First, lets talk about all the benefits a baby gets from being on his stomach. Even with the SIDS scare, parents are encouraged to give their children prolonged tummy time because the benefits are so great and it helps resolve the side effects of sleeping babies on their backs. A huge problem for parents is that newborns sleep a lot, so if they aren’t sleeping their baby on his tummy, it is impossible to give him prolonged tummy time. Or if the doctors and nurses have done their job, when he does fall asleep while in tummy time, most parents out of stark fear will turn the child over immediately. (And he usually wakes up soon after. Babies who sleep on their backs do not generally sleep three hours solidly like they do when they sleep on their stomachs. I (Verna, who had babies in the 70's and 80's) am amazed at the common complaint that young parents have that their babies just don’t sleep. When I was raising my children that was not a common complaint. I and most of my friends were surprised at how much our babies slept! Our big discussion was whether we should wake them up to eat.) Now, why were all the mothers for the last three or four generations encouraged to sleep their babies on their tummies? Let me just list a few of the many reasons
1. Eye development:
When a baby is on his stomach it gives a natural way for the eyes to develop and grow stronger. When the baby's head is turned from one side or the other as a child lies on the side of his head, the eye on top will be the one that is used, strengthening the eye development. When he turns his head, the other eye is used and strengthened. It also, forces the range of sight to be greater in the eyes. We were reminded to trade ends of the crib that our infants were sleeping in each week so that the eyes would be strengthened evenly, since a baby tends to turn his head toward the room, light and where he can see his parents. (Breastfeeding also helps with developing the eyes evenly because you change sides in the middle of feeding.) Tummy time allows for peripheral vision to be used/ developed instead of just looking ahead (up) while on the back.
2. Neck development:
According to Beth M. Iovinelli, RN, BSN, IBCLC who writes for Baby Zone,
"Tummy time literally gets babies off their backs. It provides a break for the occipital area, or back of their heads, and gives babies a chance to strengthen their neck muscles to prepare them for crawling. It also helps them to get ready to push up, roll over, sit up, and eventually stand."
A healthy baby who was just born can already hold up his head for a few seconds. Neck muscles will continue to strengthen over the next couple of days-- or if you swaddle and lay him on his back, he will lose that strength within a few days or week.
3. Strengthening the Core
4. Spinal Column shape
5. Tummy time helps with both fine and gross motor development:
6. Acid reflux: In most cases tummy sleeping helps reduce acid reflux.
7. Proper Head shape:
The problem of misshapen heads on infants is one that confuses me. According to ressearch over the last decade there has been an alarming increase in the diagnosis of positional head deformities in American babies. This problem has increased 70% and that drastic increase is directly linked to babies sleeping on their backs, or in swings bouncy seats, car seats or any other contraption that keeps them facing up.
Robert W. Steele, MD, a board certified pediatrician at St. John's Regional Health Center in Springfield, MO says
"I currently recommend that children under the age of nine months, whose parents feel the head shape is detrimental, undergo intervention in one of two ways. For mild abnormalities, different positioning may be feasible. However, for the more involved misshaping, I suggest the child be fitted with a helmet, which is custom made and to be worn no less than 23 hours a day for at least three months." This is quite a commitment, both in terms of time and money (cost is about $2000).
Now lets talk fussing and frustration. A baby is NOT going to enjoy having a helmet on his head 23 hours a day. As a matter of fact, would you? So not putting a baby on his tummy because he “didn’t like it” or “he fussed after 10 minutes” will produce a much greater degree of discomfort (not liking it and fussing) if the child has to wear a helmet for at least three months.
The formation of the head with back sleeping can cause bones to fuse together, lopsidedness and are often having to be corrected with helmets. This particularly happens when desperate parents resort to sleeping the baby in swings or car seats or swaddling older infants. Instead of the pressure being spread out over the whole head as they turn from side to side, the pressure tends to be applied in just one spot.
I don’t know if you caught it but flailing and fussing are really important for muscle development! Frustration is also the key to growth. It is impossible for your baby to grow from one stage to the next in a timely manner without frustration.
