The American Academy of Pediatrics (AAP) recommends that babies sleep on their backs instead of their tummies to help prevent Sudden Infant Death Syndrome (SIDS). In 1992, the Back to Sleep campaign was initiated and funded by the US National Institute of Child Health Development (NICHD), whose primary purpose was to educate parents about the dangers of SIDS. Since the program launched, the incidents of SIDS declined by more than 50 percent.
Today, the campaign is called Safe to Sleep and is celebrating 20 years of educating parents and caregivers about how to provide their baby a safe sleep environment. Because of the recommendation by so many pediatricians for babies to sleep on their back, it is now important for infants to have some time spent on their tummies to help strengthen and develop their core muscles.
Why playtime on the tummy is beneficial
Tummy time helps in the process of developing the baby’s skull correctly by providing an alternate position. Babies spend most of their day on their backs in car seats and cribs, which can lead to developing plagiocephaly (flattened head from positioning). Tummy time helps a baby develop control of his or her head and helps the body prepare for rolling, crawling and pulling up.
Sanjie Garza-Cox, MD, Mednax Neonatology at The Children’s Hospital of San Antonio recommends, “Infants should begin by spending a few awake moments on his or her tummy on mother’s lap. Then progress as tolerated to a total of 30-minutes per day by the time they are 4-months old. As the baby continues to develop, he or she should continue to spend tummy time for longer periods of time while the parent plays with the child.”
The benefits of infant tummy time will help in the following ways:
- Strengthening and developing muscles needed for crawling.
- Learning fine motor skills by engaging with toys.
- Developing coordination.
The best tummy positions for mom and baby
Babies don’t always like being on their tummy and may fuss. If this is the case, make sure your infant is comfortable, but try to avoid placing your baby on his or her tummy after eating to avoid spitting up and other discomforts.
The best practices include the following the three easy steps:
- Eye level — Be on the floor with your baby at their eye level so they can see you and hear you.
- Engagement — Have soft toys nearby your baby can reach for to increase strength in the shoulders and neck area. Play mats and activity centers are available at all major retailers.
- Entertainment — Interact with your baby by singing or softly clapping and make tummy time an enjoyable experience.
“Think of tummy time as baby’s first exercise, any amount is better than none,” advises Dionne Franco, M.D., a pediatrician at Northeast Pediatrics in San Antonio. “A baby should spend at least five supervised minutes on their tummy, three times a day, but every little bit helps.”
Tummy Time Alternatives
“Babies with G-tubes or belly surgery will have to be cleared by their doctor prior to spending time on their tummy. Once cleared, usual careful supervised tummy time can resume. Occasionally, tummy time has to be limited to the parents’ lap or chest until the area of concern has healed,” said Dr. Garza-Cox.
Another alternative to tummy time is to consider babywearing, where the parent or caregiver uses a wrap, sling or other soft-structured carriers to provide comfortable support for the baby. A carrier will enable an infant to sit up, which will engage the core muscles and aid in head and neck development. It will also help to alleviate any flat spot on the baby’s head.
Securing your baby’s sleep environment
Whether your baby’s crib is in your room or their own room, the crib mattress sheet should fit securely and there should not be any bumper coverings that could hinder breathing. Car seats are recommended while in a vehicle, but they should never be used inside the crib. Finally, bed-sharing can lead to a baby being smothered and should be avoided.
Rule of thumb
SIDS continues to be a major concern for infants through 6-months of age. “Remember, back to sleep, tummy to play. While tummy time is great for baby’s strength building when awake, the only safe sleeping position is for a baby to be face up,” recommends Dr. Franco.
Tip: Inform all parents and caregivers about the benefits of tummy time and the correct sleeping position for nap and bed times.
Dr. Garza-Cox advises, “It is recommended for the baby to be supervised at all times, but specifically when doing tummy time. When a baby is facing down, the breathing pipe is located underneath the esophagus. If the infant throws up, it would be very difficult for the baby to clear his or her airway. In addition, infants have a high risk of suffocation when lying on their tummy as their neck and back muscles are not strong enough to keep them from burying their face in bedding. Placing babies on their backs to sleep has reduced Sudden Infant Death Syndrome. Always, back to sleep, tummy to play.”
Rebecca Asher is a freelance writer for various media outlets and co-author of The Conflicted American. Her essay, Take a Breath is published in the soon-to-be released Eat Pray Love Made Me Do It anthology by Elizabeth Gilbert also next spring. Rebecca is a mother of two small girls, Sara (3) and Charley (18 months) and currently lives in San Antonio.