Tummy Time: A Crucial Practice for Developmental Milestone Development

From the time a baby is born, and enters a world ruled by gravity, they begin an incredible journey of growth and development. Parents and caregivers play a significant role in facilitating achievement of developmental milestones, and one of the most vital early activities to promote development of motor milestones is tummy time.

Tummy time is exactly what it sounds like: the practice of placing an infant on their stomach while they are awake and supervised. This simple yet essential activity has profound implications for a baby’s physical, motor, and cognitive development. The recommendation is 1 hour per month of age during awake supervised time. For example, a four month baby should be spending at least four hours per day on their belly during awake play time.

Building Core Strength and Promoting Visual Development

When a baby lies on their stomach, they use their neck and upper body muscles to lift their head and look around to interact with parents and observe their environment. This effort helps to build neck and core strength, as well as shoulder and arm strength, which are crucial for both visual development and the development of gross motor milestones like rolling over, sitting, pushing up into sitting, crawling, pulling to stand and walking. Strong core muscles are achieved from moving through this developmental progression later contribute to a student’s ability to maintain upright posture at school, learn more complex motor skills such as running, hopping and then learning sports specific skills later in life. Fine motor skills are also built from this foundation. Time spent in prone help infants to develop hand eye coordination and gives an infant the opportunity to learn how to use their eyes together to track.

Preventing Flat Head Syndrome

Tummy time can help reduce the risk of positional plagiocephaly, also known as flat head syndrome. Spending too much time lying on their back can cause a baby’s head to flatten in one spot. Babies can tend to lie in a position of preference and return to that flat spot when resting, and the flattening progresses and the position is reinforced. Torticollis can develop. Some babies are also born with Torticollis or neck muscle tightness with a positional preference, and will develop a flat spot on their head. Regardless of the cause, regular tummy time helps strengthen the neck extensor muscles and allows the baby to lift and change their head position and to redistribute the pressure on the baby’s head more evenly in back lying, reducing the likelihood of developing a flat spot.

Promoting Bonding and Interaction

Tummy time is an excellent opportunity for caregivers to bond with their baby. Engaging with the baby during this activity, whether through gentle play or making eye contact, fosters emotional connections and strengthens the caregiver-child relationship. A parent can lie on the floor in front of the baby and sing to them or to read them a story. Your calm demeanor and voice will encourage them and help them remain calm as they work hard to lift their head against gravity to look at you.

Encouraging Independence

As babies become more accustomed to tummy time, they develop a sense of independence and agency over their movements. They learn to move their bodies to get where they want to go. This newfound confidence can translate into increased curiosity and a desire to explore their surroundings. This helps to foster cognitive, social and fine motor development as they explore.

Start Where you are

No matter how old your baby is, it is not too late to begin tummy time. Start with the amount of time they are able to tolerate, and set a timer to help keep track. Increase the length of the tummy time sessions each day. Some fussing is to be expected, and this will get better with time and practice. Practice tummy time throughout the day to help give them many opportunities, if even just for five minutes at a time, to practice in order to develop mastery of this important skill.


Understanding the difference: Early Intervention vs. Clinic Based Care

What is the difference between Early Intervention and having your child seen in a private practice or at a hospital based clinic? Is there a difference? How does a parent choose?

Physical therapy intervention is critical, and should begin as early as possible for addressing developmental challenges or injuries in babies. Early skilled therapy capitalizes on the rapid brain development that occurs between birth to three years of age. While early intervention and clinic-based Physical Therapy both aim to improve a child’s physical abilities, they have distinct approaches and benefits. This post will explore these differences, helping parents and caregivers make informed decisions about their child’s physical therapy needs.

Early Intervention is called ECI (Early Childhood Intervention) in Texas, and is designed to provide services to infants and young children (0-3) who have developmental delays or other qualified diagnoses, often related to birth history. Services are typically provided in a child’s natural environment, such as their home or daycare. A family will usually travel to a center for their evaluation (usually performed by a team of therapists) and then the child will be seen in their natural environment for follow up sessions, which may be as frequent as 1x/ week or far apart as 1x/ month. The child may be seen by a therapist or by a teacher during their sessions, and will also be followed by a service coordinator during their time in ECI. A Coaching Model is used in Texas ECI, where a family or caregiver is given instruction and ideas by a teacher or therapist regarding ways they may help promote their child’s overall development. These coaching session are intended to provide guidance regarding each area of development (Cognitive, Fine Motor, Gross Motor, Language, Self Help, Feeding).

Summary:

  • Comfort and Convenience: Being at home may ease the child’s anxiety and simplify logistics for families
  • Coaching Model: Teachers or Therapists can give specific advice tailored to the child’s everyday environment. You child may not be actually receiving hands on therapy during these sessions.
  • Immune Issues: Staying at home for visits may be the best option for medically fragile babies, rather than traveling to a clinic setting.

Clinic-Based Physical Therapy: This approach includes services provided in specialized settings like a private practice or a children’s hospital clinics. A Physical Therapist trained to work with pediatric patients, who may hold an additional board certification in Pediatric Physical Therapy, will evaluate your infant or child, and then formulate a treatment plan and make recommendations about the frequency of visits. Patients are typically seen weekly or twice weekly, depending upon their needs. Therapy session look much like play time, with the therapist facilitating – or helping the child practice movement patterns and activities to help them progress in the areas where they are struggling. Parents are actively involved in the sessions, and the therapist will teach parents the exercises and activities to work on at home, and then help them practice and answer any questions. Toys and surfaces are sanitized in between clients. Only one client is seen in the office at a time.

Summary:

  • Hands on Specialized Care: A board certified Pediatric Physical Therapist who is trained and experienced in treating children using hands on techniques to work on areas of difficulty in the context of play. Parents are strongly encouraged to fully particiapte in sessions as they are able.
  • Home exercises and recommendations are provided to parents at each session to work on each day as part of the child’s routine in order to promote progress.
  • Advanced Resources: Access to specialized equipment can enhance therapy effectiveness, and may decrease the amount of time the child will need to be in therapy.
  • Structured Environment Children can benefit from a change in environment for playtime and for therapy, and may actually do better outside of their home for therapy.

Conclusion: Both early intervention and clinic-based physical therapy offer unique benefits to help children’s development. Early intervention may be ideal for convenience and for a child with a sensitive immune system or complex medical needs that make travel difficult. Clinic based therapy is hands on one on one treatment from a Pediatric Physical Therapist, and EI based therapy is provided by either a teacher or a therapist with coaching regarding all areas of development. Both Early Intervention and Clinic based therapy will teach parents and caregivers how to integrate therapy into a child’s daily routine. Follow through with a home program is essential for the success of each delivery model. Ultimately, the choice depends on the child’s specific needs and family preferences.

Final Thoughts: Parents and caregivers may consult with healthcare professionals to determine the most suitable approach for their child. As a parent, you have the right to choose where your child receives therapy. Remember, the goal of any pediatric physical therapy is to support the child’s development and improve their quality of life regardless of the setting.