 months Transition out of sitting; push up on hands and knees
By 9 months Belly crawling or crawling on hands and knees with belly off the floor
10-12 months Pull to a stand
12-15 months Walk
The sooner delays are identified, the easier they are to correct. If your child's skills aren't following this timeline, bring it up with your pediatrician.
Toys that teach
It may seem like toys with flashing lights and fun sounds have the most to offer babies, but the opposite is true, says Dr. Landa. "Adults are the ones who think those kinds of toys are cool," she explains. "When a baby puts blocks into a container, she creates the 'clunk' sound, she sees them fall. And that's great. She doesn't need the container to light up too." For some kids, those extras are distracting; children focus more on the cause and effect than learning to play with the toy.
You also don't have to spend a fortune on toys, says Parents advisor Jenn Berman, Psy.D., author of Superbaby: 12 Ways to Give Your Child a Head Start in the First 3 Years. Bubbles, for example, are inexpensive and excellent for encouraging eye tracking and coordination, and as your child gets older she can reach for them, chase after them, and start blowing them too. Some other objects Dr. Berman recommends:
6 months Soft balls, crinkle toys, stuffed toys, plush trucks
9 months Stacking toys, sorting toys, nesting toys, toy food, Giant Lego Bricks, bounce toys, baby dolls, fabric tunnels a baby can crawl through that fold up like an accordion
12 months Blocks, puppets, large wooden peg puzzles, wagons, music toys, finger-paint, nontoxic crayons, toy kitchens, and dolls with clothes that can be changed
Originally published in the July 2013 issue of Parents magazine.
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