Pediatric physical therapist explains why ‘tummy time’ isn’t a thing outside of the U.S.

You’d be hard-pressed to find a parent in the United States who isn’t extremely familiar with the concept of “tummy time.” Laying babies on their stomachs for brief periods while they’re awake has been presented to new parents as an important way to help babies strengthen their neck and shoulder muscles, and improve motor skills.

Interestingly, however, “tummy time” isn’t a big deal in other countries. In fact, in many places outside of the U.S., “tummy time” isn’t a thing at all.

Recently, an American mom who gave birth in France went viral for a video of a French pediatrician telling her not to do tummy time.

“I had multiple professionals being like, ‘You shouldn’t be putting your baby in uncomfortable positions especially if they’re not already getting themselves into that position,’” the American mom from the viral video says. “If they’re rolling over onto their tummy, that’s one thing, but putting them in positions that they aren’t able to get into naturally is developmentally inappropriate.”

Dr. Bonnie Soto, a pediatric physical therapist, explains why tummy time is still important—but it’s not the only way to achieve muscle strength.

“If you live here in the United States, if you’ve been around my page for a while, you know that tummy time is a big thing and it is important, but I don’t think in the way that people understand,” she said.

Soto explains that the idea behind tummy time really took off after the “Back To Sleep”/”Safe to sleep” campaign started in the 1990s. The popular saying was (and is) “Back to sleep, tummy to play” in order to remind parents of the danger of putting babies to sleep on their stomachs. Prior to this, babies who slept on their tummies were getting tummy time naturally.

“Babies were getting lots of short little bouts of tummy time throughout the day when they were laid down to sleep. There were babies sleeping on their belly. They’d wake up, press up and look around for a hot second, and people would move on,” she continued.

Dr. Soto explains that once parents learned about unsafe sleep, they overcompensated.

“People were kind of like overcompensating, overreacting there too and not placing them on their bellies for play either, probably out of fear,” she explained. “This kind of like uptick to the amount of time that babies were spending in containers because they could keep them on their backs there. So. we saw a huge increase in torticollis and plegeosephaly.”

Currently, the American Academy of Pediatrics recommends at least 15 to 30 minutes total daily by 7 weeks of age, with the number of minutes increasing as the baby grows. A 2020 study published by the AAP shows that tummy time was positively associated with gross motor and total development, a reduction in the BMI-z score, prevention of brachycephaly, and the ability to move while prone, supine, crawling, and rolling.

Dr. Soto totally validates the stress new parents feel about it—because we always want to do the right thing, follow the rules, and keep our little ones safe. But it’s anxiety-inducing, like most things are when you have a baby. So she offers recommendations to have tummy time naturally fit into your daily routine.

“Roll into tummy time after a diaper change for a few minutes and you can sit and chit-chat with them,” she said. “Your baby needs to snuggle you on your chest and take a nap, take a contact nap, get in the baby carrier, or just lay there and chit-chat in your face as you’re leaning back. Those are all part of a tummy time program.”

“Your baby needs free, unrestricted movement,” she added. “They need connection with you. You just holding your baby, snuggling them, moving them around in different positions is good for their development.”

If you feel guilty putting your baby into a position they don’t get into naturally on their own—don’t, Dr. Soto says.

“Babies are entirely dependent on us for their positioning,” she said. “So, this whole idea that we shouldn’t be putting them in positions that they can’t get into themselves… they can’t get into any positions by themselves. So, that’s baloney,” she said.

While they shouldn’t be uncomfortable or fussy during tummy time, she says it’s OK to gently introduce it into your normal activities with your baby.