Does My Baby Really Need Two Hours of Tummy Time Per Day?

What does the data say about the optimal amount of tummy time? My pediatrician is adamant that from two months on, an infant needs two hours per day. We are finding this very hard to reach given our baby’s time spent eating, sleeping, being changed, etc., and also his general disdain for tummy time. Are we terrible parents if we miss this target?
—Tummy Tortured

To back up: the goal of “tummy time” is to promote the development of movement. With infants being put to sleep on their backs (which is excellent for SIDS prevention), there is a concern about missing some gross motor skill development.

There are a number of observational studies that look at the link between tummy time and motor development. There are not any randomized controlled trials. A review of the literature argues that most of the data we have is of low quality.

When we do look at that data, the literature review finds a link between tummy time and several outcomes: brachycephaly (one form of head flattening), ability to roll, and general movement on the stomach. This would not be surprising, but it’s also worth noting the way the bias might work here. Babies who are stronger movers on their stomach may be happier on their tummies, making tummy time less of an ordeal. This is a form of “reverse causality” for these results.

I would, therefore, describe the evidence on the value of tummy time as plausible but weak. In general, it’s a good idea to try to do it, but this isn’t the one thing that is going to make or break your child (there is no one thing like this, more or less).

I will say one more important thing: The recommendation is 30 minutes a day, and the studies of this often compare groups that do less than 15 minutes with those doing more than 15 minutes. The two-hours-a-day advice is… I’m not sure where that is coming from, but it’s not the AAP or the WHO. Perhaps you’ll find 30 minutes more manageable?