Back in 2011, I shared on this space “The Case Against Tummy Time”, a perspective by Feldenkrais practitioner Irene Lyon that remains one of my most controversial posts. Many have voiced disagreement with the suggestions in the article (which includes a video demonstration by an inspiring infant named Liv). Others have been relieved to learn that it isn’t necessary to place babies on their tummies — a position that tends to be uncomfortable and immobilizing for them in the early months.
My intention here is not to rejoin the argument. Parents can read the article (and others), solicit professional and anecdotal advice, and decide for themselves. For me, a child-directed approach always resonates, so I believe in offering babies the opportunity to roll to their tummies (from the back position) in their own perfect time.
While on their backs, babies can stretch, twist, move their heads and limbs easily, see their entire surroundings, and strengthen the muscles necessary for making eventual tummy time more comfortable. Child-initiated tummy time has cognitive and psychological benefits as well as physical ones, because it encourages mastery and a sense of agency.
It’s been exciting for me to witness a new wave of parents discovering the joys of unassisted motor development.
One common question I receive is about the transitional period after babies first learn to roll onto their tummies. They can usually only remain in this new position comfortably for a limited amount of time, but they haven’t quite figured out how to roll onto their backs again. I thought I’d address that situation here through a note I received from Rajvee:
Hi Janet,
I need a suggestion for my 4-month-old. She is a very happy and playful child. Lately, she rolls to her tummy instantly, enjoys being there for a while, and once she gets tired, she wants to roll back on her back (which she is not able to do yet). In this process she gets very frustrated and tired and yells loudly. I give her assurance, talk to her and try to give her emotional support while she is trying to turn back, but all in vain. I want to practice non-interference with her motor skills and let her discover a complete roll on her own. My question is at what point do I walk up to her and physically turn her over, basically end her struggle and help her?
Rajvee
Hi Rajvee,
What you’re experiencing is normal and to be expected — a very common transitional stage for babies developing motor skills naturally. She’s figured out how to roll to her tummy, but can’t yet get back into a supine position. On her tummy she is still developing muscle strength in her neck, and she will eventually learn to lift her upper body up, arching her back and supporting herself on her hands with her arms extended.
In the meantime, this new position is very tiring! It makes perfect sense that she complains after a few minutes.
I wouldn’t encourage her to roll back. She will work on that of her volition and achieve it when she’s ready (as she has “tummy time”). She’s telling you something else now, so I would simply acknowledge, “I hear you. Sounds like you might be getting tired. Do you want me to pick you up?” Extend your arms to her as you ask this question. Then wait a moment or two for her response. She might make eye contact with you… or perhaps grunt or cry out. She might do something physically like move her head or “kick” with her legs. She might also not do any of those things or seem to indicate any response.
That’s okay. I would still give her that moment, because it lets her know you want to communicate with her – you want to know what she really wants in this moment. Then I would say, “I am going to pick you up.” And then do so. Give her a break in your arms and, then, if she seems ready, let her know again, “Now, I will place you down on the floor” (on her back). But if you believe she may need milk or a nap, then you would obviously take care of those needs.
For more about tummy time and child-led motor development:
Tummy Time Baby’s Way and NO Tummy Time Necessary by Lisa Sunbury, Regarding Baby
Plagiocephaly?!? (or Why “tummy time” is not the answer) by Sarita Galvez, moverse en libertad
“Tummy Time” May Not Be Needed by Nicholas Bakalar, New York Times
The Case Against Tummy Time by Irene Lyon and my post Baby Led Tummy Time – Rolling in the New Year on this website
(Thank you so much to Rajvee for allowing me to share your question and beautiful photo!)
I’m so happy so many babies are being liberated from the forced tummy time that became the fashion in the west some years ago. When I had my first baby I followed this fashion for a few days feeling that she of course needed it and would benefit from it. However, watching her discomfort and rather desperate facial expressions I realized that my baby was most uncomfortable and regardless of any purported benefits that she may gain in the future, I could see that it wasn’t worth it for the present stress it was causing both of us. It also dawned on me that tummy time was a western fad and that throughout our history as a species we had never needed tummy time to thrive. I gladly waited and watched as she grew into her own self discovered tummy time. What a relief!
Hi Janet,
Thanks so much for this post I have been googling RIE and tummy time frustration and several variants over the past two weeks looking for guidance. I looked back through several RIE books that I own but couldn’t find any specific guidance. I had decided it was best to pick up the baby to give her a break rather than roll her over, so very glad that you have this suggestion also! May this transitional time pass quickly!
Thank you!
Have you heard of “laid-back breast feeding”? In this position, mom is leaning back and baby is reclining forward — not laying flat on mom but perhaps 45 degrees, above the nipple. This may be a gentler and more natural way for a baby to build up strength in their neck muscles instead of floor “tummy time”.
Hi Janet, my name is Lynn and I am an early childhood educator in New Zealand. My ethnicity is Chinese. I am reading your books “Elevating Child Care” and “No bad kids.” I found them so good. I think it’s really good to share it with Chinese friends. Just wondering if I can translate the book to share in my culture and defenitly benefit lots of parents. If you can give me a contact details we can have a discuss.
Hi Lynn! How generous and kind of you! Elevating Child Care is actually available in Chinese on Kindle: http://www.amazon.com/Elevating-Child-Care-Respectful-Parenting-ebook/dp/B011IEK5W4 And I believe that No Bad Kids will soon be available as well. Thank you so much for your interest and encouraging words. Cheers to you in New Zealand!
