The Truth About Tummy Time

by Anne Zachry, Ph.D

How often do you position your baby on her tummy for play? Tummy time is especially important now that that the American Academy of Pediatrics (AAP) recommends that all babies sleep on their backs. Prior to 1994, most babies in the United States slept on their stomachs, but years of scientific research revealed that infants were approximately 12 times more likely to be found on their stomachs than on their backs when they had died of Sudden Infant Death Syndrome (SIDS). So in 1992 the AAP formally recommended that all infants be placed to sleep on their backs or sides to reduce the risk of SIDS.
Later, the side position was eliminated from the recommendation because infants could roll from their sides to their stomachs during sleep. Since this extremely successful marketing campaign, 50% fewer infants have died from SIDS. Putting babies to sleep on their backs turned out to be a simple and effective way to save the lives of infants.

Eventually, pediatricians and therapists noticed a sudden rise in infants diagnosed with flat spots on the head, and they also noticed an increase in the number of infants with mild delays in gross motor skills, such as rolling over and pulling up. Evidently, many parents were not positioning their infants on the tummy for play out of a fear of SIDS, and this limited tummy time was having some negative consequences. In 1996, the AAP formally recommended that parents provide babies with supervised playtime on the stomach to promote growth and development and prevent flat spots from forming on the head.

How well does your infant tolerate tummy time? In our “back to sleep” world, many parents are distressed because their infants resist being positioned on the stomach for play. Parents are torn between what they “should” do and what their baby seems to “want” to do. The good news is that with a little time and some simple techniques, any infant can learn to tolerate and even enjoy tummy time.  

Here are a few tips on how to introduce tummy time and increase an infant’s tolerance to the position. 

  • Start tummy time early.  As soon as your pediatrician gives you the go ahead (which may even be while you are still in the hospital), start exposing your infant to small increments of tummy time. Even if you start for only 15 to 30 seconds each session, this will be helpful in strengthening baby’s neck and upper body muscles that are necessary to maintain the position. Gradually increase the time by 30 to 60 second increments and this will help your little one gain strength and motor control.
  • Be creative! You can position your infant tummy down on your chest, and this is a great way to sneak in a little tummy time while interacting with your baby because you are “face to face”. You can also carry your baby tummy down, and holding your infant in your lap stomach down is another nice position. Use your creativity to come up with fun and playful tummy time positions that your infant will enjoy.
  • Be safe.  Tummy time that does not take place in your arms, in your lap or on your chest, should always be carried out on a firm, stable surface with no soft pillows or plush toys nearby for safety purposes.
  • Remember, distraction is your friend.  Provide fun, developmentally appropriate activities such as musical toys, a child-safe mirror, singing, making silly faces, and any other entertaining options that will distract baby during tummy time. This will help you to gradually increase the amount of time each session so that your little one increases tolerance to the position.
  • Plan ahead. Only attempt tummy time when your baby is rested, comfortable, in good spirits and has not just eaten. Try to develop a regular schedule for tummy time, such as immediately after naps, diaper changes or bath time.

Most importantly, remember that tummy time should be a pleasant and positive experience. Hopefully with these suggestions, you and your little one will soon be having a wonderful experience with tummy time; and the best part is, all the while, your infant will be gaining increased strength and muscle control which will provide a solid foundation for future motor skill development.

[For more information on the importance and benefits of tummy time as well as the recommendations of the American Academy of Pediatrics, visit their website @]

Anne Zachry, Ph.D. is a pediatric occupational therapist with a PhD in Educational Psychology, with the research for her doctorate being related to tummy time and infant mobility. She's had articles published in her profession's trade magazines and in peer-reviewed journals.