Tummy Time Advice

Hi L. - here is a link with photos/tips for tummy time for newborns (holding/soothing tactics that help promote tummy time)
http://pathwaysawareness.org/?q=node/329

I'm working with Pathways to help put together a video that shows these "moves" which should be on the site in the next few months. Hope this is helpful!

I read a lot of the responses. I am an Infant/Toddler Specialist and yes tummy time is very important and on the other hand I would not force it. I read one response by increasing the minutes a little everyday and I agree with that but you don't want the baby to hate it because they are being forced and also try a boppy pillow that helps the baby to sit up a little bit more because a lot of times being flat on their tummies is uncomfortable and the boppy pillow will prop him up and putting those favorite toys in front of him will help also. Hope everything works out well.

My doc told me little sweetie had to do tummy time whether she wanted to or not, so I did everthing. One of the best items was this soft flat cuddly hippo that I laid on the floor and she lay on top of it. she really liked it. I did let her cry and she got used to it and I think because of all the work, she started to crawl at 5 months. Once she got used to it, she liked it but it took some fortitude as she didn't like it at first.

L., I haven't read any of the other responses. But here is my personal experience. Our son was 8 weeks premature and then had open heart surgery at 3 months old for a congenital heart defect. Needless to say his upper torso muscles were very delayed and tummy time was a moot point until he was 9 months old. When we finally did start, he did the exact same thing and I finally broke down and put him in front of baby einstein videos for 20 minutes at a time. This helped dramatically and he would be distracted enough to not cry. After a week or so, he got stronger so I could lay down on the floor with him at times and play with him on his belly and not just use the videos. Sometimes you have to just break down and use the technology out there.
BTW, he is now 27 months old - completely caught up with all of his skills and doesn't like watching TV for more than 5 minutes! :) No harm done

My son (now 2 1/2 years old), hated tummy time and I could not get him to stay on his tummy for even 1-2 minutes. What I did is put him on the bed (you MUST be there at all times) and pushed him to the edge where he could look over the edge. You can show the child things or maybe the child will just be happy looking over the edge (mine was happy just to look over the edge). You have to be right there to make sure they don't roll off. My son didn't move at all, but you still have to watch as they can roll in one second. [So basically put them towards the middle of the bed so if they roll from side to side it won't matter and then push them to the edge - they will still have plenty of bed on either side]. This is what worked for my son as he was bored on tummy time no matter what we did. As long as you are there to make sure they are safe on the bed, or even have one hand on the child if you are worried- then it should be ok. Try it, and see if it works. If you are worried that your child might roll off the bed, have both parents there. All I can say is this worked for me and you know how your child reacts. If your child rolls too much this will not work, but mine was so happy to see the world from the edge that he stayed there and I could show him toys or talk to him or what ever. Or play peak a boo. What ever. You know your child better than me to know if this would work for you and if you would be comfortable doing it. Or maybe you could find something that is a little high up and create a small ledge for the child to look over. It is up to you, but this worked for me, just make sure you watch your child at all times. I never had a problem with mine rolling off or anything, but do what you are comfortable with. Hope this advice helps.

I tried a rolled baby blanket or towel under the arms to help my daughter get propped up once she had some arm strength. I agree with the previous advice to try your son on the boppy. Sometimes it just helps to get their face out of the floor. My daughter had some head flattening and one of the suggestions I got was to carry her sidelying - facing away from me, head by my elbow, my hand between the legs, my forearm along her belly, with the flat side of the head on top (i.e. not touching my arm). Really do try to get your son on his belly as much as possible! Good luck!

I have a great suggestion. If someone else already suggested it then it will just be another to back it up.:) When you carry your baby in a carrier it is like tummy time, because they have to hold their heads up and strengthen their neck and back and arms. (I have read articles about this). The great thing about it, is that they love to be close to you, and then you do not have to feel like you are forcing something unpleasant. I have four children and mine were always a lot happier in a carrier. The cool thing about this is that you can work on "tummy time" as you go about your day, and then still have times that you put him down on a blanket for some actual tummy time. I really hope that you can benefit from my suggestion. It should make you and your baby much happier!

