5 Alternatives to Tummy Time for Babies with Motor Development Challenges

Written by Kelly O'Lone

Published on October 15, 2024

• Engaging in traditional tummy time may be difficult if your baby has motor development challenges. 
• Alternatives to tummy time include side-lying play, supported sitting, and water therapy. 
• Tummy time alternatives help strengthen a baby’s neck, core, and arm muscles while offering more comfort. 

I’d be lying if I said I loved tummy time. There was something about watching my baby lay there and cry while I sat watching (sometimes, crying myself). However, I understand its importance, especially since my son needed a helmet for a flat head. 

Sometimes tummy time isn’t the best option for a baby due to motor development challenges, but it’s still vital for developing their cute, tiny muscles and helping prevent a flat head. Luckily, there are alternatives to tummy time that ensure your little one gets some of those same benefits.

We’ll cover five alternatives to tummy time to help build your little one’s important muscles! Remember to always be within arm’s reach, regardless of which tummy time alternative you choose.

1. Side-Lying Play

According to the National Institute of Child Health and Human Development, babies benefit from having two to three short¹1. Benefits of Tummy Time. Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://safetosleep.nichd.nih.gov/reduce-risk/tummy-time#:~:text=Babies%20benefit%20from%20having%20two,of%20total%20tummy%20time%20daily.(3–5 minutes) tummy time sessions daily. By two months, your baby should get 15–30 minutes of tummy time daily. 

One alternative to tummy time is side-lying play, where you assist your baby by laying them on their side and placing some toys within their reach. I recommend laying a blanket down first and then putting your baby on top. 

You’ll want to ensure your baby’s arms are in front of them and bend their legs slightly. It’s also best to rotate sides so they don’t lay on the same side of their head every time. 

If your baby is rolling over, you’ll notice this form of tummy time isn’t ideal; however, it’s great for those early days when your baby protests traditional tummy time. 

2. Supported Sitting

Supported sitting is another fantastic alternative to tummy time as your baby grows. If you have a newborn, you can still try supported sitting; just be sure you support their neck with your hand. 

You can encourage supportive sitting by placing a pillow or boppy behind your baby or holding them in your lap and facing you. I highly recommend holding your baby at their waist, where you can have a firm grip to ensure they don’t fall over. 

I’ve also used a booster seat on the ground to help my baby practice sitting. This way, they are buckled in and have a table where I could put toys in front of them.

Most babies can’t sit up unassisted until nine months²2. Baby Milestones – When Babies Sit Up, Roll Over and Crawl. Help Me Grow MN. https://helpmegrowmn.org/HMG/HelpfulRes/Articles/BabyMilestones/index.html#:~:text=At%204%20months%2C%20a%20baby,the%20sitting%20position%20without%20help., so ensure you are nearby to help. Sitting is one of the major gross motor milestones in babies, so practicing supported sitting is a place to start. 

3. Water Therapy

Water therapy, or hydrotherapy, is a different approach to tummy time but is excellent at helping strengthen a child’s bones and muscles. It’s also great if your baby hates tummy time! 

A 2023 study by Santos et al. found that baby swimming programs³3. Santos, C., Burnay, C., Button, C., & Cordovil, R.. Effects of Exposure to Formal Aquatic Activities on Babies Younger Than 36 Months: A Systematic Review. International Journal of Environmental Research and Public Health. 2023;20(8), 5610. https://doi.org/10.3390/ijerph20085610 were associated with improved gross, fine, and total motor development. 

You can find a local facility that offers water therapy or fill a bathtub with warm water (about 100°F) and gently immerse your baby in it. The warm water helps calm the hyper-exaggerated stress reflexes in premature babies. You can also get into the bath with your little one! 

Some hospitals use water therapy in the NICU for babies born before 32 weeks. Sharp Mary Birch Hospital for Women & Newborns in San Diego⁴4. Hydrotherapy in the NICU (video). Sharp HealthCare. 2018. https://www.sharp.com/health-news/hydrotherapy-in-the-nicu-video (where I had two babies!) uses water therapy to help promote brain development and motor patterns. 

