In an effort to reduce the incidence of sudden infant death syndrome (SIDS) and other sleep-related causes of infant death, such as suffocation, the American Academy of Pediatrics (AAP) has expanded its previous recommendations for infant sleep environments to a list known as Safe to Sleep. The updated campaign continues to promote placing healthy infants on their back each time they are going to sleep. The AAP also warns against the use of wedges or positioning devices in the sleep environment. Since the 1992 launch of the initial educational campaign (previously known as Back to Sleep), SIDS deaths have declined by more than 50 percent.

Now, however, some babies are spending too much time on their backs. As a result, they’re not strengthening much-needed muscles. To help develop all of their muscles and prevent flattening of their skulls, babies need to spend time in a variety of positions — including on their tummies.

Good for Babies

According to the Primary Children’s Medical Center in 2004, babies who spend more time playing on their tummies roll, crawl, pull to stand, and walk earlier than those who don’t have as much tummy time. That’s because while they’re on their tummies, babies develop the head control and upper-body strength they need to push up and learn to crawl. 

In addition, as they shift their weight back and forth to reach for toys, they develop balance. Tummy time also lengthens muscles on the front of the body and strengthens those in the back. And it helps prevent flattening of the skull, which sometimes occurs when babies spend too much time in one position.

Let Baby Be Your Guide

It can take time for babies to get used to tummy time. While on their tummies, babies see and feel different things. Some of these sights and sensations can make them feel uncomfortable. In addition, babies will try to raise their heads and look around or shift their weight to reach for toys. If they have weak muscles in their neck, back and shoulders, these activities can be frustrating.

When deciding how much tummy time is enough, let your baby be your guide. Any time babies are looking around while lifting their heads, they’re building strength and skills.

Pay attention when your baby cries, but continue to provide short periods of tummy time every day. As babies become stronger, you can increase the length of tummy time.

Tummy Time Fun

Here are some ways to make tummy time safe and fun.

  • Always supervise your baby during tummy-time play.
  • Never place babies on blankets that bunch up, restrict motion or block airways.
  • Lie on your back and place baby on your stomach or chest to interact with you.
  • Place toys on the floor in front of your child. Change variety of toys often.
  • Raise babies by placing a rolled towel, blanket or Boppy® pillow under their chests. This makes it easier for children to lift and turn their heads.
  • Use toys, music, singing or soft talking to make tummy time more fun.
  • Play with babies on their tummies several times a day for short periods. (The amount of time will be different for every child.)

Back to Sleep

Infant skulls are shaped by a child’s sleep position during the first three months of life, After the AAP recommended that babies be put on their backs to sleep, more children developed a flattening on the back of their heads. This flattening is called plagiocephaly.

Torticollis is a shortened or tightened muscle on one side of the neck. It causes infants to hold or turn their heads consistently in one direction, even when lying down.

Following these simple suggestions can help to ensure that your baby’s skull develops normally:

  • While babies are asleep on their backs, change their head position often. Turn their heads straight forward, then to the right and left sides.
  • Place visually interesting toys in the crib. This encourages children to turn in both directions when they’re awake.
  • Change the way you place children in their cribs. One day, lay them at the head of the crib; the next day, lay them at the foot.

For more information about the safe sleep environment recommended by the AAP, see A Parent’s Guide to Safe Sleep at www.healthychildren.org/English/pages-stages/baby/sleep/pages/A-Parents-Guide-to-Safe-Sleep.aspx.

This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team.