May 6, 2020

Tummy time shown to aid infant development

Research review shows tummy time improves rolling, crawling and other motor development.

A systemic review of research on the benefits of “tummy time” for infants has found that it improves total development and gross motor development, and prevents brachycephaly (where the back of an infants’ head is flattened as a result of spending a lot of time on their backs).

Tummy time is when infants are placed on their stomachs to play. They should always be awake during tummy time and under careful watch.

The aspects of motor development (a child's ability to move around) that tummy time was found to improve were the ability to move while prone (on their tummy) or supine (on their back), including rolling and crawling.

An indeterminate association was found for social and cognitive development, and for walking, standing, and sitting. No association was found for fine motor development and communication.

The review examined 16 research articles involving 4,237 participants from eight countries.

The study was led by Dr Lyndel Hewitt from Early Start at the University of Wollongong (UOW) and the Illawarra Health and Medical Research Institute (IHMRI), and is published in Pediatrics.

“When an infant is on their tummy, they are given the opportunity to practice lifting up their head, lifting up and turning their head, moving their legs and pushing up with their arms,” Dr Hewitt said.

“Tummy time strengthens the infant’s head, neck, shoulder and trunk muscles they will need to master motor skills such as their overall ability to move, crawl and roll.”

While tummy time was known to help infants’ motor development, the benefit of the systemic review was in showing which specific aspects of motor development it improves.

“Motor development encompasses many aspects. Being able to say ‘tummy time assists with your baby's ability to roll’ is a more concrete way of explaining the benefits of tummy time to parents and health care providers,” Dr Hewitt said.

World Health Organisation guidelines for physical activity, sedentary behaviour and sleep for all children under the age of 5 years recommend infants get 30 minutes of tummy time over a 24-hour period.

“My advice is to start small (30 seconds) and gradually increase the time your baby spends in tummy time. It is important to remember that the baby must be awake and supervised by their parent or carer during tummy time,” Dr Hewitt said.

“Parents are advised to see their doctor, paediatrician or physiotherapist for a motor development assessment to determine if their baby is meeting their milestones.”

Dr Hewitt said that further studies using more objective methods were needed to further assess the health outcomes of tummy time, including studies investigating the effect of tummy time on fine motor skills, walking, standing, sitting and cognition.

“Most studies that were included in this review were observational in design, which means there was not a group of baby’s receiving other interventions to compare the results to, and they used questionnaires to determine the amount of tummy time the baby received,” Dr Hewitt said.

“More studies are needed using a more rigorous design method and more objective ways to measure the amount of tummy time the babies received.”
 

ABOUT THE RESEARCH

‘Tummy Time and Infant Health Outcomes: A Systematic Review’ by Lyndel Hewitt, Erin Kerr, Rebecca M. Stanley, and Anthony D. Okely is published in Pediatrics on 5 May 2020 (https://doi.org/10.1542/peds.2019-2168).

The research was supported by the Australian Government Research Training Program Scholarship.