Transcript: Tummy Time for Infant Development
Parent Savers
Tummy Time for Infant Development
Please be advised, this transcription was performed by a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
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Wendi McKenna : In just a few short months from the time they are born, babies must transform their bodies weak muscles into fully functioning and responsive tools, that can help them explore and understand the world. Giving babies time on their tummies is one of the most important things parents can provide for their transition from womb to world. How can tummy times and other daily routines increase your babies' positive learning experiences and help their development? I'm Wendi McKenna, founder of Strides Physical Therapy and Move Play Grow, and today we're talking about tummy time. This is Parent Savers, episode 51.
[Theme Music/Intro]
Johner Riehl : Welcome everybody to Parent Savers, broadcasting from the Birth Education Center of San Diego. Parent Savers is your weekly on the go support group for parents of newborns, infants and toddlers. I'm your host, Johner Riehl, and I want to thank all our loyal listeners who joined the Parent Savers Club. Our members get all our archived episodes, bonus content after each new show plus special give aways and discounts. Subscribe for our saver monthly newsletter for a chance to win a free membership to our club each month. It's free to do and it's all on our website. Another way for you to stay connected is by downloading our free Parent Savers app, which is available on Google Play and on App Store, and it's a free way to listen to our shows as they come out and be kept up with all the latest that's going on with Parent Savers. I'm Johner Reihl, I have three young boys, six, four and almost two, three boys club for me, and I'm joined here in the studio by a couple of parents along with Wendi.
Chelle Roman : Hi! I'm Chell, I'm 28, I own the The Swaddled Sprout, a natural parenting resource here in San Diego, and I have two boys, two and a half, and 14 months.
Amy Askin : And I'm Amy, I am mother of three mermaids, Olivia - 8, Serene - 3 and a newborn, El. And I also blog at belovedatmosphere.com.
Wendi McKenna : And I'm Wendi, I'm a Pediatric Physical Therapist and mother of three beautiful children, two girls, Martha – 6, Madelene – 4, and a baby boy, Calin, of five months.
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Johner Riehl : Before we start today's show, we're going to take a closer look at a new app called “Alert ID”. It's something that you can download for free on your phone and it's also a service that you can sign up for. It's kind of tight together, you need to register so it knows your location, and then you download the app and it's for free. And a few of us here in the studio have checked it out, so we're going to talk about it a little bit and tell you guys what we think. So I downloaded it, it was free, I was able to sign up through the app, you can also do it, and I recommend doing it through our website, you go to alertid.com/newmommy and then you register your email address to set up an account. Once you do that, you're able to see, from your location, crime reports from the area, sex offenders that live in the area, and also track your family with something called “my family wall”. What did you guys think when you checked it out, Chell?
Chelle Roman : I downloaded it from my iPad and it was pretty easy to use, but the first thing that I noticed was all the alerts of sex offenders that lived in my area, it was kind of alarming. But it was definitely cool to know that my immediate neighbors are...
Johner Riehl : It's what of those things that that information is out there and I think we all kind of in our back it reminds that there's a website where I can check that out, but I know that we never did. I think I did once at a house that we moved in, but I have never really checked it for this house. And that app made it really easy to do that.
Chelle Roman : And then the other thing I noticed was that you can put in family members information and store it, and then if something happens, they go missing, you can immediately send that profile with their picture to the... I'm not sure, to the Police Department.
Amy Askin : Imagine you can send it to whomever, because it's linked to all the authorities, even to the homeland security, so I mean it's broad.
Johner Riehl : Yeah, it is broad, and my understanding is that it's a one way connection, they're not tracking you by using it, but it offers you an easy way to be in touch with them. And you get updates from them as well, updates about crime reports or if there is any police activity in the area. It was actually started by, the founder, she was an amusement park, she lost her kids for an hour and couldn't find them. Well, it happened to us at Sea World too, we...
Chelle Roman : I was lost at Sea World as a child.
Johner Riehl : Were you, really?
Chelle Roman : Yes, I was.
Johner Riehl : Were you found by the right people?
Chelle Roman : My parents found me, but everyone was looking for me and I didn't know I was lost. I was playing.
