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Question & Answer - Development



I have a 5-month-old baby who screams when placed on her tummy. She also is not rolling. I am concerned that she is behind in her gross motor development and that this will affect her other development. Should I be concerned?

QUESTION FROM: Ann in Maryland

June 2013



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Answer from Diane Bahr, MS, CCC-SLP

This is a common problem for today’s parents, and it seems related to lack of infant experience. However, first check with your pediatrician to see if your baby has any physical or medical concerns that may cause her discomfort when she is on her belly. Once you determine the problem is not physical or medical, you can teach your baby to spend time on her belly and to roll.

Why Do So Many Babies Dislike Tummy Time?

While pediatricians recommend “back-to-sleep” and “tummy-to-play,” babies do not seem to be getting enough belly time. In past generations (when children slept on their bellies), they had some natural tummy time as they moved in their sleep and when they woke up. However, today’s children sleep on their backs, and many are swaddled to help them sleep (which limits movement). Additionally, today’s parents are “on the go,” so babies go from crib, to car seat, to baby seat, to swing, etc. Today’s babies often spend so much time in some type of apparatus that they have been called “container babies.”

 

Babies (who spend too much time in containers) do not have enough opportunities to move and develop the muscles in their bodies. When placed on their bellies, they likely find that tummy time is hard for them (because they feel weak in this position). No one likes to do things that are difficult.

 

“Belly time ... provides the foundation for the development of breathing, postural control (e.g., sitting and standing), and movement (e.g., rolling, crawling, walking, eating, drinking, and talking). The muscles in your baby’s head, neck, upper spine, shoulder girdle, chest, and abdomen develop through belly time and movement” (Bahr, 2010, p. 56).

 

Therefore, you are correct to be concerned about your baby’s motor development if she is resisting belly time and not rolling. However, typically developing babies usually “make up for lost time” with the right help and encouragement.

How Parents Can Encourage Tummy Time and Related Motor Development

Today’s parents need to make a concerted effort for their babies to have adequate tummy time. Parents can accomplish this by placing the baby’s belly against the parent’s belly as they recline and relax together. It is important that the parent remain awake and alert during this time.

 

Parents may also get on their own bellies (on the floor or bed) with the baby on her belly. For younger babies, parents can make eye-contact, talk, and smile. For older babies they can look at toys and picture books together. Pack N Plays or a blanket on the floor can also be good areas for tummy time as long as babies have supervision and no one will step on them.

 

If belly time seems too difficult and/or stressful for a baby (at first), parents can provide support by:

  1. Placing small towel rolls under the baby’s arms or
  2. Positioning the baby on a wedge, so she does not have to bear her full weight

However, we want to keep babies “on track” in their development. 

What to Expect at 5 to 6 Months of Age

Here are the skills we want to see in a 5-month-old baby when she is on her belly (Bly, 1994):

  1. Good head control, and she can move her head from side-to-side easily
  2. Weight-bearing on her forearms and hands, and she can reach forward for toy

With regard to rolling, a 5-month-old baby should roll from her back to her side on her own. When she is on her side, she should be able to bring her hands together and to her mouth. By 6-months, a baby should actively roll from her back to her stomach (Bly, 1994).

 

Parents can play a game to help a baby learn to roll from her back to her side at 5 months.  Place your hand under the baby’s shoulder or hip, and gently help her begin to roll to her opposite side. You may gently guide her arm or leg across her body, but do not pull on them (to avoid dislocation of the joints). This gentle rolling game can be fun for the parents and the baby.

 

Thank you for asking this very important question, as many parents are likely experiencing this very same problem. You are not alone.

References:

Bahr, D. (2010). Nobody ever told me (or my mother) that! Everything from bottles and breathing to healthy speech development. Arlington, TX: Sensory World.

Bly, L. (1994). Motor skills acquisition in the first year: An illustrated guide to normal development. San Antonio, TX: Pearson.

 

This Q & A has also been printed with permission from Diane Bahr on Own A Daycare.