My son, now 21/2 years old, in his first 10 months always, always hated tummy time. I felt worried that he wasn’t developing like his peers. I would try lots of tricks to try and make him want to lie on his tummy as I was terrified he wouldn’t develop normally from what I was being told. If I put him on his tummy-a position he never got himself into until he was 10 months old. He would scream and cry in desperation, he was obviously very uncomfy and hated it and it made me very anxious. I gave up and stopped tummy time at about 4 months. He didn’t roll until 10 months or crawl until 12 months, he walked at 16 months. I was forever worried that he was delayed (he was 5 weeks perm). I wish I hadn’t looked at miles stones articles or charts, and not worried because now he is just like any child that reached these miles stones earlier than him.
My son, who is 5 months old now knows how to roll from back to tummy, but does not do it. He learned to even roll occasionally when he was 2 months old with a very strong neck already. I always thought that tummy time is the best, but he never liked it. He rolled to his side automatically since he was 3 months. He rolls occasionally, but he can not roll back, and therefore he does not try either rolling. I never did tummy time so rigorously. I always think that giving babies their own space is good. I always leave him to play on his back while I do some chores or relax. But I have seen that giving him tummy time does help , specially one day he tried tummy crawling to escape from it. He does some crawling postures while on his tummy. I am not hundred percent sure of the method of stopping it completely as I am a parent who believes that one can strike a balance between helping and also letting the child do things independently. Every child is different, some needs some push and others do on their own. I agree with you that forcing is not a solution as children record unpleasant experiences and never try it again. Thanks for such an article.
While I agree with many of the RIE and baby led principles and appreciate your work, a critical consideration is missing from these articles on tummy time. Primary, or infant reflexes. Bauer crawl, one such reflex, is initiated from birth and is stimulated by the infant lying prone (on belly). An infant as young as a few hours can be seen initiating a reciprocal crawl pattern and can actually crawl to moms breast. Spinal galant, spinal Perez, hand supporting and symmetrical tonic neck reflex (STNR) to name a few require that a baby be placed prone in order to integrate these reflexes into higher level movement patterns. In addition, many reflexes should be integrated, or no longer active by 5-6 months of age. If we don’t allow babies to work through these reflex and postural patterns until they can get there on their own, we may have missed the critical window for neurological development.
If babies hate tummy time, there may be a neurological reason for it. Their reflexes may be hypo or hyperactive, creating distress. I encourage you to read more about reflex integration and the importance of developing these reflexes. Masgutova method is a good place to start. (Masgutovamethod.com)
Infants need tummy time. From a neurological development standpoint, for the maturation of their primary postural and motor reflexes. The way these reflexes do or do not mature are incredibly important for later skills and development. Please explore the research here and consider revising your recommendation.
Respectfully, Nicole
Nicole – the Pikler/Gerber approach takes a quite different view. Yes, infants need tummy time and it IS the position they choose of their own volition when they are ready, assuming they are given plenty of free movement and floor time. The RIE philosophy values trusting the child to initiate readiness, because of all the physical and also psychological benefits that self-initiative offers.
Hi Janet. Thank you for your compassionate parenting advice. After reading your articles, I decided not to give my son tummy time; I wanted him to get there on his own. He didn’t have it for 3 months. He had a traumatic birth, so I took him to my chiropractor at 5 days old. His sacrum and atlas were severely affected, the tests showed. When he was going on to 4 months (after his third adjustment), Dr. Brittany told me to increase tummy time “to help him develop his neck muscles to offset it! The low back (pelvis) follows the atlas (top bone in the spine) and knowing he was a C-section baby [she thought that it was] coming from his neck!” This text was alarming as I hadn’t given him any tummy time, although he had begun to roll over. I followed Dr. Brittany’s instruction right away, supervising him closely and turning him over when he looked uncomfortable. I felt a sense of relief that I hadn’t put that on him sooner when it didn’t seem like he was ready. I’m also glad we caught that soon enough to promote alignment that leads to wellness.
On a similar note, I learned about subluxation just yesterday. Chiros explained that sleep is micro-physical stress on the back. Since babies sleep from 2-8 hours on their back, they suggested giving them 30 minutes of tummy time daily to even out the activity on the nervous system. That was new to me!
My son is 8 months now. He’s a happy crawler.
I hope this is useful in considering other factors.
Great article! My 6 month old has never enjoyed tummy time and I was constantly told in her early weeks to keep practising it every day with her for 5-10 minutes. After seeing how uncomfortable she was I would always come down to her level and talk to her calmly – sometimes I would get a smile so I knew then she was ok, other times she would look me in the eye and cry out which I knew was her telling me she’d had enough and wanted help getting back over. I never forced tummy time on her I let her learn her own way and only helped if she really needed it. She is now a brilliant ‘roller’ and gets from one side of the room to the other quite easily!
I have tried to hold on to the advice by Irene Lyon of not doing tummy time and just allowing my son to turn over when he is ready. I am just slightly concerned because I’m one week he’ll be 6 months and he has made no effort and showed no desire to turn over. Is there a particular point when it would be time for the parent to initiate the movement?
I’m going to respond to your question. As a pediatric occupational therapist, while I respect following the child’s lead, at some point the child may need some additional outside support to help with reaching the developmental milestones. By 6-months old we would expect a baby to be able to roll in either direction, back to tummy and tummy to back. We would also expect him to start sitting by himself when placed (not for very long before toppling over). If the advice here is taken 100% then a baby won’t ever be placed in sitting or standing until he/she does it themselves. That is just not realistic. The baby’s world is not laying on his back staring up at the ceiling. This will likely cause plagiocephaly (flattening of the skull bones) which creates other issues. Nor should he be placed in “containers” to hold him upright until he can do it by himself. I would start encouraging tummy time and rolling through toys, mirrors, and social interactions! If you have developmental concerns, you can seek out a screening through your local Early Intervention program.
Thank you so much for this! I wish I read it sooner and I can only hope pediatricians read it too!