The Issue is…..Tummy Time

Aimee Ketchum, OTD, OTR/L & Anne Zachry, PhD, OTR/L

Statement Regarding CPSC Federal Safety Standards for Infant Support Cushions page (Published Document: 2024-25181 (89 FR 87467)

As pediatric occupational therapists, we recognize the critical role that tummy time plays in infant development. Tummy time is essential for the strengthening of infants’ neck, shoulders, and back muscles, which are crucial for achieving motor milestones such as rolling, sitting, crawling and even fine motor skills (2010).  Additionally, regular tummy time helps prevent positional plagiocephaly (flat head syndrome) by reducing pressure on the back of the head (2014). It also promotes vision and sensory development by offering infants a new perspective and encouraging them to explore their environment. The American Academy of Pediatrics (AAP) recommends beginning supervised tummy time at birth and building up to 15-20 minutes of tummy time per day by seven weeks (2022).

Many tummy time products, such as activity mats, toys, and pillows can be instrumental in helping infants tolerate tummy time, particularly those born pre-term or with developmental delays (2024). Tummy time without additional support of a wedge or pillow under the baby’s armpits, lacks chest support for infants to relieve the strain of muscles as they develop the strength to hold their head up. This makes tummy time difficult for babies and frustrating for parents, often decreasing tummy time practices overall (2010). In a study by Ricard and Metz (2016), 56% of the caregivers stated that their infants were intolerant of tummy time. 35% of the infants in the study were intolerant of the prone position. Forty-four percent of those resistant infants spent less than 15 min in tummy time during their waking hours

Because of the many benefits of tummy time, several studies and parenting websites recommend strategies to extend tummy time and make it easier for parents and more tolerable for babies (2010). We as occupational therapists encourage these strategies and supervised tummy time aids to support developmental milestones.  The recent CPSC regulations limiting cushioning and incline angles may hinder the effectiveness of these products, potentially impacting developmental outcomes. We advocate for a balanced approach that ensures safety while preserving the developmental benefits these products provide.​  By providing infants with appropriate tummy time products, we can support their physical development and help them reach important milestones.