Hi Everyone! Thank you for coming to The Movement Team blog page. The team is very much enjoying sharing some of our thoughts and experiences with you. I hope these short articles help you feel better informed about some movement issues that pass us by every day.
My name is Tim Effeney and I am one of the Owners of The Movement Team. I am a Physio whose clinical expertise is with children and babies!
Paediatric Physiotherapy - What even is that?!
When most people think of Physiotherapy they tend to be aware of just a small part of what the Physiotherapy profession does. Certainly when I first chose Physio as a career I was very much focussed on the role that Physio’s play in injury rehabilitation, especially in sports people.
Physio’s though do work across the full scope of the health industry. A large part of being a registered Physio is the process of continual professional development and ongoing learning, and as a result of this clinician’s will develop targeted skill sets in the area in which they work and are interested. After gaining a broad base of experience, the clinical area which for me became my passion is Paediatric Physiotherapy.
You can find Physio’s who have specific paediatric skills working with babies and children in hospitals, special care nurseries, outpatient teams, disability services, schools, hydrotherapy centres and private clinics. I have been very fortunate to be able to work in great teams in nearly all of these areas. Regardless of what area of Paediatric Physiotherapy a therapist might work in, there are some topics that always seem to pop up. The idea of ‘tummy time’ for babies is one of these.
Tummy Time… ever actually wondered why?
This baby positioning practice is a universal one. It is not specific to a medical situation or condition. The need for babies to spend regular ‘awake time’ on their tummy is now widely advertised however it is still very often a source of confusion, anxiety and frustration for parents.
It doesn’t need to be though.
I could get very excited here and let the nerdy side of my Physio self out now and talk about, reference and detail all the benefits of ‘tummy time’ for a babies development. Now is not the time for that however so here is my overview of the key points:
Tummy time is about more than just building neck strength.
Tummy time is not a one-size-fits-all concept and it is more than just putting your baby flat on the floor.
Tummy time is not a magical fix; in fact it could be argued that tummy time is no more important than any of the other position you can put a baby in (back, side lying, supported sitting, carrying over your shoulder, over your arm, playing ‘aeroplane games’ etc).
Do not underestimate tummy time though. It is key to a baby being able to learn some very important foundational skills. As a young infant it is helpful for learning head control and reducing the risk of SIDS. As a baby grows, tummy time then plays a key role in that baby being able to interact with their environment. Tummy time is the first place where we start to overcome gravity and be able to move on our own.
However, and here it is, the big problem with tummy time, it is hard! It is often poorly tolerated by babies and often is a source of misplaced fear for parents. So perhaps this is the reason we push tummy time so strongly; it is so often left out; it is easy to overlook it; to give up on; to avoid or to just do a little token effort once a day.
“My baby hates tummy time!”
If your baby is not a super star at tummy time, do not fear. Do not worry. Do not feel guilty. Most importantly do not give up!
Often just a change in perspective from the thought that your baby hates tummy time to more productive thinking that your baby finds it difficult can help a parent immensely. All babies will eventually get exhausted on their tummy. Think about any position where you need to push your own weight against gravity. Push-ups, planks, many yoga postures… all of these are hard work. Why would it be different for babies?
Some babies will tire much quicker than others. When babies are tired or unwell their ability to cope with the position will reduce. Sometimes other factors increase the complexity of tummy time (reflux is very tricky!). It is a very personal thing that requires yourself and your baby to explore and improve at together. You are the motivator! Use whatever tricks you have to make tummy time more exciting. I like to use mirrors, easy to grab toys (like interlocking rings) and get down in front of bub so they can see and talk to me.
How much tummy time is enough?
The research is not exactly clear what ‘dose’ or how much tummy time we actually need at different ages. This is probably in part because development and learning to move is so different for each of us. Even when the goal is the same (or similar) the path is often not. While there will be similar principles, what yourself and your best friend would need to do to prepare for the same sporting event might be quite different. So while we wait for one of the excellent teams of researchers out there to discover and report more on how much tummy time is needed, here are my basic tips that will help you and your baby hopefully find tummy time a little easier!
- Recognise that tummy time is hard work. As we covered above, knowing that tummy time is hard work can help you understand why your baby might react unfavourably to spending a long time in this position. The perspective change from ‘dislike’ to ‘difficult’ might help here.
- Short bursts, very often! As well as improving your baby’s ability to tolerate tummy time, this strategy makes physiological sense. We know from the myriad of research in adults that to increase strength, short sets of heavy weights are more effective than long periods of low weighted resistance. While we haven’t studied it in infants, the same concept is likely to be true. It is also way easier to keep a baby entertained in short bursts of time! Therefore, don’t try and set a personal best for longest time on their tummy every time you practice this position with your baby. Also don’t be satisfied with just a couple of practices each day. If you know your baby starts to struggle after about 2 minutes, aim for lots of 1 ½ minute bursts! If your baby is tired or irritable, make the position easier or reduce the time, but don’t let your baby miss out entirely!
- Build it into your routine. As with most things, building good habits is the key to success. Find ways to build regular bursts of tummy time into your routine. Perhaps this might be every nappy change, every time you walk past the play mat on the floor, or lay your baby on your chest or lap every time you sit on the couch.
- Modify it! As indicated above, tummy time does not need be limited to placing your baby flat on their tummy on the floor. Early on, anything forward of vertical can count as tummy time. As your baby improves, make things more difficult! Towel rolls, prone play mats, wedges, different carrying techniques and gym balls all provide opportunities to make this position easier and more fun. Just remember to carefully supervise your baby and ensure they are safe. The first time a baby rolls off their tummy is often a surprise and occurs suddenly, so always keep a hand on your baby when they are resting on a raised surface.
If you are worried about your babies ability to move, you should definitely see your local health professional. Please remember that tummy time should always be a supervised activity for your baby to do while they are awake. If you are not familiar with the SIDS guidelines and worry about the difference between sleeping and playing in a prone position, please check out www.sidsandkids.org where there are some wonderful resources!
Thank you for reading the blog and good luck with helping your baby learn to move a little better! Remember that you are the expert on your own baby. Work out how your baby can most enjoy tummy time and include it as a regular part of their day. Don’t forget the 4 key points:
- Tummy time is hard work,
- Short bursts, very often,
- Build it into your routine, and
- Modify it!
I will be hosting regular ‘parent education’ seminars at The Movement Team in Samford. These are largely Question and Answer type sessions around the practical issues of how babies learn to move. At the moment we are not advertising these widely, but please keep an eye on our website or contact the clinic for details if you are interested.
B.Phty (Hons), G.D. Paed. Neuro. Rehab.
Tim has 8 years of Physiotherapy experience and is an expert in Paediatric (Baby’s and Children’s) Physiotherapy. Tim’s the person to see if you have any concerns about your baby or child’s movement skills or development.
Along with Yanek, Tim is owner and director of The Movement Team. Tim also holds an Advanced Physiotherapist position within a Child Development Service in the public health sector.
Tim has worked across the breadth of paediatric health (acute hospital, disability care, developmental, community and private clinics) and has completed numerous national and internationally recognised education courses in topics including developmental orthopaedics, high risk infant management, respiratory functioning and infant movement.
Tim's formal training consists of:
Bachelor Physiotherapy (Hons) - University of Queensland
Graduate Diploma Paediatric Neurological Rehabilitation - University of Western Australia
Tim additionally holds the following positions and memberships:
Chairperson of the Queensland Paediatric Physiotherapy Clinical Network 2013 - present
National Paediatric Group Member - Australian Physiotherapy Association
The clinical information included in this article is of a general nature and might not apply to every family. Please see your local health professional for individualised developmental advice.