Recommended book - The Truth About Tummy Time: A Parent's Guide to Sids, the Back to Sleep Program, Car Seats and More
by Stephanie J. Pruitt PT CKTP
1. Eye development:
When a baby is on his stomach it gives a natural way for the eyes to develop and grow stronger. When the baby's head is turned from one side or the other as a child lies on the side of his head, the eye on top will be the one that is used, strengthening the eye development. When he turns his head, the other eye is used and strengthened. It also, forces the range of sight to be greater in the eyes. We were reminded to trade ends of the crib that our infants were sleeping in each week so that the eyes would be strengthened evenly, since a baby tends to turn his head toward the room, light and where he can see his parents. (Breastfeeding also helps with developing the eyes evenly because you change sides in the middle of feeding.) Tummy time allows for peripheral vision to be used/ developed instead of just looking ahead (up) while on the back.
2. Neck development:
According to Beth M. Iovinelli, RN, BSN, IBCLC who writes for Baby Zone,
"Tummy time literally gets babies off their backs. It provides a break for the occipital area, or back of their heads, and gives babies a chance to strengthen their neck muscles to prepare them for crawling. It also helps them to get ready to push up, roll over, sit up, and eventually stand."
A healthy baby who was just born can already hold up his head for a few seconds. Neck muscles will continue to strengthen over the next couple of days-- or if you swaddle and lay him on his back, he will lose that strength within a few days or week.
3. Strengthening the Core
4. Spinal Column shape
5. Tummy time helps with both fine and gross motor development:
- Once on their tummies, babies tend to kick and flail, working their large motor muscles. Later, rolling onto their tummies will help babies strengthen neck and leg muscles.
- Babies on their tummies tend to grasp at a parent's shirt or blanket, encouraging fine motor development.
- Fine motor development will begin with the babies' hand development. When first born, they will only make fists but by 2 months of age should be spending more time with hands open. On their tummies, babies' hands are able to be opened up while learning to push and grab. Laying on the back does not allow for this to happen as spontaneously.
6. Acid reflux: In most cases tummy sleeping helps reduce acid reflux.
7. Proper Head shape:
The problem of misshapen heads on infants is one that confuses me. According to ressearch over the last decade there has been an alarming increase in the diagnosis of positional head deformities in American babies. This problem has increased 70% and that drastic increase is directly linked to babies sleeping on their backs, or in swings bouncy seats, car seats or any other contraption that keeps them facing up.
Robert W. Steele, MD, a board certified pediatrician at St. John's Regional Health Center in Springfield, MO says
"I currently recommend that children under the age of nine months, whose parents feel the head shape is detrimental, undergo intervention in one of two ways. For mild abnormalities, different positioning may be feasible. However, for the more involved misshaping, I suggest the child be fitted with a helmet, which is custom made and to be worn no less than 23 hours a day for at least three months." This is quite a commitment, both in terms of time and money (cost is about $2000).
Now lets talk fussing and frustration. A baby is NOT going to enjoy having a helmet on his head 23 hours a day. As a matter of fact, would you? So not putting a baby on his tummy because he “didn’t like it” or “he fussed after 10 minutes” will produce a much greater degree of discomfort (not liking it and fussing) if the child has to wear a helmet for at least three months.
The formation of the head with back sleeping can cause bones to fuse together, lopsidedness and are often having to be corrected with helmets. This particularly happens when desperate parents resort to sleeping the baby in swings or car seats or swaddling older infants. Instead of the pressure being spread out over the whole head as they turn from side to side, the pressure tends to be applied in just one spot.
I don’t know if you caught it but flailing and fussing are really important for muscle development! Frustration is also the key to growth. It is impossible for your baby to grow from one stage to the next in a timely manner without frustration.
Recommended book - The Truth About Tummy Time: A Parent's Guide to Sids, the Back to Sleep Program, Car Seats and More
by Stephanie J. Pruitt PT CKTP
Tummy Sleeping
As a newborn, being on the tummy keeps him from jerking awake when the startle reflex happens. (Startle reflex: A reflex seen in normal infants in response to a loud noise or a loss of support. The infant will make a sudden body movement, bringing the legs and arms toward the chest.) When a child is on his stomach there is not a need to swaddle – his arms and legs will be secure and he will feel secure and very likely sleep soundly.
