How can we help infants to tolerate the “tummy time”?

The Study of Palmer (2019) showed that teaching proprioceptive touch and transitions to prone, would facilitate prone tolerance, parent behavioral support, and parent self-efficacy.

 “Tummy time” is important for movement and positional development. Palmer and her team reported that being on the belly contributes to spatial, cognitive, emotional and social development and prepares for locomotion and reaching skills (p. 280).

Many children and especially children with special needs do not tolerate being prone.

In this study, 42 infants age 2-5 months participated. 23 infants and their parents participated in a “Child Space” Feldenkrais Movement Lesson, 19 were in a control group. Pre- and Posttest were the tolerance of their infants to be in a prone position.

 Parents in the Feldenkrais Movement Group were trained with a scripted lesson, including “a sequence of steps for the parent to engage the infant's attention, help the infant sense him- or herself, and guide the infant gently in movement. Steps (in the lesson and the handout) included face-to-face interaction, tapping and squeezing arms and legs, bringing a knee toward the belly, bringing knee over to assist side-lying and eventually coming to prone, stroking alongside the spine in prone, and bringing the knee back through the same arc to allow the infant to feel the return to supine. These steps were repeated on the other side as well, and all steps were contingent on the infant accepting each step. Parents whose infants slept through the lesson were offered the opportunity to do the actions with a doll. The sequence of movements for bringing each baby to his or her side, and then at his or her own pace to prone, provided the parent and infant with a more organic and (eventually) infant-initiated transition to tummy time (i.e., the infant could take over the actions), compared with the typical approach of simply placing the infant directly on his tummy. The lesson script also formed the core of a reminder handout that the teacher distributed following the lesson” (p. 282).

The outcome:

Parents who participated in an infant-centered, tummy-time movement lesson reported that their infants spent significantly more time tolerating the prone position in the week following the lesson. In live interaction, lesson parents used more targeted behaviors, more varying behaviors, and fewer inconsistent behaviors with their young infants, as compared with waiting control parents (p. 285)

Summary: The study demonstrated how a lesson in preparatory touch, and gradual transitions, promoted infant prone tolerance and also parent support of rolling, side-lying, and prone positioning. The lesson could be incorporated in parent education and early pediatric visits, helping infants and parents negotiate the prone challenge and setting the stage for further parent support of infant development.

Source: Palmer, C., Rindler, D., & Leverone, B. (2019). Moving into tummy time, together: Touch and transitions aid parent confidence and infant development. Infant Mental Health Journal40(2), 277–288.

More resources to child development, sensory processing and motor learning:

Baniel, A. (2012). Kids Beyond Limits. Penguin Group

Sanz-Cervera, P., Pastor-Cerezuela, G., González-Sala, F., Tárraga-Mínguez, R., & Fernández-Andrés, M. I. (2017). Sensory Processing in Children with Autism Spectrum Disorder and/or Attention Deficit Hyperactivity Disorder in the Home and Classroom Contexts. Frontiers in psychology, 8, 1772.

Lane, S., & Schaaf, R. (2010). Examining the Neuroscience Evidence for Sensory-Driven Neuroplasticity: Implications for Sensory-Based Occupational Therapy for Children and Adolescents. The American Journal of Occupational Therapy, 64(3), 375–390.

Shelhav, C (2019). Child Space. North Atlantic Books

Thelen, E. (2000). Motor development as foundation and future of developmental psychology. International Journal of Behavioral Development, 24(4), 385–397.