For long time I’ve been driving down the importance of Tummy Time to countless parents who have come to the clinic seeking help for conditions like gross motor delay(missed/late crawling, sitting, standing), torticollis (neck tilt) and light and shabby handwriting. This past March, I saw a child 8 months of age brought to clinic with parents citing concerns of sleeping for long hours, getting tired easily and not rolling yet. When I went through a detailed history, it was understood that the child A was born preterm at 34weeks with birth weight of 1.5kgs. Being low birth weight, parents didn’t put the child on tummy or play activities in his initial months with worry of causing harm. This concern can be faced by many parents and early intervention is the need of hour in these scenarios.
Let’s look back a little and discuss why Early intervention and Tummy time is so important for your child’s development. All through gestation (pregnancy time) foetus as it grows in mother’s womb curls up in flexion for want of space. As a result, babies are born in relative flexion and stay that way for 4 weeks, till gravity acts on them and all the random movements in first month of age, gets them to straighten gradually from 2nd month onwards. Tummy Time facilitates extension which helps the babies to come out of the flexed fetal position. Every newborn, when placed on her mother’s abdomen, soon after birth, has the ability to find her mother’s breast all on her own and to decide when to take the first breastfeed. This is called the ‘Breast Crawl’. It was first described in 1987 at the Karolinska Institute in Sweden (Widström et al, 1987).
This is the best time to start introducing Tummy Time!
From my experience, a baby right from newborn does not tend to mind being face down while against mom or dad’s chest. Start with few seconds e.g. 15 seconds such that baby doesn’t cry and slowly increase to 30minutes as baby gets older. So lay back, and enjoy these cuddles with your baby, it’s the starting place for building your baby’s endurance in Tummy Time.
As advancement, try placing your child on a soft blanket on the mat or over your knees.
Cultivating the habit of Tummy Time is best when done as part of routine like after a shower, diaper change, active play time with baby. These frequent, short intervals of Tummy Time build endurance and strength without too much resistance from your baby and you’ll soon notice your baby is beginning to lift their head a little by 2 months of age to look around.
By 3 months of age, your baby will be a lot of active with more wakeful hours. This is a great time to get your baby a ‘Baby Gym’ as is popularly called. It has colourful patterns, textured soft surface and sensory toys hanging over and around them. Playing with your baby is best at baby’s eye level. So make it funny and get down on the floor to engage with your child. You will realise the baby is starting to sing to you in her own language. The Tummy Time will also do wonders for your sore back from work! Get eye to eye, sing a song, plant a few kisses, rattle a gentle toy, push /pull a toy. Essentially as per age of baby, anything that diverts them for few minutes off the hard work performed! And please, let them hassle a little before you pounce on your urge to move them. Ensure you ROLL them over, don’t pick them up. Let them learn that rolling will get them out of Tummy Time. Once settled, gradually as your baby gets comfortable you can roll them back to their tummy and do another few minutes.
Important tip is: Don’t carry your baby all the time when you are home. Let the baby play on mat and explore the environment around.
So back to why is Tummy Time so necessary?
It helps to:
• strengthen neck and back muscles thus preventing positional torticollis, plagiocephaly and delays in development
• strengthen shoulder and hand muscles aiding better grip and handwriting
• promote visual development
• promotes crawling which builds a very strong foundation for upper body strength, abdominal-gluteal strength and eye hand and eye foot coordination thus overall improving muscle tone
• promote digestion (helps babies to push out gas, making them less crankier)
Zoom forward to baby A, at discharge at 13 months of age, he was way more active, sleeping lesser hours than before, picked up on crucial milestones of crawling, pull to stand, standing independently and parents were ecstatic when he took those much awaited first steps.
Written by: Shivangi Trivedi, (Registered Physiotherapist, Specialized Pediatric Training)
MATRIX PHYSIOTHERAPY TORONTO