Johner Riehl : But it's a scary thing if don't know the right things to do, but so they created this, I think that was the original intent, to have all that information handy, and then it expended to have all this other really cool functionalities. So overall I definitely would recommend this for all parents and families, you should check out Alert ID, sign up for it, like I said, go to alertid.com/newmommy and you can sign up for your account there and head on over to the app store or Google Play for whatever device you have, and download it for free. Would you guys agree?
Chelle Roman : Yeah!
Amy Askin : Yep!
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Johner Riehl : Alright, today's topic is tummy time, and it's something every parent of a newborn should be interested in, I knew it was something that we are definitely interested in as soon as our babies were born, and getting them on their tummies instead of their backs. So today we're talking with Wendy McKenna, who is a pediatric physical therapist, she's the founder of Strides Physical Therapy, Inc., which developed the Baby and Child Wellness program called Move Play Grow. Welcome Wendi!
Wendy McKenna : Thank you, thanks for having me!
Johner Riehl : So what exactly is tummy time that we're talking about? Let's start with a very basic question, and I know it's a broad topic, but what exactly is tummy time and why is it so important?
Wendy McKenna : Tummy time is any awake time where your baby has pressure from a surface, any support surface, on their tummy. And gravity is actually pulling them into that surface.
Johner Riehl : So gravity is a key part of that.
Wendy McKenna : Gravity is a key part of it. In the literature they talk about how it's important for the gross motor development, so babies will be able to roll over and to crawl, and to basically move around their environment. They also talk about in terms of head control and decreasing the incidence of torticollis, which is a crooked neck, as well as plagiocephaly and brachycephaly, which is the misshapen heads. And really over time, since the Back to Sleep program, plagiocephaly has increased from 1 in 300 to up to 1 in 6 children, so
Johner Riehl : Oh, wow! And which one, plagiocephaly?
Wendy McKenna : Plagiocephaly.
Amy Askin : Flat head.
Wendy McKenna : Flat head on an obliquity. Flat head on a diagonal, where you have flatness on either the left side, or the right side, and it causes the head to look like a parallelogram. And the brachycephaly is when you have a broad flatness on the back of the head.
Johner Riehl : And that's increased by what is that, a factor of...
Wendy McKenna : Head shapes are created by pressure. Pressure from an internal brain growing and external pressure from gravity. And your head being placed on surfaces or whatever. So what happens is that when babies are on their backs too often, or on their sides too much, on one side versus another, the external gravity, the external pressure from gravity is really what helps shape that head. And then the problem is, because babies don't have very good head control, if you get a really flat spot, that's where they're going to be comfortable. It's going to keep going there, because then you created the ridge on the side, that they don't have control to get over the ridge, to the other side. So that flatness just becomes bigger and bigger and bigger.
Johner Riehl : They're just this soft little malleable features. And then it starts and they kind of built on it.
Wendy McKenna : Right, because the sutures between all of the bones of the skull are open until about 18 months of life. It's why babies are able to be birth, because they have to have their bones to be able to shift so that they can get through the birth canal, and so it makes sense that they need to have softer heads, but it also makes them very vulnerable to gravity once they get out there, because gravity is a new experience for them, from day one.
Johner Riehl : I'm picturing poor little cave babies back in the day,
Wendy McKenna : But they were held, they were held, and that's the big thing, because that's the other thing that we're not... tummy time doesn't really directly address our container culture, and that's something else I want to really address today, because babies are in things all the time, they're in car seats, they're in swings, they're in strollers, they're not being held. And you can hold you're baby and also have that pressure off their heads.
Chelle Roman : Does baby carry count for...
Wendy McKenna : ...Absolutely, well it doesn't count for tummy time, but it's just as important as tummy time.
Johner Riehl : Let's talk a little bit more about our container culture, as you put it, and this idea that we have swings and we're putting them in there, does that have a really negative effect on a baby's development?
Wendy McKenna : Yes! Yes, it does, and I almost think it has more of a negative effect than the Back to Sleep program itself, because really starting even earlier than Back to Sleep, all these big box baby stores where coming up with containers to make our lives as parents easier, not to help support the development of the baby.
Johner Riehl : Right.
