Babies Need More Than Tummy Time to Strengthen Necks and Prevent Flat Heads

The Conversation                August 20, 2018

Supervised, awake tummy time is recommended to facilitate a baby’s development and minimize flat head syndrome.  But some babies don’t like tummy time, and will kick up an almighty fuss to let you know. Luckily, tummy time is not all you can do to get your baby moving.


What is flat head syndrome?

Flat head syndrome, or “plagiocephaly”, occurs when the baby’s soft skull can mould and cause a flat spot at the back of the head, or a bulge at the forehead. This is due to gradual pressure on the back of the head from the baby lying on that spot as the head grows rapidly.

Plagiocephaly is surprisingly common, affecting 46.6% of infants at 7-12 weeks and 50% at six months. One study found  80% of infants were considered normal by five years of age.

In more severe cases, the baby may be prescribed an orthotic helmet; but this is controversial and parents have reported problems such as child stress and high costs. In 2014, a randomised controlled trial discouraged the use of helmets, but the same year a study reported 95% improvement in asymmetry with helmet therapy.

Studies have shown three-year-olds with plagiocephaly had statistically significant delays in cognitive, language and adaptive behaviours. Another study of three to five year-old children found postural changes and poor balance compared to children without flat head syndrome.

A systematic review of flat head syndrome and developmental delay concluded flat head may be a marker of developmental needs requiring early intervention.

Just tummy time isn’t enough

Supervised tummy time, or rolling the child onto their stomach, has long been recommended, although currently there are no national guidelines regarding the frequency and duration of tummy time an infant should receive.

Tummy time helps strengthen babies’ necks. It gets them off the back of their heads where flatness can occur and leads to strengthening of the extensors (straightening muscles) in the back of the neck, which hold the head up when babies are on their stomachs.

Some research found tummy time alone is not enough to prevent flat heads. In addition to tummy time,parents should encourage “face time” to strengthen the muscles at the front of the neck to enable baby to move their head while on their back.

Face time is challenging for the baby as it requires the flexor (curling up) muscles to coordinate the head to lift it forward towards you, and against gravity.

Face time can be done when baby is awake by supporting them in front of you “face to face” and engaging them with direct eye contact. If they are happy and settled they will follow your eyes to the side and, if you keep eye contact, turn their head to see you.

Even newborns will be able to move their heads from side to side to keep your eye contact. from

Previous studies have shown reduced plagiocephaly rates when parents prepared the environment to allow free and spontaneous movement (such as placing the baby on a mat when they’re awake), when infants spent less time in carriers, and when parents were aware of the infant’s head position. This research adds specific advice for active head movement that can become part of daily activitiesBoth tummy time and face time can be started from birth. Tummy time can be face time as well if you lie down with them on your stomach. When they can hold their head up themselves in tummy time they can go on a mat with some toys for short sessions.

If they’re upset, get down and play with them to see if they settle, otherwise you need to pick a better time when they are active and awake.

What parents should know

It’s important to follow safe sleeping advice, which specifies a baby should sleep on their back. Along with this, parents should interact with their baby as in the above illustrations and know:

  • Even newborn babies can move their head to each side by following their parents’ eye contact or their voice and they should be encouraged to do so
  • From birth, babies need both tummy time and face time when they are awake and happy
  • Baby’s head should be supported until they can hold it themselves.

The best way to encourage babies to be more active is to play with them, provide tummy time and engage face to face with eye contact, smiles and talking, from birth.


The Advantages of Tummy Time


For those of us active in infant care and the training of parents the topic of Tummy Time is central.  There is nothing that has more affect on the physical strengthening and development of your baby.  Unless your baby has the opportunity to push against the surface of her bed or the floor her trunk muscles (abdomen, chest, shoulders, etc) will be dalyed in development.

This is food for thought.  There are advocates on either side of the  argument.  But it is essential that your baby learn to enjoy and take advantage of time on her tummy.



Positive Parenting Tips

I find it is alway good to review thoughts on how to help your baby develop well.  You never know when you will learn something new.  It is easy to become overwhelmed with life and forget easy ideas that will help.

