Why Babies Need Tummy Time: A Guide for New Grandparents
Jennifer was born in 1980. Her daughter was born in 2008. Expert pediatric physical therapist Trevor Carlson explains why Jennifer's daughter needed more tummy time than she did. No, kids aren't born weaker than they used to be...
How Baby Sleep Practices Have Changed Since You Were a Parent
It's 1980. A baby is put down in its crib and left for the night.
Twenty-eight years later that baby has a baby of her own. Jennifer puts Emily in a crib and leaves the room.
What's the difference?
Sleep position. Before the 1990s, most parents put babies on their bellies to sleep. However, researchers started discovering that Sudden Infant Death Syndrome (SIDS) was reduced when babies were laid to sleep on their backs.
In 1994 the National Institute of Health and Development started the "Back to sleep" campaign to encourage parents to place babies on their backs when sleeping. Follow-up research has shown that from 1994 to 2008, SIDS was cut in half from 1.34 to 0.64 deaths per 1,000.
When Babies Need Tummy Time: Recognizing the Consequences of Back Sleeping
But as we follow Emily's story, we see some unintended consequences of this safer way to sleep.
At her four-month check-up, Emily's pediatrician noticed something peculiar. Her previously round, symmetrical head had an indentation. Jennifer touched the back of her head. No, the doctor said, it wasn't genetic. It was environmental. Every time she was placed in her crib or carrier, her head settled into this spot of comfort and familiarity. Over time the weight of her head against the surface shaped her soft skull.
"There's something else," the doctor said. "Emily should be trying to roll by now."
Jennifer remembered her mother telling her that she first rolled over when she was 3 months old. By contrast, Emily was content lying on her back and made little movement.
"To improve her flat spot and development, she needs at least 30 minutes of tummy time each day."
He put Emily on her tummy. She immediately started crying. Jennifer winced, then lurched forward and picked her up.
"She's going to have to get used to that position. It's not going to hurt her."
Why Modern Babies Need Daily Tummy Time: A Physical Therapist's Perspective
Emily's story is one I see very often in my practice as a pediatric physical therapist. Parents have gotten the message that they should put their babies to sleep on their backs. However, many parents do not give their child enough tummy time. Sometimes this is due to lack of understanding, and sometimes this is due to fear surrounding safety or the child's apparent discomfort.
When Jennifer was a baby, she got used to being on her tummy. Every time she adjusted her sleep position she used the muscles of her spine to lift her head slightly and turn it the other direction. To look at the things in her room required similar effort.
Emily got used to being on her back. When she adjusted her head, she easily turned it to either side without needing to lift it. She could see the things around her with little effort.
How Tummy Time Builds Strength Babies Need for Development
Jennifer got stronger using the muscles of her spine to lift her large head against the force of gravity. As this became easier, she lifted her head higher and learned to push up on her arms to lift her head higher still.
Emily didn't need to lift her head to turn it, so she didn't. In fact, she started moving her head less.
Out of habit, her parents always put her in the same position each night. In this position, Emily could see them come and go from her room if she turned her head to the right. Over time, she spent more and more time looking to the right. The pressure of her head against the mattress started to form a flat spot.
To turn her head to the left now required extra effort. Imagine a basketball with a flat spot. Once it settles onto the flat spot, it takes more effort to get the ball rolling. For Emily, the extra effort required to turn her head out of this flat spot wasn't worth the view of a blank wall.
Understanding Why Babies Need Tummy Time to Prevent Health Issues
This flat spot is called plagiocephaly. If the flat spot gets bad enough it will lead to changes in the skull that cause facial asymmetry and jaw alignment issues.
These issues did not affect Emily, but other symptoms were starting to show.
As Emily got used to looking right, she changed the way she used her hands. She saw her right hand more, so she used it more. She saw her left less, so she started using it less.
Babies should be symmetrical. Using one hand more than the other should not develop until at least three years of age.
There was one more thing that started happening. She started losing the ability to turn her head all the way to the left. It really is true: if you don't use it, you lose it.
How Much Tummy Time Do Babies Need for Healthy Development?
Thanks to physical therapy, and the hard work of Emily and her parents, she made a full recovery. She got the strengthening she needed to catch up with her development; she started using her left hand as much as her right; her flat spot disappeared; and she was able to look as far to the left as she could her right.
However, this extra work could have been avoided if only she had been given 30 minutes of tummy time each day, starting the first week she was born.
Bridging Generations: Supporting Parents with Current Baby Care Practices
Tummy time is just one example of how childcare practices have evolved since you were raising your children. As a grandparent, understanding these evidence-based changes helps you become a valued partner to parents. By staying up-to-date about current recommendations like babies’ need for tummy time, you can offer informed support to parents as they keep your grandchildren safe and healthy.
Dr. Trevor E. Carlson, PT, lives in Eureka, CA with his wife and three girls. He is the author of Tummy Time to Walking which helps parents and caregivers build lifelong success through infant movement. Learn more about Dr. Carlson and his book at www.tummytimetowalking.com.
Frequently Asked Questions About Babies and Tummy Time
When should babies start tummy time?
Babies should begin tummy time within the first week after birth. At first, just 1-2 minutes, 2-3 times per day. The duration can be increased as your grandchild becomes more comfortable with the position. Even newborns benefit from short periods of supervised tummy time when they're awake and alert.
How much tummy time do babies need each day?
By the time babies are 3-4 months old, they should get at least 30 minutes of tummy time daily. This doesn't have to happen all at once—it can be spread throughout the day in shorter sessions of 5-10 minutes. As babies grow stronger and more comfortable on their tummies, caregivers can gradually increase the time.
What if my grandchild cries during tummy time?
It's normal for babies to dislike tummy time at first, especially if they're not used to it. If your grandbaby cries, these approaches may help:
Get down on the floor at their eye level to interact with them
Place a mirror or colorful toy within their view
Roll up a small towel and place it under their chest for added support
Try tummy time on your chest while you're reclined
Keep sessions short but frequent until they build tolerance
Remind parents that persistence is key—most babies gradually accept tummy time as they get stronger and more comfortable in this position.
How can grandparents support tummy time?
As a grandparent, you can help make tummy time fun and engaging. Get down on the floor or ask parents if you can video chat* to interact with your grandchild during tummy time. Whether in person or via Facetime, you can sing songs, make funny faces, or read books. Always follow parents' guidelines and never leave a baby unattended during tummy time. Your support with this important activity is a wonderful way to bond with your grandchild while contributing to their healthy development.
*Due to the negative effects of screen time on babies' developing brains, the American Academy of Pediatrics recommends that children under the age of 18 months do not spend time looking at screens with the exception of time spent video chatting with family members. Some parents are more conservative and do not allow video chats. As always, respect parents’ decisions regarding their child.
Are there special toys that help with tummy time?
The best way to entertain your newborn grandbaby during tummy time is by getting on the floor and interacting with them. As babies get older, consider asking parents if they would appreciate tummy time toys for your grandchild. Look for tummy time-specific toys like water mats with floating objects, mirrors designed for floor play, or toys that encourage reaching. No matter what their age, interacting with them during tummy time should always be the first priority.
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