Wendy McKenna : But it was really touted as, “This is going to be great for your baby”, but really is great for the parent. So you don't need all of those containers, and what a container does, it's a plastic device that holds your baby in one position. A lot of them are sleep crouches, absolutely, but the problem is that more often or not they place the baby in a position that their bodies cannot support developmentally yet, because babies, especially when they are newborns, do not have the muscle control to be able to hold themselves up against gravity, but yet all of these containers put them on an angle up, rather than being supported flat on the ground. And so what ends up happening is that your baby, and I'm sure all of you have seen this, is that you put your baby in, they may look great when they first get in, but they slide down and they slump over and their head falls to the left or right, and you're always repositioning, even in the car seat, they're head falls to one side and you're always reaching back, trying to get it back in the middle again, where they fall asleep and so really, all these containers, they have straps in them to contain your baby and to make sure that he doesn't fall out. But they don't align your baby correctly. So there is a product out there that helps to align your baby, if you're going to be using containers, to help support the alignment of your baby so they don't have so much stress and strain on their joints and limbs. But really, in general, a container is just that, a container contains, and it does not allow your child to explore their world, to explore the myriad of movement options that are out there, because it's blocked. It's blocked by the container. And especially in a car seat, because a car seat now has a base that can be left in the car, you click it in and out, you put in the snap and go, you click it in and out, and more often I've seen a lot of babies in their car seats being carted around everywhere. And the designers are coming out, “Oh, it's easier to hold this one, it's easier to hold that car seat”, it's more about the handle than why is our baby in a car seat.
Amy Askin : I was going to say, I do leave with this one, with my second one, we were in a living situation where we didn't have a car, and so I would wear her. And a- it's more comfortable, because in order for these car seats to be safe, they have to be a certain weight, and for them to be a certain weight it's killing you. And so we started baby wearing and I keep hearing how much better developmentally it is, so we're huge advocates, and in Asia, where we were living, everyone wears their babies, and it is better overall. The other thing I was going to point out is that you're saying these things about the containers, it's interesting to me, having lived in Asia and then coming back to the US, the container thing is a phenomenon. They're trying to put things on the container, little thing that entertains the baby, so it makes you think, “Oh, well, she's being stimulated”, because she's looking at herself in the mirror, there's a little mirror on it, and we love our swing. But, there is a big “but”.
Wendy McKenna : And all those things that help to entertain or stimulate your baby, are usually overstimulating, the best place that a baby can be is with you, corresponding with your eyes as you're looking at them, and really not you trying to get them look a certain way, but really, when you approach your baby for the first time, look where they are looking, and the go to where they are, explain what they're looking at, and really talk to them about where they are. They'll hear your voice and come look at you. And then, rather than say, “I'm over here!”, or, “Look at me, over here!”, testing them by, “Oh, let's see if you can turn your head this way”, don't do that, go where they are, respect them as an individual and then expand on their play and communication from there. And by approaching your baby in all instances throughout the day, even when you're changing their diaper, let them know, “We're going to take off your diaper, it's going to get pretty cold here as soon as we do it”, or, “I'm going to pick you up now”, rather than just doing it quick. And that's another thing that we teach in our class, how to transition babies from surfaces so that it's an easy transition for them to make as well as something that's developmentally appropriate.
Chelle Roman : I have a question about the containers, because I definitely use the swing a lot more with my second than with my first, because it was difficult for us to do as much constant tummy time as I could do with my oldest, because I had a 17-month-old running around. What would your recommendations be for that? I was either holding my son, or he was in the swing for months.
Wendy McKenna : And I had the same situation, my second baby, I had a 2-year-old running around and so the baby's not quite safe anymore, because the 2-year-old is running around. What you can do though is if again you start day one usually they'll tolerate tummy time a little bit more, you can put a play yard around your baby.
Chelle Roman : Sure, that's a great idea!
Wendy McKenna : So keep the dog away, keep the cat away, keep other kids away, so you can definitely get away from the containers, and really, when you think about swings and you mention them being sleep aids, we trained our babies with what we do with them, they don't come out knowing, “Oh, I need a swing to sleep”. They fall asleep in the swing because we put them in a swing, and they fall asleep there and it's like, “Oh, great, they're asleep, let's do it again” , until finally they learn that that's what they need, that's how they go to sleep. Versus being able to put your baby down where they are still awake, helping them to learn how to get into that sleep pattern by themselves. We swaddle a lot more to really help with the sleep thing because babies are unable to sleep on their tummies anymore, because the ground before used to be the swaddle, 'cause that's what blocked them, but now they're on their backs, the swaddle really helps. And just one comment about swaddling – a lot of people do teach swaddling with either the arms down, by the sides, or across the chest, you really want the arms up, so the hands are close to the mouth and out a little bit, you don't want the swaddle to be tight and the baby can't move, they should be able to move a little bit. But one of the reasons why you want those hands by the mouth is so that if they turn their head they can self-soothe.