I agree with your doctor for the most part and hesitate to suggest something different, yet I would give more tummy time after you pick up and calm. The prescription is 1/2 waking hours on tummy, right? Side-lying when you think he has just had enough. If your son gets upset before you are able to pick up, ok--just pick up so that he gets the comfort of you and knows you are there when he gets frustrated. At this developmental age there really is not "tough love" per say. Babies cry and that is all right. However, if you can offer them some support and encouragement, why not? Support in my terms means pick up when cry, and encouragement meaning put back on tummy and smile at him and say encouraging words, make it fun, put toys right there in front of him (bright objects, black and whites).

At this age, I don't agree with just letting him stick it out and cry. In my humble opinion you are just trading in his low tone in his neck concerns for other concerns that leaving him to cry it out might cause---much of these concerns are unknown due to an inability to measure them...

Really, just do what you think is best and take out of my opinion what you think is worthwhile for you and yours

Best of luck

Hi L.-

I am a pediatric certified occupational therapy assistant, and agree with everything Jackie H wrote. I would not recommend "forcing" tummy time. If he lasts 5 minutes without crying, do 5 minutes. Just do it more often. And it doesn't have to be done all on his tummy on his floor. If you are on the floor on your back, put him on your tummy/chest, as another poster mentioned. That way, he's getting tummy time, but it's in the comfort of you. I have some great handouts on tummy time -- if you are interested, email me, and I can email them to you (____@____.com)

Also, keep in mind that at 6 weeks premature, your son's adjusted age is 3 1/2 months. That is important to remember when talking about his development.

A previous poster recommended the Bumbo seat. I would like to say that I do not recommend this at all, especially at 3 1/2 months adjusted age. You mentioned your son has low tone in his neck and shoulders, so I would guess there are some tone issues throughout his body. The Bumbo seats place children in positions they are not developmentally ready for. The way the child is placed in it, they are working muscles that are not the muscles that are really used for sitting, so it's not actually helping the child learn to sit. Many children like sitting up because it gives a new perspective on the world. But once they learn that view, they are not always interested in getting back on the floor, making tummy time that much harder.

Good luck!

My son too hated tummy time. Our ped gave us really great advice, alot of it has been posted from the other ladies.
If it's 3 min or 5 minutes he can only tolerate then thats fine, just do it throughout the day. Make it as fun as possible, play with him, sing songs, toys etc.
At one point my lil guy was getting bored , so the pediatrician actually told me that why don't I use the baby einstein dvd's that I had.
I had asked her about what age they can watch tv and told me to hold off. Well at that time she said it was ok to put it on here and there for a few minutes to see if it helped.
I don't know how you feel about this as alot of moms refuse to put a tv on for their little ones, but our ped said a few minutes will not harm a child.
Anyways we had a few appropriate educational dvds we had and used those( baby einstein etc) I have to say he loved it, he would work his neck muscles cuz he would have to look up at the tv and was so intrigued that if i used the dvd every other day ( i would mix it up with toys etc) I noticed that he would be so into the colors and shapes he would tolerate being on his tummy for a longer time.
It doesn't hurt to try... Good luck.

I am an occupational therapist who has worked with children for 10 years and the mother of two boys and let me tell you I can't stress enough the importance of tummy time. It helps strengthen back and neck muscles which is a pre-requisite for sitting and walking, and also, believe it or not, helps with vision as well. The stronger the neck muscles, the more stable the head is, the easier it is for the eyes to do their job. It is also SO important for kids to push through their arms to strengthen their arms not only for crawling but also to help the proper hand muscles develop for future use for writing, buttoning, cutting, etc. The more you can do to help him while he is younger, the less trouble he will have in his future. But you also have to take into condsideration his emotional state, too. It would be VERY reasonable to start at 5-ish minutes of tummy time and then work up from there...you will find the more time that he spends on his tummy, the more comfortable he will be...it would probably help to sing songs, find toys that encourage him to spend time on his tummy, and try to distract him as long as possible when he is on his tummy...I bet the time he tolerates it will increase pretty quickly. He may just have weak muscles and it is very tiring for him to be on his tummy for too long..just like if you just started weight training you wouldn't start at 50lbs. for the first time...you might work your way up to that after a period of time. Good luck..hope that helps!