4. Play Mats with Propped-Up Activities

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I’m a huge fan of play mats and love the ones with various activities for my babies. (My favorite is the Baby Einstein 4-in-1 Kickin’ Tunes Music and Language Play Gym and Piano Tummy Time Activity Mat!)

Some play mats have a small pillow to prop your baby to provide support. (Remember, you should only use a baby pillow at playtime, not bedtime.) 

You’ll want to lay their tummy on the pillow, with their arms hanging over it. This allows your baby to work on keeping their head up, but without lying flat on the ground. 

You can lay toys within their reach, which also helps work on vital motor skills like hand-eye coordination. 

Play mats are ideal for working on a baby’s neck strength as they look at the world around them. They also help a baby develop control in their back and legs while offering a cushioned surface. 

5. Chest-to-Chest 

Sitting chest-to-chest with your baby is an excellent way for them to work on tummy time. It’s also fantastic for skin-to-skin, which is highly encouraged, especially in those early days. I always loved those moments! 

For chest-to-chest time, you’ll want to lie back in a semi-reclined position and place your baby on your chest with their tummy down. You can adjust the pillow on your couch, though it works even better if you have a recliner. 

Chest-to-chest sitting allows your baby to be more upright, making it easier to keep their head up. I also recommend chest-to-chest tummy time if your baby has reflux. My second child had horrible reflux, and I found chest-to-chest the best fit for him when it came to tummy time. 

Tummy Time Tips 

Now that you have some alternatives to tummy time, here are a few more tips to consider:

• Remember to always be with your baby during tummy time. 
• Dress your baby lightly to allow for more flexibility in their movements. 
• If one method of tummy time doesn’t work, it’s OK to try another. 
• Gradually increase the time you work on tummy time. 
• Add toys and other props to help make it fun. 
• Lay down next to your baby so you are on eye-to-eye level with them. 
• Plan for tummy time after naps when your baby is most rested. 
• Avoid tummy time after your baby eats so they don’t spit everything up. 
• Be consistent so your baby gets used to (and maybe even likes) tummy time. 
• Use baby mirrors so your baby can see their reflection. 

It seems overwhelming to read everything you should and shouldn’t do, but remember, you know your baby best. As a mom of three, I know every baby is different, and you’ll realize one method may work for one baby but not the next. 

FAQs 

Why is tummy time necessary?

Tummy time helps babies build strength in their arms, shoulders, neck, and core muscles, which are vital for gross motor skills like rolling over, sitting, crawling, and walking. If your baby doesn’t do tummy time, it may take longer for them to develop some motor skills. 

How much tummy time should babies have daily?

Babies benefit from having two or three short (3–5-minute) sessions daily. By two months, your baby should get 15–30 minutes of tummy time daily. 

What are some signs that my baby might need an alternative to tummy time?

You may want to try an alternative if your baby is constantly fussy or crying during tummy time. It’s natural for some babies not to enjoy tummy time, but if they continually turn their heads or spit up frequently, you may want to try a new method. Remember to consult your pediatrician with any concerns. 

References

1. Benefits of Tummy Time. Eunice Kennedy Shriver National Institute of Child Health and Human Development. (n.d.). https://safetosleep.nichd.nih.gov/reduce-risk/tummy-time#:~:text=Babies%20benefit%20from%20having%20two,of%20total%20tummy%20time%20daily.
2. Baby Milestones – When Babies Sit Up, Roll Over and Crawl. Help Me Grow MN. (n.d.). https://helpmegrowmn.org/HMG/HelpfulRes/Articles/BabyMilestones/index.html#:~:text=At%204%20months%2C%20a%20baby,the%20sitting%20position%20without%20help.
3. Santos, C., Burnay, C., Button, C., & Cordovil, R. (2023). Effects of Exposure to Formal Aquatic Activities on Babies Younger Than 36 Months: A Systematic Review. International Journal of Environmental Research and Public Health, 20(8), 5610. https://doi.org/10.3390/ijerph20085610
4. Hydrotherapy in the NICU (video). Sharp HealthCare. (2018, January 4). https://www.sharp.com/health-news/hydrotherapy-in-the-nicu-video