Participating in mommy and me classes is another great way to learn new ways to help your baby grow.  These also give you the opportunity to spend time with other new mommies.  These classes can be found in your community news letters, at local churches, and community centers.

Infants (0-1 year of age)

Developmental Milestones

Skills such as taking a first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Developmental milestones are things most children can do by a certain age. Children reach milestones in how they play, learn, speak, behave, and move (like crawling, walking, or jumping).

In the first year, babies learn to focus their vision, reach out, explore, and learn about the things that are around them. Cognitive, or brain development means the learning process of memory, language, thinking, and reasoning. Learning language is more than making sounds (“babble”), or saying “ma-ma” and “da-da”. Listening, understanding, and knowing the names of people and things are all a part of language development. During this stage, babies also are developing bonds of love and trust with their parents and others as part of social and emotional development. The way parents cuddle, hold, and play with their baby will set the basis for how they will interact with them and others.

Following are some things you, as a parent, can do to help your baby during his first twelve months of development:

  • Talk to your baby. He will find your voice calming.
  • Answer when your baby makes sounds by repeating the sounds and adding words. This will help him learn to use language.
  • Read to your baby. This will help him develop and understand language and sounds.
  • Sing to your baby and play music. This will help your baby develop a love for music and will help his brain development.
  • Praise your baby and give him lots of loving attention.
  • Spend time cuddling and holding your baby. This will help him feel cared for and secure.
  • Play with your baby when he’s alert and relaxed. Watch your baby closely for signs of being tired or fussy so that he can take a break from playing.
  • Distract your baby with toys and move him to safe areas when he starts moving and touching things that he shouldn’t touch.
  • Take care of yourself physically, mentally, and emotionally. Parenting can be hard work! It is easier to enjoy your new baby and be a positive, loving parent when you are feeling good yourself.

Have so much fun with your little person!!!



Ideas for Staying Healthy in 2020

Last Saturday morning my daughter and I spent 2.5 hours in the Urgent Care facility at Kaiser.  The place was packed!  Ill people everywhere!  She was experiencing stolen glands and pain in her neck.  She and everyone else in Orange County!!!

Here are some simple ways to avoid infection and illness during this time of year!

First, wash your hands and the hands of your little ones often.  This is such a simple process and makes a huge difference.  No matter how careful you are your hands touch way more than you realize.  Just washing them with soap and water will make a big difference in infection and illness in your life!

Second, brush your teeth several times a day to cut down on bacteria. This is a new method being practiced in hospitals and care facilities.  Studies have found this has greatly reduced the occurrence of pneumonia and other contagious diseases!!!

Third, wash your clothing more often during this time of year.  When you have been out in public go home and change clothes.  This is a precaution against allowing more germs into your home.  If you go somewhere with many sick people, Dr. offices, urgent care, or a hospital understand there are millions of germs floating around.  Protect yourself.  (Hospital personal are taught not wear their shoes from work into their homes.  They leave them in the garage to avoid spreading germs)

Fourth, if you work in an office, and many associates parade through your space, wipe down surfaces with disinfectant wipes.  Don’t do this in front of coworkers, you make yourself look a little crazy.  But be aware.

Fifth, when other children come to play be sure they are healthy.  Encourage everyone to wash their hands and faces when they arrive.  It is just good practice.  Make it fun, have colorful soaps and fun paper towels to dry with.  Make it a game.

Sixth, when visitors go home put you kids in the bathtub.  Put their clothing in the laundry.  Teach them to wipe down their toys and games. If they used the computer or video games wipe them down with antibacterial wipes. Just as a precaution.  Only at this time of the year when sickness is prevalent.

These are some helpful hints for keeping you and your family well when illness is everywhere.  Hope they help.  Please send your suggestions so we can all have a healthy happy 2020!

Thank you,  JUDY


We have arrived.  The huge mirrored ball in Times Square, New York has dropped.  The fire crackers have popped, and it is now 2020.  A Leap Year, no less!!!  An election year!.  Wow, there is already much on the table for 2020.  There will be allot of excitement, dialogues, discussions, and outcomes!  2020 promise to be invigorating!  How will it affect you and yours?  I am looking forward to great things!!!