Allyson Wessells, PT, IBCLC
What are motor milestones?
How does an infant move?
Infants move spontaneously, reflexively and voluntarily. Spontaneous movements observed in newborns may consist of an arm gracefully moving up while a leg fluidly moves down, all driven by primitive messages in the brain and gone by around 4 months of age. Reflexive movements are automatic responses to the environment such as baby’s hand tightly grasping one’s finger, and baby’s mouth rooting toward a breast. Many reflexes present at birth are gone by around 6 months of age as more voluntary movement emerges. Voluntary movement is purposeful and enhanced through experience.
Why is tummy time important?
Part of the experience necessary to optimize development of voluntary movement is time spent lying on stomach. In this position, babies begin pushing upward from a firm surface to develop head and jaw strength for more voluntary feeding by 6-8 weeks; along with trunk and hip strength for eventual rolling, sitting and crawling by 6-9 months.
As with any position, it is not something to be forced, but rather something to be gently encouraged with sequential holding, lying on back, rolling to side and then onto stomach, reversing out when baby shows signs of being ready. A parent, sibling, or friend down on the floor along with baby is most engaging and developmentally stimulating not just for general strength, but for emotional connection and regulation. Amidst feeding, sleeping, changing, and adjusting to the demands of parenthood, tummy time should be fun!
While lying on tummy is a biologically natural position from which to grow and stretch from a curled up in utero position, there is research to support its significance. Studies show that nearly 90 minutes of tummy time throughout a day correlates with greater success acquiring motor milestones at 4 months of age. Additional studies suggest that tummy time can help improve breastfeeding and breastfeeding, in turn, helps optimize motor development and so much more. This evidence, along with prevalence of container positioning and back to sleep recommendations, underscores the importance of making sure babies get natural time on their tummies!
How can it be a natural part of the day in the middle of busy, new life?
A typical day in a newborn’s life hopefully consists of responsive feeding, sleeping, being held or worn, and freely moving on tummy at least 3-5 times throughout each day for up to 90 minutes by around 2 months. The myriad of containers available can be convenient, but must be used with understanding that more than a couple hours in them each day can create developmental challenges. Parents are often heard saying “my baby doesn’t like tummy time.” Easing baby into this position rather than placing them directly onto tummy and abruptly picking up from tummy is helpful. Talk to and really look at each other when down on tummies and make sure an equal amount of time is spent with head turned in both directions to avoid neck tightness or head flattening into one direction. Whether for 30 seconds or 30 minutes, any time is beneficial and grows with experience. A good time is after eating as the firm abdominal pressure can actually help with digestion. Engage siblings, grandparents, friends to do the same. It really can make a difference in how a baby develops, feeds and regulates emotions. In short, tummy time can save time for good development throughout life!
As a physical therapist and lactation consultant in Columbus, Ohio, with Nurture Columbus, Allyson Wessells considers breastfeeding a milestone like any other for which quick care is needed when challenges arise. She provides in home consultations as well as TummyTime!TMMethod classes to empower families and help all babies reach their full potential.
Resources and References:
Tegan, G, et al (2017). Breastfeeding and Motor Development: A Longitudinal Cohort Study. Human Movement Science, Volume 51. pp. 9-16. doi: 10.1016/j.humov.2016.10.001
Wen, L, et al (2011) Effectiveness of an Early Intervention on Infant Feeding Practices and “Tummy Time,” A Randomized Controlled Trial. Archives of Pediatric Adolescent Medicine.165(8):701-707. doi:10.1001/archpediatrics.2011.115
Dudek-Shriber, Linda EdD, OTR/L et al. The Effects of Prone Positioning on the Quality and Acquisition of Developmental Milestones in Four-Month-Old Infants Pediatric Physical Therapy: Spring 2007 – Volume 19 – Issue 1 – pp 48-55 doi: 10.1097/01
Pin, T., Eldridge, B. and Galea, M. P. (2007), A review of the effects of sleep position, play position, and equipment use on motor development in infants. Developmental Medicine & Child Neurology, 49: 858–867. doi:10.1111/j.1469-8749.2007.00858.x