Posted on April 8, 2011

Tummy time: Tips to help you position, carry, hold and play with your baby

Your baby needs supervised time on her tummy throughout the day while she’s awake. Mary Free Bed’s pediatric specialists offer these ideas and activities to ensure your baby gets the exercise she needs.

How you play and interact with your baby helps her increase strength and decrease the risk of tight muscles.

Increasing tummy time can:

  • Improve neck and shoulder strength
  • Decrease the potential for tightness in the neck, which can lead to abnormal head shape
  • Build a balance of strong muscles for skills such as rolling, crawling, and sitting

What Is Proper Alignment?

Midline alignment is when your baby’s body is straight, whether she’s on her back, on her stomach, or sitting up.

For proper alignment, you want your baby to be able to stay in midline, move out of midline, then return to midline. Moving in and out of midline is important for proper eye-hand-head coordination and balance during your baby’s first year.

The Importance of Tummy Time Activities

Your baby spends a lot of time sleeping on his back. When he’s awake, lying on his tummy is a healthy position for him. More and more carriers – including car seat and stroller combos, bouncers, and swings – are available that make it hard to remember to put your baby on his stomach.

Tummy time strengthens the muscles in your baby’s neck, arms, and trunk. He has to lift his head in this position, which makes his back stronger. When your baby looks around, he’s strengthening his neck. Your baby is also building strength when he pushes through his arms, which helps him learn to reach and crawl as he gets older.

When you first put your baby on his stomach, he may not like it. Start out by having your baby on his tummy for only a few seconds. As he gets stronger, he’ll want to stay on his stomach longer.

Tummy time is:

  • Always supervised
  • A bonding time with your baby
  • A fun time to play and interact with your baby

Activities of Daily Living

Your baby has important activities to do during the day, such as eating, sleeping, and playing. You can help your baby build strong muscles by how you position her during these tasks.

Feeding: Hold your baby so she’s facing up, and make sure her spine is aligned with her neck. Keep your baby’s bottle in the middle of her mouth so that both of her arms are holding the bottle or coming toward the bottle. If you’re nursing, you’ll naturally be switching sides. Make sure your baby’s head is in midline alignment. You may find that a football hold is easier to use to keep her head in this position.
Diapering: Make eye contact with your baby when you’re changing his diaper. Be sure to keep his head and spine aligned while changing his diaper. After his diaper is changed, roll your baby onto his stomach for a few minutes of supervised tummy time.
Sleeping: Always put your baby on his back to sleep, unless your physician directs you otherwise. Each night, alternate the direction your baby’s head is turned.

Riding in Car Seat: When you put your baby in her car seat, make sure she’s sitting squarely on both hips, with her shoulders level and her head aligned with her spine. Adaptation: Use a rolled towel or an infant insert for head support while your baby is in her car seat. An infant insert is a foam support that comes with most infant car seats. If your baby’s car seat didn’t come with an insert, you can buy it separately.


Playtime is one of the best times to challenge your baby and help him grow stronger. Use a variety of positions – and play with a purpose!

It’s important for your baby to spend time on the floor every day playing. Minimize his time in his bouncy seat, car seat, swing, walker, or exersaucer. If your baby is sitting in a seat, carrier, or stroller, exploration of movement is limited.

Your baby learns to move by playing on the floor on his tummy, back, and sides. At first, he may tire easily and cry. Slowly increase his floor time with frequent bursts of floor activities. It’s particularly beneficial for him to be on his tummy when he’s awake and you’re supervising him.

Also remember that making eye contact with your baby is motivational for him. If you lay on your stomach in front of your baby, he’ll be encouraged to lift his head to see you.

Playtime Ideas and Tummy Positioning

Tummy – Towel Roll: Place a towel roll under your baby’s chest and drape her arms forward. Put your hand on her bottom to help keep her from rolling or hiking up her legs.

Tummy – Over a Boppy Pillow™: Place your baby over a Boppy Pillow, with the pillow under his upper chest. His arms may be straight or bent.

Side – Towel Roll: Using the curve of your leg let your baby lay on his side. His top arm will be able to reach for toys. You may have to use your hand to hold your baby at the hip to keep him from rolling.
Back: When your baby is playing on her back, her spine should be straight, not curved to the side. As she starts rolling, she’ll twist and turn more. It may be helpful to have a toy overhead that your baby can reach for or look at to keep her spine straight.
Back – With Feet Support: With your feet touching and your legs making a circle, rest your baby’s head on your feet. Make sure her body is properly aligned. This position is great for face to face interaction. Your baby will also learn her midline in this position as well as how to reach for toys. When your baby is a little older, she’ll explore her feet, which will make her tummy muscles stronger.

Back with Towel Support: If it’s uncomfortable to sit with your feet together, try positioning your baby between your legs, with or without a towel under his head.
Baby Under Play Gym: Place your baby so he’s looking straight up at a toy that’s in his direct line of vision. Try to keep his body still while he reaches straight up for the toy with both hands.
Sitting: Make sure you give your baby the support she needs when she’s sitting. Start by supporting her head until she can hold it up on her own. Next support your baby at her chest – and, eventually, not at all.

Carrying or Holding: Babies love to be held. Hold your baby so he’s facing out to see the world, or close on your shoulder or chest to snuggle. Remember to carry your baby on alternating shoulders and alternate the direction of his head

Tummy Time Alternatives

Sometimes your baby will have a hard time staying on her tummy. Tummy time alternatives are activities to make being on her tummy a little easier until your baby is strong enough to lay on the floor.

Baby Lying on Your Chest: Lay on your back with your baby lying on your chest facing you. You can lay flat on the floor or propped on some pillows. Your baby’s arms can be bent or straight. Help your baby stay in midline when you are holding her.

Baby Lying Across Your Lap: Lay your baby across one or both of your legs with his arms hanging over your legs. Use your hand on his back or hips to keep them stable. Place a toy in your baby’s line of vision that’s close to the ground and gradually move the toy higher.