1. Tummy sleeping keeps a baby from startling themselves awake with the "startling reflex."
2. The baby sleeps longer periods of time on the tummy and gets the good REM cycle needed for rest and brain development.
If you are worried, let me encourage you to try it out during the day where you can keep an eye on him and see how he does. If he starts crying and then in that crying pushes up or lifts his head, then you know that he can do that. The more he does it the stronger he will get and will be able to use those muscles when he needs to. At some point, you have to put him in God's protection and let him sleep the way his body was designed to do it best.
One of the main things that we suggest is tummy sleeping from the get go. If you think about it, the difference between tummy and back sleeping is pretty big, and the issue is definitely, definitely worth thinking through. It's not as cut and dry as the back to sleep campaign makes it seem.
1. Tummy sleeping keeps a baby from startling themselves awake with the "startling reflex."
2. The baby sleeps longer periods of time on the tummy and gets the good REM cycle needed for rest and brain development.
If you are worried, let me encourage you to try it out during the day where you can keep an eye on him and see how he does. If he starts crying and then in that crying pushes up or lifts his head, then you know that he can do that. The more he does it the stronger he will get and will be able to use those muscles when he needs to. At some point, you have to put him in God's protection and let him sleep the way his body was designed to do it best.
One of the main things that we suggest is tummy sleeping from the get go. If you think about it, the difference between tummy and back sleeping is pretty big, and the issue is definitely, definitely worth thinking through. It's not as cut and dry as the back to sleep campaign makes it seem.
Swaddling
Look back over the benefits of tummy time and consider how tightly binding a child's limbs in order to prevent the startle reflex while sleeping does the exact opposite of what tummy time provides. Sleeping in swings, car seats and other non-flat surfaces also immobilizes the neck from turning left or right and aggravates all the negative issues with back sleeping. Additionally, you need to recognize that sleeping your baby in those positions is also against the technical AAP recommendation- just like tummy sleeping is.
Every child will grow out of the swaddle or become strong enough to break out- then they have to learn to sleep in a new way, again.
CAUTION - Never swaddle a baby and then place him on his tummy. Arms and legs must be free to move when a baby is on his tummy.
Every child will grow out of the swaddle or become strong enough to break out- then they have to learn to sleep in a new way, again.
CAUTION - Never swaddle a baby and then place him on his tummy. Arms and legs must be free to move when a baby is on his tummy.
Taking a closer look at the SIDS scare
Verna's thoughts and observations about tummy sleeping:
I had the opportunity on a long sailing race to have a friendly but passionate debate with a pediatrician friend about how pediatricians are steering young parents (mostly mothers) to parent by fear. I think we both came away with food for thought and I had some of my questions answered about what they are actually saying to these new parents.
Of course, he strongly supported the American Academy of Pediatrics recommendation that babies be put to sleep on their backs based on a study done about Sudden Infant Death Syndrome (SIDS) in the 1990’s. The more we talked, the more I understood why he did. After giving him cause to question the findings, he told me frankly that even if he thought otherwise, as a professional he had to give this caution to parents. If he didn’t he could be liable for a lawsuit against him for neglecting to give the recommendation.
We talked about all the reasons why most Americans had their babies sleeping on their tummies for the decades before the “Back to Sleep” campaign was launched. All the benefits for tummy sleeping I learned from child development studies when I was a young mother, are still acknowledged to be true. Neck and arm muscles are strengthened, eye muscles are used more broadly, causing both eyes to develop together, heads take on a rounded shape giving the brain room to fill, all these still give reason for doctors to encourage giving babies at least an hour of “tummy time” each day. This doctor friend tells his clients to make sure not to neglect this during the day. He even suggests that they let them nap on their tummies if the mother watches the infant closely. That surprised me because most new moms report to me that their doctor tells them to turn the baby over immediately if he falls asleep during “tummy time.”