Johner Riehl : So really tummy time then is part of the importance of keeping pressure of the head.
Wendy McKenna : Part of that. It is also gross motor development. Really what we're looking at is the development of the baby's body, as well as their sensory system as well. When they first get out, babies are born with sensory receptors and so they are taking in information all day long, from all the different parts of their bodies, and that's giving information up to their brain and then motorically they move to respond and explore. And so when babies are on their tummies, when they're first born, they are used, especially in a new term, full-term baby, as used to being smashed. They've been smashed in utero, you put them on their tummy from day one, they're being smashed. It's comfortable for them, it's familiar to them. And so a lot of parents look at their babies on the ground, it's like, “Oh, that looks terrible”, they would never want to put a baby there like that, because they can't themselves being smashed on the floor, but that's where they're comfortable, because that's where they've been. And so if you start day one, it brings them back, it gives them self-soothing skills as well, because it brings them back to what they're familiar with. In addition, when they're on their tummy, babies have a lot of random movements that can scare them and startle them, but if they happen to move or startle, and they're on their tummy, they move into the floor, which blocks their movements, so they don't have a big wide range of motions that scare them and startle them. In addition to that, the way the babies are positioned in full flexion when they first come out it's a great position for them to be able to get their hand to their mouth immediately, without having the motor control to be able to do it. Because if you're on your back you have to have motor control to be able to get your hand up and try to get it to your mouth and just hitting your face, but on the floor, because the floor is supporting them so much, that hand can go right to the mouth and they start that really very important self-soothing skill that it's so important for them to be able to do.
Amy Askin : I was going to ask you when is it ok to start tummy time, because we started straight away with El and with each child I've done it sooner and sooner, and I'm hearing from, how shall we say, the older guard, that, “She's crying! It's upsetting!”, so we literally set a timer in how long is appropriate for a newborn. She was three weeks early and we did all the things that you're talking about. We in fact kind of swaddled her to keep her limbs a little, not tight swaddled like you would place her to sleep, but kind of a looser swaddle and put her arms in, so she could push up, and she has really good neck control, she's already lifting her head. She's not even two months, or she is just over two months old, but she can move, she can roll. She rolled over, and we were like, “Oh my gush, it's too early!”, she rolled over at a week.
Wendy McKenna : Their heads are so big that a lot of times that they get themselves in a position, their body is going to follow, not only that, but because they don't have the segmental mobility in their spine, when one part goes, they all go together. So those are all really great questions, the important thing is to know that you already start as soon as the baby is born, because the first place the baby goes is right on your chest, on their tummy, that's their first tummy time. So really when you don't hear it from nurses and doctors saying it's important, they're already doing it, they're already helping to facilitate it without knowing it, and so really one of the first best places to do tummy time is on your chest. The idea with tummy time is not exercise time, I don't want to say, “Oh, we have to do tummy time to increase all their abilities to do all those gross motor skills”, if you just think about it as – it's the place to be when you're going to put your baby down. Then you don't have to set a timer, you're just going to know that whenever you put your baby down, it's going to be on their tummy first, and if they like it, and they're happy there, that's great. And if they don't like it, you can make a couple modifications and we'll go over some of those a little bit later, and if they don't like it after one or two modifications, take them off their tummy. Because really what we want is we want them to learn, and to be in a state of mind where they can learn, and if a baby is upset or crying, they're not learning. So there is no need to set a timer and say, “No no no, you have to do it five minutes here”, or “You have to do ten minutes here”. But if you think about it as if it is the place to put your baby, when you're going to put them down, rather than put them in a car seat or swing or stroller, you don't need any of that stuff. At home right now, I have a car seat to transport my baby, and I have a playmat on the floor, and that's it. I don't have a swing, I don't have an infant seat, I don't have one of those rockers, I don't have any of that stuff. You don't need it. All you need is a playmat, that's really good on the floor, that's transportable, washable. And really one of the other things that we'll talk about later on is doing naked tummy time, which is best.
Chelle Roman : I did a lot of that, not on purpose, my son likes to take his diaper out.
