Babies have many milestones, but one of their first will be their ability to lift and hold their heads as the muscles in the neck and shoulders strengthen. A way to help your child or grandchild build those muscles is through tummy time.

Tummy time describes a designated amount of time when parents place infants on their stomachs so the children develops muscles from lifting their heads.

“Tummy time can be done for one to five minutes several times per day at first and build up to an hour per day during waking hours by the end of three months,” says Kelly Hidalgo, a board-certified specialist in pediatric physical therapy with Southeast Georgia Health System. “It does not have to be done all at once. It all counts! The intent is to develop muscles in their back, neck, and trunk while meeting developmental milestones.”

Tummy time can take place in a variety of ways. For instance, the parents can lay down and place the child on their chest or sit and place the child on their lap. Carrying the baby on his or her tummy also qualifies as does placing the infant on a changing table, crib, pack-n-play, or floor. “However, changing table, floor, or chest make it easier for a parent to be able to interact with the baby,” Hidalgo says.

Tummy time can begin as soon as you bring the infant home from the hospital with short sessions to build up muscles over time. “It should only happen when the infant is awake and can be engaged,” says Dr. Melissa Wood-Katz, board-certified pediatrician with Southeast Georgia Physician Associates-St. Simons Pediatrics, a strategic affiliate of Southeast Georgia Health System. “Tummy time should always be supervised,” she adds. “Please do not leave the infant, even for a second, to grab your phone for a quick picture. Baby should always be awake and alert during tummy time as well.”

Family members can become part of the process. “This is a good opportunity for bonding with your infant. Parents can talk, sing, and make faces to baby during this time,” Wood-Katz says, also mentioning how older siblings can help and have special bonding moments with their new brother or sister. “Babies love faces, so caregiver or sibling at eye level works well,” Hidalgo adds. She also recommends tummy time with a mirror, where babies can try to lift to see themselves, or dangling a favorite toy to encourage the children to lift their head.

Several development benefits come from placing infants on their stomachs. “Tummy time allows the baby to see their world from a different perspective than always on their back. It also helps with proprioception, understanding their positioning, by pushing against a firm surface,” Wood-Katz says. “It is very important to provide different stimulation for your baby in the form of textures, sights, and sounds to promote development and provide extremely important emotional interaction.”

There are many ways to see how tummy time is helping. For instance, infants will start to lift and hold their heads briefly or control their head movements more. “Parents will also notice, with adequate tummy time, that the head shape will stay nice and round. Tummy time is an important part of altering positions for baby to prevent positional plagiocephaly, deformation of the skull due to prolonged pressure and lack of changing positions throughout the day,” Wood-Katz says.

A few signs that a baby needs more tummy time can be if the infant develops a flat portion on the back of the head, or positional plagiocephaly, as Wood-Katz mentions. Another sign is positional torticollis, or a tightness in one side of the neck. “Babies can also have delayed milestones,” Hidalgo says. “By 3 months, babies should be pushing up on arms and lifting his or her head when on tummy.”

Babies getting fussy can be common when tummy time first starts. “If they are engaged and enjoying it, then continue until it is no longer fun or they tire out. If they are unhappy, then it is best to break up tummy time throughout the day with a total of 15 to 20 minutes of tummy time daily,” Wood-Katz says.

Once the infant begins rolling over, around four months, the baby will be more active and likely will not stay on tummy and will become more mobile, Wood-Katz says.