Since the American Academy of Pediatrics (AAP) began recommending that babies be put "back to sleep" more than a decade ago, the incidence of sudden infant death syndrome has dropped drastically, but more infants are developing flat spots on the back of their skull, a condition called positional plagiocephaly. What's more, always lying belly up can delay motor development, because a baby gets less of a chance to work the muscles in his upper body. Lack of tummy time can not only affect how long it takes for your little one to master such basic skills as lifting his head and turning over, it may also have an impact on physical milestones like sitting, crawling, and walking.
Tummy time should start when your baby is a newborn, according to the AAP. Start by placing her belly-down on your chest or across your lap for a few minutes at a time so she gets accustomed to the position. Just don't do it right after a feeding—pressure on her full abdomen may cause her to spit up—ideally you want to do tummy-time activities when she's most awake and alert, such as after a diaper change or nap.
In the beginning, newborn tummy time should consist of two to three 3-minute sessions daily. As he gets older and stronger, gradually increase the length of time, working up to a total of 20 minutes a day.
By about 4 months, your baby should be able to lift his chest off the floor and lean on his elbows with his head upright. He may even be able to lift his arms off the floor, arch his back, and kick his feet. As your baby stretches and pushes on the floor, he may accidentally lean to one side, fall over, and roll from his belly onto his back. Don't worry; that's normal. At 5 or 6 months, he will begin to pivot on his belly and use his arms to reach in front of him or to the sides.
When your baby learns to make his body do new things, he feels a sense of accomplishment. This gives him the confidence to try new skills as he grows and his coordination improves.
Some babies hate doing pint-size push-ups and will initially protest when they're placed facedown. "While on his belly, a baby has to work extra hard against gravity to keep his head up—it's strenuous," explains Henry Shapiro, M.D., medical director of developmental and behavioral pediatrics at All Children's Hospital, in St. Petersburg, Florida.
Try to keep him on the floor for three minutes but if he refuses, just do it for a minute or two and continue increasing and encouraging his tummy time slowly. Eventually your baby will get used to being on his stomach and start to enjoy this daily routine. "Make tummy time part of regular play, not a chore," Dr. Shapiro suggests.
The more fun you make the experience—with plenty of face-to-face eye contact and tummy-time toys—the less your baby will fight being on her belly. Try the following:
- Recline on your back with Baby on your stomach, her head facing yours, then talk to her. She will try to lift up her head to see your face.
- Lay your little one down on a flat, clean surface, such as a blanket or playmat on the floor. If she squirms or cries, roll up a small receiving blanket and tuck it under her chest for extra padding.
- Lie down on the floor with your baby and make goofy noises and expressions, or sing songs to her. You might feel silly, but she'll be distracted from her tough workout.
- Place your brightly colored stuffed animals around your baby on the floor and help her reach for and play with them. Or hold a mirror in front of Baby to capture her attention.
When playing with your child in this position, make sure he is on a low, solid surface, so he doesn't risk rolling off of a couch or bed. Putting Baby on the floor on top of a blanket is the best bet for your child's safety. Also, if you have other children or pets, make sure your littlest one is safely out of their (and harm's) way.
Never leave an infant unattended on his belly as he could get into a position that is dangerous and suffocate. If your baby gets drowsy or falls asleep while on his tummy, switch him to his back for a nap. You should never let him sleep on his stomach because this could put him at risk of dying of SIDS.