Where does the controversy around the prone position come from?
Until the early 1990s, parents were advised to have babies sleep on their side or stomach to reduce the risk of choking. In 1992, recommendations shifted to favor the back or side, and by 1996, the back position became the safest due to its link with reducing the risk of sudden infant death syndrome (SIDS).
In Canada, the “Back to Sleep” campaign helped reduce cases of SIDS by 50% between 1990 and 2000. Since then, the back position has remained the recommended position for infant sleep.
Today, recommendations are clear: babies should always be placed on their back to sleep to reduce the risk of SIDS.
However, it’s important to know that when a baby is awake, there is no risk associated with SIDS. There is therefore no concern in placing baby on their stomach during awake time, and it is even essential to do so several times a day.
When should you start tummy time?
Tummy time can begin in the first days of life, always when baby is awake and supervised. For example, skin-to-skin contact on your abdomen is a great way to gently introduce this position.
During the first three months, prioritize short periods repeated multiple times a day. A few minutes at a time is enough, depending on your baby’s tolerance.
- Respect signs of fatigue or discomfort
- Let baby rest as soon as they cry
- Resume after a short break
The goal is to accumulate several short periods so that by around 6 months, baby naturally prefers being on their stomach.
Why place baby on their stomach?
Motor development
The prone position is essential for healthy motor development. It engages the neck, shoulder, and back muscles, allowing baby to lift their head and prepare for the next developmental stages.
Read our article on motor development.
Prevention of flat head
Reducing time spent on the back helps prevent plagiocephaly (flat head). However, this position does not correct an already flat head. In such cases, a consultation in pediatric physiotherapy is recommended.
Sensory stimulation
On their stomach, baby discovers their environment from a new perspective. They see more of what is happening around them and develop their curiosity, vision, and body awareness.
Learning to move
This is the position from which baby begins their first movements: rolling, crawling, and eventually moving on all fours.
By around 6 months, motor development no longer progresses on the back. If baby is not comfortable on their stomach, their development may slow down.
My baby doesn’t like tummy time: what can I do?
- Turn baby from back to stomach while keeping their body close to the surface
- Use a mirror or high-contrast toys to capture attention
- Get down to baby’s level to encourage them
- Position elbows under shoulders to make lifting easier
- Slightly incline the position using a cushion or your abdomen
- Support the chest with your hands to reduce effort
Over time, baby will tolerate longer periods, often 5 to 10 minutes or more at a time.
When should you consult in pediatric physiotherapy?
It is recommended to consult if:
- By 2 months at the latest, baby cannot tolerate more than 5 minutes on their stomach without crying despite trying the strategies above;
- At 2 months or older, baby does not lift their head in the prone position;
- At 6 months, baby prefers sitting rather than being on their stomach;
- At 7 months, the prone position is not their preferred position.
Do you have questions or concerns about your baby’s motor development? Book an appointment with a pediatric physiotherapy professional for personalized support.