We bantered back and forth about how the professionals give parents the sense that SIDS is or has been an epidemic rather than a rare occurrence (at the beginning of the study, only one half of one percent of babies were dying of SIDS). As I expressed my concern that parents are so fearful that they watch their babies on monitors and hardly sleep themselves, he agreed that one of his biggest concerns is the exhausted mother who may make poor choices because she is so extremely sleep deprived. I shared with him my experience of seeing the opposite result. When parents have the option of sleeping their babies in the position that the baby prefers and begin taking steps to help them learn to sleep when the family sleeps, the result has been that most are getting 6 hours of solid sleep at night by the time the baby is three to four weeks and 8 -12 hours by two months, making well-rested, happy parents and babies. This pediatrician’s compassionate response was that he wished this could be true for all his patients.
I asked him two questions that caught his attention. If you scare the mom out of her mind about SIDS so that she will vigilantly sleep her baby on his/her back – does this give a guarantee that the baby won’t die of SIDS? His answer was no and he admitted that babies are still dying of SIDS while sleeping on their backs. But the questioning that really sobered him was this, “So the parents are watching their babies like a hawk, giving up sleep and their own routines, but have you ever told them what they are watching for and what to do if they see signs of the baby dying? Should they give infant CPR? Will they even be able to see it before it happens? He looked at me with shock and sadness as he thought about these questions. No, he agreed, he had not been trained to help parents do something, other than potentially, prevent it and live in fear that it might happen.
In our conversation I was impressed with the deep care he has for the struggling parents of an infant and I realized that this was the place where our hearts were in complete agreement. I, too, share my insights with parents because I want to see them be able to enjoy the incredible gift that God has given them, and to introduce them to the truth that only God can give them the courage to trust Him with that life and not give way to fear.
The other thing that saddened me in our conversation was the distrust that this propagates between generations. When I first started talking about how babies sleep so much better on their tummies, he said, “Oh, you are who I warn my new mothers not to listen to! I tell them not to listen to their mothers or their grandmothers if they recommend tummy sleeping.” Yes, we all slept our babies on their tummies because it generally was what most babies naturally preferred and because all the studies done in child development concurred with the importance of doing so. What happened to the value of mothers encouraging their daughters with the wisdom they gleaned through walking in those shoes first? If they aren’t supposed to listen to those who have raised them, where are they to learn the things they need to know?
My friend and I visited her daughter who had a three-month-old baby for a weekend. She was a working mom who was trying to pump milk at night for her baby to have during the day. Add to that that her baby never slept longer than three hours at night and you can guess that she was totally exhausted and not enjoying motherhood at all. I wondered how she had survived this long.
I held the baby and I was surprised at how floppy his head was. I asked her about tummy time and she just rolled her eyes and said that he screamed through it so she didn’t give it to him much. I put him on his stomach and got down on the floor, at his eye level. He just lay there, unable to lift his head and cried. I propped him up on a Boppy pillow and started talking to him and playing with toys with him, showing him that it could be fun. I asked her lots of questions and learned that the baby was still sleeping in their room and that even her husband was exhausted. After talking about all the different options, she decided she was going to put him in his own bed on his tummy that night. The next morning, she excitedly told me he had slept solidly for five hours (the first time in his life) and there was joy in her eyes again.
I talked to her a week later and learned that she was finally getting rested and her little boy was sleeping so much better. When she had taken him to the babysitter (a mother with two toddlers and a baby) she told her that she was going to let him sleep on his tummy now. The babysitter said quietly, “I do that with my babies, too.” Gradually she became aware that other mothers were also doing the same thing. She was indignant that it had taken her so long to learn this secret and wondered why it had to be such a secret club.
I had the opportunity on a long sailing race to have a friendly but passionate debate with a pediatrician friend about how pediatricians are steering young parents (mostly mothers) to parent by fear. I think we both came away with food for thought and I had some of my questions answered about what they are actually saying to these new parents.
Of course, he strongly supported the American Academy of Pediatrics recommendation that babies be put to sleep on their backs based on a study done about Sudden Infant Death Syndrome (SIDS) in the 1990’s. The more we talked, the more I understood why he did. After giving him cause to question the findings, he told me frankly that even if he thought otherwise, as a professional he had to give this caution to parents. If he didn’t he could be liable for a lawsuit against him for neglecting to give the recommendation.
