Baby hates tummy time? Find out why before you try to fix it

If your baby hates tummy time, the cause is usually one of three things: not enough head control yet, a tummy that is uncomfortable after a feed, or a strong wish to be held. Each one has a different first fix. Work out which it is, try that one thing for a few days, and remember that tummy time on your chest still counts.

Why do so many babies dislike tummy time at first?

Because lying face down is hard work for a body that has not done it before. A newborn's head is heavy and the neck and shoulder muscles that lift it are still weak. On the floor, all your baby can see is the blanket, and you have gone out of view.

The AAP says it plainly on its page about back to sleep, tummy to play: some babies may not like the position at first. That is the starting point, not a problem.

It is still worth doing. The Safe to Sleep campaign at the NIH explains in its page on the benefits of tummy time that supervised tummy time strengthens the neck, shoulder and arm muscles a baby uses to sit up and crawl, and helps prevent flat spots on the back of the head.

Tummy time is only ever for an awake baby with an adult watching. Sleep is always on the back.

The three question checklist: what to try first

Ask these in order. Stop at the first yes, try that fix for three or four days, and only then move to the next question.

1. Does your baby's head drop or the face press into the floor within seconds? That points to head control. Try tummy time on your chest first, reclined so your baby lifts their head to see your face. If that goes well for a few days, move to the floor with a small rolled towel under the arms.

2. Does the crying start soon after a feed, with spit up, arching or a hard tummy? That points to discomfort after feeding. Move tummy time away from feeds first, for example straight after a diaper change or after a nap, and try a slight incline on your chest. If the fussing carries on at every time of day, go to question three.

3. Does your baby settle the moment you pick them up, and fuss on the floor even when fed and rested? That is a preference for being held. Keep the closeness and change the position: lap time and the tummy down carry first, then floor time with you lying face to face.

If none of the three fits, or two fit at once, start with the chest. It works for all three.

Is it a lack of head control, and what helps that?

If your baby's face drops toward the floor almost at once, the neck muscles need more practice in an easier position. Make the job smaller rather than stopping.

• Lie back and put your baby on your chest. The AAP names this position, and the more upright you sit, the less weight your baby has to lift.

• Prop the arms. The NIH Safe to Sleep page suggests a rolled up towel under your baby's arms to lift them slightly. Stay right there the whole time.

• Keep it short. The same page describes two or three short sessions of three to five minutes a day for most babies at the start.

Head control builds week by week. The CDC lists holding the head up when on the tummy among its milestones for two month olds, which is why tummy time usually gets easier around then.

Is it reflux, and what changes the position to try?

If the protest comes with spit up, arching or crying soon after feeding, a full tummy pressed flat is likely part of it. The fix is timing and angle, not giving up.

• Move the session away from feeds. The AAP suggests after a diaper change or when your baby wakes from a nap. Both are often a while after a feed.

• Use an incline. Your chest, with you sitting back, puts your baby on a gentle slope instead of flat on the floor.

• Try the lap. Lay your baby across your thighs, tummy down, with a hand on the back. It doubles as a burping position.

Spit up that is forceful, green or bloody, or a baby who is not gaining weight or refuses feeds, is a call to your pediatrician today, not a tummy time question.

Is it simply a preference for being held, and how do you build up from there?

Some babies just want to be close, and the floor feels far away. Bring yourself to them, then build distance slowly.

1. Start held. Chest to chest, lap time, or carrying your baby tummy down along your forearm all put weight through the tummy while you stay close.

2. Get on the floor too. Lie face to face at your baby's eye level. Your face is the best thing in the room to lift a head for.

3. Add one thing to look at. A toy, a soft book, or an older sibling chatting at floor level. The AAP suggests placing yourself or a toy within reach.

4. Build by a minute, not by a session. Stop before the crying peaks. A short session that ends calm is worth more than a long one that ends in tears.

For floor play ideas as your baby gets stronger, our guide to play ideas for a 6 month old has more to try.

When does resistance to tummy time deserve a call rather than another try?

Call your pediatrician when the dislike comes with a sign that something physical is in the way. Book a visit if your baby:

• keeps the head tilted toward one shoulder, or always turns to look the same way

• has a flat spot on one side or the back of the head that is getting worse

• still cannot lift the head at all on the tummy at around two months

• screams in tummy time at every time of day, however short, after a few weeks of trying

• has spit up with weight worries, feeding refusal, or green or bloody vomit

A head tilt can be torticollis, a tight neck muscle that pulls the head to one side. Cleveland Clinic advises speaking to your pediatrician as soon as possible if you suspect it, and a pediatric physical therapist can show you stretches and positions for home. For other early signs worth raising, see our guide to baby milestones and when to worry.

FAQ

How much tummy time does a baby actually need each day?

Start with two or three short sessions of three to five minutes a day. The AAP's tummy time guidance says to work up to 15 to 30 minutes in total each day by seven weeks, and the NIH Safe to Sleep campaign gives the same total by about two months. Many short sessions add up, and they all count.

Can tummy time happen on a parent's chest instead of the floor?

Yes. The AAP lists lying back with your baby on your chest as a tummy time position. It is often the easiest way to start, and floor time can follow as your baby's head control improves.

Does a baby who hates tummy time catch up on the skills it builds?

Most babies who dislike tummy time early get more comfortable as their neck and shoulders strengthen, and the AAP says that eventually a baby will enjoy tummy time. What matters is regular practice in any position that puts weight on the tummy. If your baby is not lifting the head at around two months, or favours one side, raise it with your pediatrician.

Is it fine to skip tummy time on a hard day?

Yes. One missed day does not undo anything. On a hard day, count the small moments: a minute on your chest, a lap burp, a tummy down carry across the room. Pick up the usual sessions tomorrow.

Start with one minute on your chest tonight

Tonight, lie back on the sofa with your baby on your chest and talk until they lift their head to look at you. That is tummy time. Get the free Milestone checklist from the HelianWell library, and if you want help with your own baby, you can meet the child health and development experts who coach HelianWell families.

Photo by Alex Bodini on Unsplash