Tummy time: when to start, how long by age and what if baby hates it

Tummy time means putting your baby on their tummy to play while they're awake and you're right there with them. You can start the day you bring your baby home, with sessions of just a minute or two, and build up as they get stronger. It strengthens the head, neck, arms and back for rolling, sitting and crawling, and gives the back of the head a break from lying flat.

The AAP's tummy time guide suggests starting with about 3 to 5 minutes, 2 to 3 times a day, and its safe sleep guide suggests working up to at least 15 to 30 minutes a day by 7 weeks. The WHO recommends at least 30 minutes a day, spread through the day, for babies who aren't yet mobile. Sleep is always on the back.

Why does tummy time matter?

Because babies sleep on their backs, they spend a lot of time lying that way. Pregnancy, Birth and Baby's tummy time page explains that tummy time gives your baby a new position, helps prevent a flat spot on the head, and builds head, neck and upper body strength for crawling, rolling over, sitting up and standing.

Red Nose in Australia says tummy play helps muscle development in the arms, neck and back, can help prepare babies for crawling and sitting, and may help prevent a misshapen head. The AAP says it helps babies build the muscles and skills they need to reach important milestones.

You'll see that strength show up in the milestone checklists. By 4 months, the CDC's checklist includes pushing up onto elbows or forearms when on the tummy. By 6 months, the CDC's 6-month checklist includes pushing up with straight arms and rolling from tummy to back. See rolling over.

When should you start tummy time?

From birth. The AAP says you can start the day your baby comes home from hospital, Red Nose says from birth with the time increasing slowly, and Pregnancy, Birth and Baby says soon after birth, as part of an enjoyable daily routine.

If your baby was born early or has a health condition that affects how they can lie, ask their care team how to adapt tummy time. Pregnancy, Birth and Baby notes that babies with low muscle tone, such as some babies with Down syndrome, can benefit from tummy time with a favourite toy to encourage head lifting.

How much tummy time does a baby need at each age?

Sources describe a gradual build-up rather than a fixed target:

These totals are a guide for the whole day, not one session, and several short goes count.

The WHO also recommends that babies are active several times a day, particularly through interactive floor-based play, and aren't restrained for more than 1 hour at a time in a pram, high chair or carrier. It doesn't recommend screen time at this age.

How do you do tummy time?

Start wherever your baby is most comfortable, and move to the floor as they get stronger.

1. On your chest. The AAP suggests lying on your back with your baby on your chest. They'll lift their head and use their arms to look at your face.
2. Across your lap. Pregnancy, Birth and Baby suggests laying your baby across your lap on their tummy, which many newborns find easier.
3. On the floor. Put your baby on a rug or play mat on the floor. Get down to their level so they can see your face.
4. Add interest. The AAP suggests placing yourself or a toy just out of reach, or toys in a circle so your baby reaches in different directions. Pregnancy, Birth and Baby suggests a non-breakable mirror, a picture book or moving a toy from side to side. The CDC's 6-month activities include putting toys just out of reach to encourage rolling.
5. Pick your moment. The AAP suggests after a nappy change or when your baby wakes from a nap. Pregnancy, Birth and Baby says to choose a time when your baby is happy and alert.

What if my baby hates tummy time?

Many babies protest at first. The AAP says some babies don't like the position at first, and that over time most learn to enjoy it.

• Keep it short. A minute or two at a time, several times a day, is still tummy time. Stop before your baby gets really upset and try again later.
• Change the position or place. Pregnancy, Birth and Baby suggests changing the activity or location, or lying down and putting your baby on your chest while you play with their hands and feet.
• Add company. Lie alongside and chat, sing, stroke their back or rock them gently. The AAP suggests letting an older child play with your baby while you supervise.
• Count every bit. Red Nose says any time your baby isn't on their back is a form of tummy time.
• Mind the tummy. Pregnancy, Birth and Baby says babies with reflux may find tummy time uncomfortable and suggests trying it before a feed.

If you note sessions in a diary, record what your baby enjoyed and for how long, not just minutes. It's a useful thing to share at a check-up if tummy time is a struggle.

Does tummy time prevent a flat head?

It helps. The NHS guide to flat head syndrome says it's common for young babies to develop a flat area, that it doesn't affect their brain or development, and that it usually improves as they grow. It suggests plenty of supervised tummy time, moving toys so your baby turns their head both ways, changing the side you feed and carry them on, and not leaving your baby lying in a pram or sitting in a car seat for long periods. The AAP also suggests limiting time in swings, bouncy chairs and car seats.

NICHD says flat spots from back sleeping are usually not dangerous and typically go away once a baby starts sitting up. Never change your baby's sleep position to prevent a flat spot: the NHS says babies should always sleep on their back.

How do you keep tummy time safe?

• Awake and supervised, every time. The AAP says tummy time is for babies who are awake and closely supervised. Red Nose adds: not too tired.
• Never leave your baby alone on their tummy. Pregnancy, Birth and Baby says it can be very dangerous if your baby falls asleep on their tummy or their airways become covered.
• Sleepy baby, back to bed. If your baby gets drowsy, Pregnancy, Birth and Baby says to place them on their back to sleep in their cot.
• Use a safe surface. A rug or mat on the floor, rather than a bed or sofa where your baby could roll off or sink into cushions.
• Watch your own tiredness. If your baby is on your chest and you start to feel sleepy, move them to their cot. See contact napping and safe sleep.

When to get help

Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) now if your baby is struggling to breathe, turns blue, grey or very pale, is floppy or hard to wake, or has a seizure, during tummy time or at any time. These are on the NHS list of when to get urgent help.

Talk to your GP or child-health nurse if:

• your baby's head is always tilted to one side or they have difficulty turning it, which the NHS says can be a sign of tight neck muscles (torticollis)
• you're worried about the shape or size of your baby's head
• by around 4 months, your baby isn't holding their head steady when held or pushing up onto their forearms on their tummy, both items on the CDC's checklist
• your baby seems to lose a skill they had before

The CDC's advice is not to wait: share your concerns and ask about developmental screening. See milestones from 0 to 3 months and milestones from 4 to 6 months.