Infant Occupational Therapy Building Blocks for Development

Infant Occupational Therapy services can be the building blocks for development. Simple concepts we’ve all heard of like tummy time play an important roll in your infant’s strength, engagement, and motor skills.

What is tummy time?

Tummy time is an important activity which helps to facilitate infant development. Tummy time occurs when an infant is either supported on the belly, on a parent/caretaker’s chest or left freely on the floor while awake. Supervision is necessary in order to observe airway clearance as the baby does not have the head control to reposition his/her body. A baby can be placed in this position as early as shortly after birth for a brief period of time and gradually increasing the duration and frequency (Ma, 2009).

The recommendation for tummy time was developed in response to the American Academy of Pediatrics “Back-to-Sleep” Campaign. This was initiated in 1994 with the recommendation for parents to place their babies on their backs to sleep in order to reduce the risk of Sudden Infant Death Syndrome. While this initiative helped to reduce the amount of infant deaths by 50%, pediatricians noticed an increase in infant torticollis, a condition which results in a head tilt and/or plagiocephaly, a flattening of the head, which can lead to motor delays and visual deficits if left untreated. It is important to continue to follow the guidelines of the “Back-to-Sleep” Campaign; however, it is also beneficial to understand the positive effects of tummy time during the waking hours (Collett et al., 2019). An Infant Occupational Therapist can provide a parent with guidance and knowledge about the benefits of tummy time.

Why is tummy time important?
Tummy time aids in countering the effects of prolonged time spent on the back during sleeping which can result in plagiocephaly and developmental delays (Hewitt et al., 2020). The American Academy of Pediatrics recommends that babies should spend much of their waking time on the tummies (Ma, 2009). Tummy time promotes full body strengthening including the neck,  arms, hands, and abdominals. These components are vital building blocks in the development of transitional movements such as crawling and side-sitting which help promote the development of adaptive skills such as feeding and dressing.

As children continue to move along in their developmental processes, the weight-bearing provided through their arms helps to promote bimanual and fine motor skills which leads to the establishment of handwriting. Tummy time also assists with reflex integration which can be hindered if time is primarily spent in “containers” such as bouncers and walkers. If reflexes do not integrate, it may contribute to skipping/lack of crawling, mixed hand/foot dominance, anxiety, attention problems, challenges with handwriting, coordination, balance, vision issues and gross and fine motor skills. Infants need to develop the strength to sit up by themselves instead of being placed in containers which frequently promotes malalignment of joints and promotes fixing which do not assist with development of musculature.

Reach Milestones with Infant Occupational Therapy Services

Tummy time allow infants to seek out new experiences while gaining strength in a safe environment. Having the freedom to move and explore on the floor allows babies to build their postural muscles. It also encourages progression of gross motor skills and vestibular development such as rolling, sitting, crawling, standing and walking. Through these positions and exploration by trial and error, babies are able to develop their motor planning and problem solving skills which is necessary for the next set of developmental milestones. Clinicians agree that, ultimately, movement builds the brain and the less an infant is contained during supervised play, the more access he/she has to explore the natural environment.

How to facilitate tummy time:
If the baby does not have any medical condition that prohibits specific positioning, tummy time can be started in the early weeks of life by placing the baby on the caretaker’s chest or on the floor. In order to enhance a baby’s sensory experiences, removing socks is also recommended. This provides the feet with rich tactile stimulation which helps the baby gain information from the environment. Placing toys within their visual field also promotes visual engagement and attention which serves as a motivator for sustained tummy time. As a baby develops, moving objects farther away helps promote weight shifts, reaching and this encourages progression of motor skills. While the baby is on his/her tummy, face-to-face interaction promotes the development of early social skills and social interaction. While there is no exact amount of time for a baby to be on their tummy, most clinicians agree that more is better and consistency is key.

Contact Wedell Home Therapy for more information about infant Occupational Therapy services.

References
Collett, B. R., Wallace, E. R., Kartin, D., Cunningham, M. L., & Speltz, M. L. (2019). Cognitive Outcomes and Positional Plagiocephaly. Pediatrics, 143(2), e20182373 https://doi.org/10.1542/peds.2018-2373
Hewitt, L., Kerr, E., Stanley, M., & Okely, A. (2020). Tummy Time and Infant Health Outcomes: A Systematic Review. Pediatrics June 2020, 145 (6) e20192168; DOI: https://doi.org/10.1542/peds.2019-2168
Ma, D. (2009). Babies should sleep on their backs, play on stomachs. AAP News, 30(9),30. https://doi.org/10.1542/aapnews.2009309-30f