My triplets were preemies as well and in the beginning we had issues with low tone and torticollis (sp?). NICU recommended that we contact Early Intervention, which we did and at about 6 months, they were in at home physical therapy which helped tremendously. That would be my first suggestion. The second is to keep trying the tummy time. We found a few tummy time toys at Babies R US that helped keep their interests - Infantino & Fisher Price have great toys for this. If your child starts to cry, then pick him up for a little bit and then start again a little later. It doesn't have to be and shouldn't be negative experience for him or for you. Eventually he'll beging to tolerate longer lengths of time. Remember if he's 5 months know, his adjusted age is 6 weeks less than that so you have to adjust your goals a little bit. My trio were born at 32 weeks so in the beginning, if they were 6 months they were really 4 months. We were always having to adjust their milestones until they caught up (at 18 months).

As for the tough love or crying it out - it just wasn't for us. Excessive crying leads to lowered oxygen levels in infants and especially preemies so I wouldn't recommend that route for you and your child.

We loved our Physical Therapist so if that's the route you want to go, contact me privately and I'll send you her information.

My twins went through this around 4 months - DD loved tummy time, DS always rolled to his back. My solution was to literally get down on the floor with him on my tummy, face to face, and play with him to keep him occupied. Peek-a-boo worked wonders and also I'd lay out some of his favorite books on the floor right in front of his face. Also, their activity play mat has ribbon-tabs and colorful pictures to look at, so I would try to put him on his tummy on the mat.

I would fret and worry about this too, then all of a sudden you'll realize your son is always on his tummy and will forget how to roll back! Good luck!

Hi L.,

My son hated it at first too and would cry when we put him on the floor for tummy time. When I brought it up with my doctor she said "well I don't really like exercise either but I do it" - lol. That put it in perspective for me as it is hard work for them. I put my son down as often as I could and would leave him until he got really upset then we would do some tummy time on me or his dad. He progressed quickly to the point where he actually started enjoying it and the time lengthened. Hang in there - it is really important for them.

Good luck,
H.

my first daughet didn't have the same issues but also hated tummy time and would cry at less than five minutes. then we found some great tummy time toys that in no time changed that. the best being a water mat that had little toys floating in it and rattles and a horn to reach for. after we had the right equipment tummy time was not a struggle any more. the mat was from target there are probably a ton of them out there at any baby store. good luck!

L.,
I was taking care of a little boy who was a month premature and the doctors told his parents that he needed more time on his tummy; The back of his head was getting flat from always being either laying down or sitting up. I would lay down next to him and rub his back when he was on his tummy and he was fine. I would help him by propping him up on a pillow that came with this little pad they used and get him interested in a rattle that was attached. He would be distracted by the rattle or me talking to him and he never got upset at all. I got him started by laying him down across my lap to burp him for a few minutes and then we worked our way up to the mat time. Unfortunately I ended up having to quit because I gave his parents a break and only charged them $5 a hr while driving a 1/2 hr each way and ended up helping with cleaning, laundry and taking care of their two dogs and they refused to give me a raise and acted like I was ripping them off for charging them $5 to begin with. It broke my heart because I miss the baby and feel bad because the poor dogs were crated all the time but felt like they did not apprieciate all that I was doing. I even sent his mom pictures via my cell phone every day so she could see how well he was doing. I hope this helps you some. I would also sing to him if he started to get upset.
M. K

My daughter got a lot of tummy time in the early months by lying on my chest when I was reclining. She was premature and has Down's Syndrome, but has developed good back and neck strength.

This might be a kind of tummy time your son might tolerate since he gets to be close to you. He will also have an incentive to raise his head to look at your face, which will strengthen the neck muscles.

If he needs to work up to 1/2 waking time, then let him. Do tummy time 6 times a day for 5 minutes. That's a 1/2 hour. Then make it 7 minutes. Use a timer or watch for fussiness. He will get stronger and be able to make that goal. Good luck.

