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Ages & Stages

Back to Sleep, Tummy to Play

What are two of the most important ways to keep your baby safe when they sleep and help them grow and develop when they're awake?

  1. Back to sleep. Healthy babies are safest when sleeping on their backs at nighttime and during naps. Side sleeping is not as safe as back sleeping and is not advised.

  2. Tummy to play. Tummy time is for babies who are awake and being watched. Your baby needs this to develop strong muscles.

Read on to learn more about tummy time with babies and creating a safe sleep environment for them.

How much tummy time should a baby have?

Play and interact with your baby while they are awake and on their tummy 2 to 3 times each day for a short time (3 to 5 minutes). You can start the day your baby gets home from the hospital.

As babies grow older and stronger, they need more time on their tummies to build their own strength. Tummy time prepares babies for being able to slide on their bellies and crawl. Work up to 15 to 30 minutes each day by 7 weeks.

Tip: A great to do tummy time activities with babies is after a diaper change or when they wake up from a nap.

What if my baby does not like being on their tummy?

Some babies may not like the tummy time position at first. Place yourself or a toy in reach for them to play with. Eventually your baby will enjoy tummy time and begin to enjoy play in this position.

Does sleeping on their back cause babies to have a flat head?

Parents and caregivers often worry about the baby developing a flat spot on the back of the head because of sleeping on the back. Although it is possible for a baby to develop a flat spot on the head, it usually rounds out as they grow older and sit up.

There are ways to reduce the risk of the baby developing a flat spot:

  • Alternate which end of the crib you place the baby's feet. Babies naturally urn toward light or objects in different positions, which will lessen the pressure on one particular spot on their head.

  • When your baby is awake, vary their position. Limit time spent in freestanding swings, bouncy chairs and car seats. All these items add pressure on the back of the baby's head.

  • Spend time holding the baby in your arms as well as watching them play on the floor, both on their tummy and on their back.

  • A breastfed baby would typically change breasts during feeding; if the baby is bottle fed, switch the side that they feed on during feeding.

How can I exercise my baby during tummy time?

There are lots of ways to play with the baby while they are on their tummy.

  • Place yourself or a toy just out of the baby's reach during playtime to get them to reach for you or the toy.

  • Place toys in a circle around the baby. Reaching to different points in the circle will allow them to develop the appropriate muscles to roll over, scoot on their belly and crawl.

  • Lie on your back and place the baby on your chest. The baby will lift their head and use their arms to try to see your face.

  • While keeping watch, have a young child play with the baby while on their tummy. Young children can get down on the floor easily. They generally have energy for playing with babies, may really enjoy their role as the "big kid" and are likely to have fun themselves.

Back to sleep & beyond: How to create a safe sleep environment

Follow these easy steps to create a safe sleep environment in your home, family child care home or child care center (see Keep Your Sleeping Baby Safe for more information):

  • Always place babies on their backs to sleep, even for short naps.

  • Place babies on a firm, non-inclined sleep surface that meets current safety standards. For more information about crib safety standards, visit the Consumer Product Safety Commission Web site.

  • Keep soft objects, loose bedding or any objects that could increase the risk of entrapment, suffocation, or strangulation from the baby's sleep area.

  • Make sure the baby's head and face remain uncovered during sleep.

  • Place the baby in a smoke-free environment, away from areas where people use tobacco products.

  • Don't let babies get too hot. Keep the room where your baby sleeps at a comfortable temperature. Babies may be too hot if they are sweating or if their chests feel hot. In general, dress babies in no more than one extra layer than you would wear. Dressing babies with layers of clothing is safer than using blankets to keep them warm.

    You can also use wearable blankets, like a sleeping sack or warm sleeper clothing—just make sure it is the right size for your baby and doesn't cover their head. Note: Do not use weighted blankets or weighted clothing. Also, skip the baby hat when indoors except in the first hours after birth or in the neonatal intensive care unit.
  • If you are working in a family child care home or center, create a written safe sleep policy. Help ensure that staff and families understand and practice back to sleep and other safe sleep practices in child care, like those to reduce sudden infant death syndrome (SIDS) or suffocation. If you are a parent with a child in out-of-home child care, ask about and advocate for a safe sleep policy.

More information

Last Updated
Adapted from Back to Sleep, Tummy to Play (Copyright © 2022 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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