We talked about all the reasons why most Americans had their babies sleeping on their tummies for the decades before the “Back to Sleep” campaign was launched. All the benefits for tummy sleeping I learned from child development studies when I was a young mother, are still acknowledged to be true. Neck and arm muscles are strengthened, eye muscles are used more broadly, causing both eyes to develop together, heads take on a rounded shape giving the brain room to fill, all these still give reason for doctors to encourage giving babies at least an hour of “tummy time” each day. This doctor friend tells his clients to make sure not to neglect this during the day. He even suggests that they let them nap on their tummies if the mother watches the infant closely. That surprised me because most new moms report to me that their doctor tells them to turn the baby over immediately if he falls asleep during “tummy time.”
We bantered back and forth about how the professionals give parents the sense that SIDS is or has been an epidemic rather than a rare occurrence (at the beginning of the study, only one half of one percent of babies were dying of SIDS). As I expressed my concern that parents are so fearful that they watch their babies on monitors and hardly sleep themselves, he agreed that one of his biggest concerns is the exhausted mother who may make poor choices because she is so extremely sleep deprived. I shared with him my experience of seeing the opposite result. When parents have the option of sleeping their babies in the position that the baby prefers and begin taking steps to help them learn to sleep when the family sleeps, the result has been that most are getting 6 hours of solid sleep at night by the time the baby is three to four weeks and 8 -12 hours by two months, making well-rested, happy parents and babies. This pediatrician’s compassionate response was that he wished this could be true for all his patients.
I asked him two questions that caught his attention. If you scare the mom out of her mind about SIDS so that she will vigilantly sleep her baby on his/her back – does this give a guarantee that the baby won’t die of SIDS? His answer was no and he admitted that babies are still dying of SIDS while sleeping on their backs. But the questioning that really sobered him was this, “So the parents are watching their babies like a hawk, giving up sleep and their own routines, but have you ever told them what they are watching for and what to do if they see signs of the baby dying? Should they give infant CPR? Will they even be able to see it before it happens? He looked at me with shock and sadness as he thought about these questions. No, he agreed, he had not been trained to help parents do something, other than potentially, prevent it and live in fear that it might happen.
In our conversation I was impressed with the deep care he has for the struggling parents of an infant and I realized that this was the place where our hearts were in complete agreement. I, too, share my insights with parents because I want to see them be able to enjoy the incredible gift that God has given them, and to introduce them to the truth that only God can give them the courage to trust Him with that life and not give way to fear.
The other thing that saddened me in our conversation was the distrust that this propagates between generations. When I first started talking about how babies sleep so much better on their tummies, he said, “Oh, you are who I warn my new mothers not to listen to! I tell them not to listen to their mothers or their grandmothers if they recommend tummy sleeping.” Yes, we all slept our babies on their tummies because it generally was what most babies naturally preferred and because all the studies done in child development concurred with the importance of doing so. What happened to the value of mothers encouraging their daughters with the wisdom they gleaned through walking in those shoes first? If they aren’t supposed to listen to those who have raised them, where are they to learn the things they need to know?
My friend and I visited her daughter who had a three-month-old baby for a weekend. She was a working mom who was trying to pump milk at night for her baby to have during the day. Add to that that her baby never slept longer than three hours at night and you can guess that she was totally exhausted and not enjoying motherhood at all. I wondered how she had survived this long.
I held the baby and I was surprised at how floppy his head was. I asked her about tummy time and she just rolled her eyes and said that he screamed through it so she didn’t give it to him much. I put him on his stomach and got down on the floor, at his eye level. He just lay there, unable to lift his head and cried. I propped him up on a Boppy pillow and started talking to him and playing with toys with him, showing him that it could be fun. I asked her lots of questions and learned that the baby was still sleeping in their room and that even her husband was exhausted. After talking about all the different options, she decided she was going to put him in his own bed on his tummy that night. The next morning, she excitedly told me he had slept solidly for five hours (the first time in his life) and there was joy in her eyes again.
I talked to her a week later and learned that she was finally getting rested and her little boy was sleeping so much better. When she had taken him to the babysitter (a mother with two toddlers and a baby) she told her that she was going to let him sleep on his tummy now. The babysitter said quietly, “I do that with my babies, too.” Gradually she became aware that other mothers were also doing the same thing. She was indignant that it had taken her so long to learn this secret and wondered why it had to be such a secret club.