Why is Tummy Time Important?

Not just for infants!

What is tummy time?

Tummy time is considered any type of weight bearing through upper extremities. This is important to develop key muscles needed to meet developmental milestones. If the child does not develop these muscles they may have issues with crawling/walking, grasp patterns, fine motor coordination, manipulating fasteners, visual perceptual skills, handwriting, oral motor skills, feeding, articulation, and much more. If your child has difficulty in these areas consider incorporating more tummy time (yes even for our older kiddos!) Incorporating these exercises will help develop the muscles needed to improve these areas.

How exactly does tummy time impact these areas?

Head development

● Prevention of flattening of the head leading to brachycephaly/plagiocephaly

● May result in asymmetrical facial deformities on the side of the flattening

● May result in using one eye more than the other

● Tilting head to rest on flat spot that may lead to torticollis

● Refer to cranial orthotist

○ Free evaluations at Cranial Technologies https://www.cranialtech.com/(https://www.cranialtech.com/)

○ Can begin banding child’s head to allow space for growth where head is flat at 4 months-18 months old

Vision

● Depth perception

○ When an infant develops head control on their tummy, they bump their head frequently and they learn how far the floor or a toy is from their face.

○ This is not developed laying on their backs because it is difficult to judge how far the ceiling or a mobile is from their face.

● *Midline Eye Convergence *

○ When infant does not develop both sides of neck muscles equally their head may tilt

○ This causes one eye to turn into center leading to double vision

○ Child will continue turning their head further to keep both eyes facing center to prevent double vision (may lead to torticollis)

○ Kids may blink frequently, rub/lose their eyes, turn their head, or turn their eyes away because they are seeing double.

○ May need vision therapy through an optometrist if you see these red flags

Gross Motor Development

● Propped Sitting

○ Requires triceps and glute strength developed through tummy time to hold self up

● Rolling over

○ Requires pushing through hands to trigger reflex (Asymmetrical tonic neck)

○ Involuntary arm flexion with head turn to the other side

○ Causes child to bend arm and roll to side learning to roll over

● Crawling

○ Tummy time integrates reflexes needed to crawl by 6-7 months (Asymmetrical tonic neck)

○ Involuntary arm flexion with head turn to the other side

○ Makes it difficult to keep arms extended while crawling and looking around room

● Pushing

○ Pushing open a door or a walker toy

○ Requires serratus anterior and core strength developed on tummy to push object

● Walking

○ Poor depth perception makes stepping from surface to surface frightening

○ Poor floor scanning when walking leads to bumping into and tripping over objects

● Stairs

○ Poor depth perception impacts fear to move foot to next step

○ May slide foot down to feel for next step

○ May be reliant on handrail for balance or bring feet together on each step

● Jumping

○ Tummy time integrates reflexes needed to jump (Symmetrical tonic neck)

○ Involuntary leg extension (straight) with head flexion (bent)

○ Makes it difficult to bend knees to jump when neck bent looking down

Fine Motor Development

● Grasp and release of toys

○ Requires extension of wrist developed when pushing through hands on tummy

● *Poor grip strength and grasp patterns *

○ Develop all the small muscles within the hands for grasp and pinch while pushing through open hands on tummy

● *Indwelling thumbs *

○ Thumb extension developed opening palms and pushing through hands

● Handwriting, pencil grip, pencil pressure, endurance

○ Decreased hands strength to move pencil with fingers to appropriately adhere to lign, size letters, and add spaces between words

○ Decreased coordination to produce lines on a diagonal- letters, triangles, diamonds, etc.

Feeding

● *Drooling *

○ Increased open mouth posturing

○ Poor shoulder and jaw muscular strength to hold mouth closed to control drool

○ Impacts frequent illnesses

● Tongue movements

○ Jaw asymmetry (unequal) due to not activating both sides of the neck equally in tummy time

○ May elevate or lift tongue at rest for stability due to poor jaw stability

○ Leads to poor tongue lateralization (movement form side to side) to chew foods

● Chewing

○ Poor bite strength due to jaw asymmetry

○ Poor endurance due to decrease muscle tone in neck and jaw

● Digestion

○ Helps with gas and constipation

Speech

● *Frontal sounds and bi-labial sounds *

○ Inability to hold mouth closed impacts frontal sounds (p, b, f, v, t, s)

○ Decreased neck strength may lead to neck hyperextension causing oral structures to shift posteriorly in mouth

○ Language exercises in prone bring oral structures anteriorly in mouth and improve frontal sounds

Sensory System

● Proprioception

○ Developed through heavy work pushing into the ground

● Vestibular

○ Developed through movement of head and achieving balance

● Tactile

○ Developed through reaching and grasping objects

What if my child does not tolerate tummy time or laying on belly?

● Elevation is key! Elevating the child on a ball, boppy, pillow, lap, etc. decreases the demand and promotes success.

● Wall push ups, laying on their belly to color, walking on their hands and feet like an animal, etc. are great weightbearing activities for older kids.

● Short frequent bursts of tummy time is better than one long attempt.

● It is okay to hold their head up to provide assistance until they can do it on their own.

● Very important to promote holding head in midline, so they develop muscles equally on both sides including their neck muscles and eyes.

Tools to improve head in midline:

○ Baby Mozart/Bach, Hey Bear Sensory videos placed directly in front of them

○ Talk and sing at eye level

○ Tap your nose as you slowly move your face closer and further away from infant

○ Visual perceptual puzzles in midline for older kids

Tummy time is important for infants to teenagers!

Pister, C. (2018). Evidence-Based Strategies for Infant Positioning and Handling: Using Tummy Time to Influence Motor, Vision, and Language Development. Summit Professional Education.

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