My second daughter was a little behind in holding up her head and raising on her arms. When I told my doctor that she didn't like tummy time, she cried after a few minutes, she told me let her cry, she needs at least 10 minutes. So I would try once a hour for 10 minutes. It wasn't pleasant but after a week or two, she would start to enjoy tummy time and she had her head control. I would let him cry a few minutes at least to get in that tummy time. I wouldn't let him have a complete meltdown though.

Hi there, we had a very similar experience with our son. He was born 5 1/2 weeks early, and at his 4 month appt we were told the same thing about his head, needing more tummy time, and not yet at the point where he needed a helmet but something that should be monitored. He also cried like we were torturing him if we put him on his tummy for more than about a minute.

Not sure about how other mommies have handled this, but I just wasn't into the notion of making him so miserable. We did continue trying the tummy time and giving him lots of encouragement, but it never got anywhere close to the point where he would spend half of his day on his tummy. So we bought a jumperoo (we got the Fischer-Price Rainforest Jumparoo). When he was sitting in that, it relieved pressure that would have been on the back of his head from laying in a bouncy seat or on the floor on his back.

My doctor cautioned us against over-using the jumparoo so that his tummy/core would have a chance to develop properly. But that worked for us, and he's almost 2 and doing great!!

Our boy hated tummy time on the floor so we spent tons of time together in the La-Z-Boy.

Do you have a recliner? If so, put him on your chest and recline back. That automatically puts him in a 'tummy time' position. He'll have the comfort of physical bonding and he has a goal of looking at the person who brings him the most comfort and confidence - you!

Make silly faces, play peek-a-boo, put a toy or a burp cloth on your head, hold up a mirror, do anything to command his attention. There were days that I'd just plop him on my chest for 30-60 minutes at a time, just playing and being goofy with him. We eventually graduated to the floor where he and I would both be on our tummy playing with each other.

You're the mom, you do what you think is best. If you can handle the crying, do it. I know that I couldn't. Maybe use toys to keep him on his belly? He will get used to it, either way. None of my boys really liked being on their bellies much until after they were 6 months old.

I suggest calling early intervention and getting a therapist to ases him and get him some OT therapy will really help and especailly being a preemie with low muscle tone tehre is more than this that they will help with!
good luck
J.

Always respond to your child's cries! Fussing is fine, but getting him right before the meltdown is sooooo important. That means he feels you understand him, and that he can rely on you.

Follow the exercises given to you by the PT and doc.

Tough love comes later in life, not for an infant; you are still building up trust;)

I would like to give you some long term advice based on our experience. My grandson was born at 26 weeks. My daughter had been given the steroid shots to help his lungs when they realized a c-section was imminent. Unfortunately, our daughter passed away when he was 14 months old. He was raised partially by us during his early years and follow-up nursery said he was doing fine. We wound up adopting him and raising him. He is now 18. At age 10, he was complaining a lot about back pain. We saw an orthopedic guy who diagnosed spina bifida occulta, in which one vertabrae was affected. we were told he would be in pain the rest of his life and there was nothing to be done. When he was 16, we contacted a specialist at Children's because migraines were added to the backaches. He prescribed physical and occupational therapies where we found that his upper body had not grown properly and he was not even breathing properly due to the immature lungs he was born with! The therapeis have done wonders for him. He has even grown a little, breathes easier, has less backpain and migraines disappeared. When asking therapist why, they stated no one checked on these things along the way. Yet, simple tests like xrays and blood tests were used to make the diagnosis. I understand your present problem, but could not resist warning you to watch for problems as the child grows. In five years, things will be different. My gs had the best of medical care in his early years and we cannot figure out why they did not look for these things, exepting that maybe then they did not realize these problems could exisit. Outside of that, he has been a very normal, highly intelligent kid. Good luck.

You not alone. Some times babies don't like this due to minor misaligments of the bones in the upper neck. If this is the case, he is uncomfortable and correcting this will make your little man much more pleased with tummy time. Feel free to call the office ###-###-#### or find another pediatric chiropractor near you by looking at www.icpa4kids.org.
In Health,
Dr. J.

hi L.. i didn't check to see what others have said though i'm sure you've gotten lots of advice. here's mine:

i'd let him cry for a minute to start and make sure you're trying to distract him the whole time--show him how fun it is to be on his tummy... mirrors, toys, tickling, books, break it all out. our doctor said that it's the getting mad that builds strength because he'll start to lift his head and push up. soon enough, though, he'll understand that being on his tummy equals pushing up to all fours and moving, which is really the best part!

but let him cry for a minute--set a timer if you need to b/c a minute can seem like a LONG time w/ a crying baby!--and then make it a little longer every day. soon he'll get that it's fun and be able to pull himself around with his arms and really love it!

good luck and be strong! you're doing a great job!

