Tummy time

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The American Academy of Pediatrics' (AAP) 1994 recommendation that babies be put to sleep on their backs reduced the number of deaths from SIDS; however, it has also reduced the amount of time babies spend on their tummies, which can mean delays in the development of certain motor skills such as learning to push up, roll over, sit up, crawl, and pull to a stand. In addition, an average baby spends approximately 60 waking hours each week in a restrictive container such as a swing, bouncy seat or car seat, which further exacerbates these problems.

When your baby is on his tummy, he has to lift his head and push up on his arms to see anything (when he's on his back, he can see everything simply by turning his head from side to side), strengthening and developing important muscle groups. Spending time on his tummy also encourages your baby to practice reaching and pivoting - skills that are often the precursors to crawling - and promotes trunk stability, limb coordination, and head control.

Motor control develops in a cephalocaudal fashion - meaning a baby gains control of his head first, then his shoulders, then his abdomen, and so on down his body. Developing head control first allows a baby to visually explore his environment, and propping himself up on his arms helps develop the muscles necessary to get into a quadruped, or all-fours, position which is the first step in learning to crawl. It also helps him to develop the pelvic stability needed for standing and walking, and later running and climbing. 

According to the AAP, you can begin tummy time as soon as you bring your baby home from the hospital by playing and interacting with your baby on his or her tummy two to three times a day for short intervals. While his neck strength is still limited, he may enjoy lying on your chest so he can raise his head to see your face. As your baby becomes accustomed to the position and enjoys playing this way, and as his neck control and strength increases, you can increase the length of tummy time. By three or four months of age, your baby's neck should be strong enough for greater mobility and control.

Before the AAP recommendations, babies were usually put to sleep on their tummies and were much more familiar and comfortable in that position; but today's baby may find tummy time unfamiliar, awkward, and frightening. If your baby resists being placed on his tummy, try the following tips:
Join in the Fun
Get down on the floor with your baby and keep him company. Your baby has a limited view of the world when he's on his tummy - especially when he's younger and doesn't have the neck or arm strength needed to push up and look around. So join him on the floor and talk to him, shake his rattle, make funny faces, sing or play peek-a-boo. Try lying on your back and placing your baby on his tummy on your chest; he will lift his head and use his arms to try to see your face.

Entertain Your Baby
Place a mirror or an activity mat on the floor underneath your baby to provide some entertainment for him. The AAP also recommends placing toys in a circle around your baby so he has to reach in different directions to get at them or see them. This will help develop the muscles he needs to roll over, scoot, and crawl. Or have an older sibling or other child play with your baby while on his tummy (always supervised by you or another adult caregiver). Young children can get down on the floor easily, they usually have more energy to play with babies, and may enjoy their role as the big brother or sister.

Support Your Baby
Once your baby's neck is strong enough (around 3 or 4 months old), help your baby get a better view while he's on his tummy by propping him up with a rolled towel or receiving blanket placed under his chest with his arms out in front. This will help him get a better view while his arms are still not strong enough to prop himself up.
Timing is Everything
Make sure your baby isn't full, too hungry or tired when you try tummy time. When he gets upset, try to entertain him and see if he'll stay there a bit longer; but if he's really unhappy, pick him up and try again later. Your baby may only tolerate tummy time for a few minutes at a time until he gets used to it.
Tummy time is not only an important developmental opportunity for your baby, it's a great time for you two to bond and play together. Make a point to schedule some quality tummy time into every day.


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