Early Childhood Development and Tummy Time
About a month ago, I reprimanded a baby in my local community. Her mother said she wasn’t doing tummy time because she cried the whole time. My first instinct was to get on the ground, look at the 6 week old baby in her car seat, shake my finger at her and say in my best “teacher voice,” “You need to do tummy time! If you don’t you won’t grow big strong muscles you need to be successful later!” Luckily her mom responded with interest and questions about why I responded so strongly rather than picking up her child and running away. Why is tummy time so important? Recent trends show a strong correlation between an increase in early motor delays and the decrease in the amount of time children spend in the prone position (on their tummies). The decrease in tummy time is linked to many factors including recommendations from the American Association of Pediatrics to put babies to sleep on their backs and the increased use of “containers”– car seats, bouncy chairs, Bumpo seats, baby carriers, swings, and wraps. Both of these trends have led to an increase in the amount of time babies spend on their backs and decrease the time engaged in active play and exploration necessary to build strong muscles and integrated sensory systems.
There is a clear linear pathway for motor development. The age old saying you have to crawl before you can walk is true. Each previous developmental milestone lays the ground work and preps the muscles and sensory systems for the next stage. If a child doesn’t get enough time in any one stage or skips a step, the system doesn’t develop properly, though it may not be noticeable until the child starts school and has to begin sitting at a desk and holding a pencil. Checklists of motor and sensory developmental milestones and videos can be found at https://pathways.org/milestones/.
Tummy time is a vital first step to development of the core extensor muscles of the trunk and neck and provides opportunity for exploration to guide the development of sensory systems. The extensor muscles are what will eventually allow the child to hold his head up and stand and walk upright. Inner hand muscles necessary for grasping writing utensils are developed as the baby begins to push up on the surface. Eye coordination develops as the baby moves his/her head to track objects in the environment and obtain preferred objects with his/her hands.
How we process the information we take in from the environment is a complex process that is impacted by every experience from the day we are born. During tummy time, the child is able to explore various textures with his hands and feel the surface she is laying on throughout her body to develop the tactile system. In prone, a baby gets feedback through the hands, feet, legs, arms, and ribs via the proprioceptive system which begins to develop body awareness. Placed on the stomach, a baby’s head is initially pointed down and he/she has to work against gravity to pick it up. This effort not only develops the muscles of the neck and back, but also provides information to develop the vestibular sense and tolerance for movement. The visual and auditory senses are also strengthened through tummy time as the baby explores his/her environment in new ways. Lack of exposure to various stimuli in early development can lead to dysfunction later, such as hypersensitivity, poor coordination, or other sensory dysfunctions.
The American Association of Pediatrics (AAP) recommends starting a tummy time routine the day the baby comes home for 3-5 minutes at a time. By age 3 months, a baby should be engaging in an hour total each day of tummy time (several sessions of 5 minutes or so at a time) Even if it is a challenge at first, be comforting and persistent. Let a baby lie on your chest or lap on their tummy to get used to the experience.
Tips for Tummy Time activities can be found on links below.