Children’s health: Why back to sleep, tummy to play is so important

What are two of the most important ways to keep your baby safe when they sleep and help them grow and develop when they’re awake? This pair of simple daily habits can make a big difference: placing your baby on their back to sleep and giving them supervised tummy time when they’re awake.

Healthy babies are safest when sleeping on their backs, both at night and during naps, while tummy time is for babies who are awake and being closely supervised. Tummy time helps them build strong muscles and skills they need to reach important developmental milestones such as crawling. It’s exercise for baby, so it could help to tire them out for their naps as well! It also helps make sure to take pressure off their head, helping with head shape in the future.

Now how much tummy time should a baby have? The American Academy of Pediatrics recommends you play and interact with your baby while they are awake and on their tummy two to three times each day for a short time. About three to five minutes will be sufficient. You can start doing tummy time the day your baby gets home from the hospital.

Some babies may not like the tummy time position at first. Place yourself or a toy in reach for them to play with to help encourage them. There are a variety of ways you can play with your baby during tummy time. To get babies reaching for toys, try setting them in a circle around the baby or placing yourself or another toy just out of reach. To help them work their other muscles, lie on your back and place them on your stomach. They will naturally try to lift their face to look at yours. Eventually your baby will enjoy tummy time and begin to like playing in this position.

Once the baby starts to enjoy their tummy time, gradually increase the amount of tummy time. You can work up to about 15 to 30 minutes of tummy time each day by the time they are at seven weeks. Making tummy time activities a part of your baby’s routine, such as after diaper changes or when they wake up from a nap, can be a great way to incorporate some tummy time.

Small children, such as siblings, can also help babies get the most out of their tummy time ― when they are supervised by an adult. Young children can get down on the floor easily and they also generally have energy for playing with babies. Siblings or other small children may really enjoy their role as the “big kid” and are likely to have fun themselves when playing with infants.

Remember though ― tummy is for play, back is for sleep. To create the safest environment for a sleeping baby, place them on their backs, on a firm, noninclined sleep surface that meets current safety standards. There should be no other objects such as loose bedding or stuffed animals that could obstruct their airway. Make sure the baby’s head and face remain uncovered during sleep and place them in a smoke-free environment, away from areas where people use tobacco products.

It’s also a good step to keep the room cool where the baby is sleeping so they don’t overheat. Remember, it is safer to add layers of clothing to a sleeping baby than to add a blanket that could prove dangerous. You can also use wearable blankets, like a sleep sack or warm sleeper clothing ― just make sure it is the right size for your baby and doesn’t cover their head. Do not use weighted blankets or weighted clothing. Also, skip the baby hat when indoors except in the first hours after birth or in the neonatal intensive care unit.

Parents and caregivers often worry about the baby developing a flat spot on the back of the head because of sleeping on their back. Although it is possible for a baby to develop this, it usually rounds out as they grow older and sit up. And if you are practicing tummy time ― you are working to make sure this doesn’t happen!

Other ways to reduce the risk of the baby developing a flat spot include alternating at which end of the crib the baby’s head is placed, varying their position and occasionally holding them while awake, and switching sides during feedings, whether it be from the breast or bottle. All of these can remove pressure from one particular spot that can become flat.

Back to sleep, tummy to play, babies require 24/7 care, so make sure you get support to help your baby develop and rest their best.

• Children’s health is a continuing series. This column was provided by the American Academy of Pediatrics. Learn more at healthychildren.org.