Just keep trying. You can also have him lie on your stomach and you can interact with him. He may stay there for a little longer. I feel that those 5 minute sessions throughout the day add up. I wouldn't get him so upset that tummy time is a chore for both of you. They have tummy time mats at Baby's R'Us that seemed to work for us. Good luck.

I agree with Stacey that having him do his tummy time on your abdomen or chest while playing with you may help make it a more enjoyable time for both of you.

L.,
Our daughter had tummy time issues too, which we found out might have been caused from acid reflux. Because of the lack of tummy time she was diagnosed with low tone at 10 months which is when we started PT (and now at 18 months we are still going). The best suggestion I can give, is get your son on his belly on an incline to help ease the gravity issue (his head should be higher then his feet). My husband built a small padded "ramp" for our daughter.
Make sure to stay on top of things, making sure your son knows how to roll and eventually sit, crawl, etc. If you want another opinion, ask your dr for an RX for physical therapy and you can have your son evaluated through early intervention or privately.

L.,

I did not have the same issues with my son as you are having with yours, but I can say that my son also hated tummy time. I think it's normal for babies to hate it, since when they're on their backs they can see so much more than if their head is facing the boring old floor. But their anger is actually what helps them strengthen their arms and neck muscles. They hate being on their tummy so much, they strain to push themselves up, and this is how they develop. It's tough to see and hear them crying knowing that you can do something about it, but it's to their benefit if you let them struggle. If he starts fussing after 5 minutes, let him struggle for 5 more (total of ten minutes) and then pick him up. Cuddle with him to calm him down, do some side-time, then try the tummy time again. Maybe try to help him work his tummy time up a minute or two a day. You should see the improvement in his strength (and ideally the shape of his head) in a relatively short period of time.
Good luck!

~P.

Dear L.,

I just wrote a long post about head flatness to another poster today. If you look for it you will find it. Flat spots on the head (plagiacephaly) and a tilted head/tight neck muscles (torticollis) are extremely common in children who have been in the nicu. The nurses are all trained to do things the same way, the majority of people are right handed, so the babies get put down on the same side, diapers changed on the same side, etc., and then all of a sudden they have flat spots on their heads. I would recommend the bumbo chair, you can get it at Target for about $30. It is a molded rubber thing that lets babies who can't sit up yet sit up. There is nothing touching baby's head, which is good. Please read my other post for lots of other ideas for getting pressure off baby's head. Sorry -- not much about tummy time though!

L.,
We tried tummy time with our baby. Lay your baby on your stomach and try it for as long as he allows. We don't do it as much as we should, but she responds well to it as long as she doesn't have to keep doing it for a long period of time. A few minutes a day at most, is all that worked for us.
Thanks,
S.

I'm a bit concerned that some of the advice out there is to take a "tough love" approach and knowingly allow your son to suffer for five minutes. Being angry makes him strong?!?! It also makes him angry! Try tummy time on top of you - I bet your son would love to lay on your chest while you smooch him. Also, I don't see much advice here on how baby-wearing can help with spine development. There are so many benefits to wearing your baby in a sling. If you wear your baby chest against chest in a ring sling for example, he will be exercising his spine and neck by making constant little adjustments. When babies lay cradles in a car seat carrier or bouncy seat, their backs are curved and they have no opportunity to arch their backs. In a ring sling, your son will be against your chest, feeling your heartbeat, breathing rhythm and the warmth and smell of your skin. He will be upright, giving him a different and more interesting perspective of the world. And most of all, like I mentioned before, he will not be cradled in such a way that he won't be able to arch his back - he will be able to strengthen his spine by having the flexible supportive freedom to move his spine and neck. So, my advice is to do some research of baby-wearing.