Amy Askin : What about Back to Sleep? We hear that a lot.
Wendy McKenna : Right. So Back to Sleep started in about 1992, and than the public relations campaigns started in 1994 from the American Academy of Pediatrics. They called it Back to Sleep because what they really wanted to do is decrease the incidence of SIDS, which is Sudden Infant Death Syndrome. There were actually in a lot of those literature articles 11 different recommendations to help decrease the rate of SIDS. However, what really got the media attention was the tummy sleeping versus the back sleeping. Now, remember, before SIDS and Back to Sleep program, babies were routinely put on their tummies to sleep, and were told to, so because of the medical opinion that if a baby were to spit up, they would choke on in if they were on their back, so you'd better put them on their tummy. So it switched, in 1994, 50% of babies were sleeping on their backs. By 2005, literature shows that 85% of babies were now put on their backs. So it totally flip-flopped. And in the same time, SIDS rates decreased by 50%, which is huge, it's a great clinical finding. So SIDS and Back to Sleep program is here to stay, and really it's not called Back to Sleep anymore, it's now called Safe to Sleep, which I think is great, because they're bringing in more of the warnings and cautions and things that you can do, like no bumpers in the bad, no blankets in the bad, no stuffed animals in the bad. There is a higher incidence of SIDS when there's smoking or drinking in the house, you know. So all of these other elements are now coming in in Safe Sleep. But everyone knows Back to Sleep, and hopefully the next slogan is Safe to Sleep and Tummy to Play. Tummy to Play is actually part of Safe to Sleep, but they added it later, it really took about ten years for pediatricians to notice that there was a really problem with babies not meeting their milestones, and so it went from Back to Sleep to now Back to Sleep, Tummy to Play. The problem is, and the literature also shows this, that pediatricians don't have a really good guideline for when to tell parents to start, how long it should be, what it should really look like, what tummy time is, and all of those things, so that's why we created Move Play Grow and these baby wellness classes, to really talk about tummy time, the importance of it, but also understanding how it fits into your daily routine, not something like extra-extra-exercise.
Johner Riehl : I think that after the break we'll talk a little more about specific ways that we can do it, and I want to hear a little more about Move Play Grow as well, so thanks, we'll be right back.
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Johner Riehl : Welcome back to Parent Savers, we are talking to Wendy McKenna, pediatric physical therapist, who is the founder of Move Play Grow. Tell me a little more about Move Play Grow and how it fits into the tummy time movement.
Wendy McKenna : Move Play Grow really started with my colleague, Rachel Griffin and I, and we started about two years ago, and the reason that we started it was because we were getting more and more referrals for babies who needed physical therapy because they weren't meeting their gross motor milestones, because they had torticollis, which is a medical diagnosis where you have a crooked neck, or plagiocephaly, which is the flat head that we talked about earlier. And these are all preventable. And really no one was talking about how do we prevent these, so that's why we are out there, trying out to educated people how to prevent this stuff, but also supporting your baby the best way that we can, the best way that we know how, in their development as a whole child. And so our classes go beyond tummy time, into more of bonding and communication and supporting the gross motor and sensory motor development of the baby. Tummy time being a large part of that, but by all means not the only thing.
Johner Riehl : Is that something that's just local here in San Diego?
Wendy McKenna : It is right now, and hopefully it will grow over time, but right now yes, it is just local in San Diego. However, we do on our website have online consultations available, so anyone can sign up for that, we can Skype or chat or do video consultations.
Johner Riehl : That's a nice service.
Amy Askin : So what are some specific exercises that we want to focus on with tummy times or like other any props, things that we can use to facilitate and help?
Wendy McKenna : The ideal place to do tummy time is on a firm surface on the floor, without props. However, there are a lot of babies out there who do not like tummy time on the floor. And when you are starting with a newborn, it's not about trying to get them to lift their head and turn their head, it's about giving them an experience where they are calm. And again, smashed into the ground, like we talked about before, the idea is for you to get down to their level, get on the floor, don't just sit in front of them, lye down next to them, get on their eye level, your head into their range, right on the floor with them, between eight to ten inches away from them. And you can talk to your baby, they can see you, you can tell them about their body, you can tell them about what they're doing and how they're moving and tell them about you and who you are, you know, just keep talking to your baby with that wonderful, nice voice that we all adopt. Just be there with them. In addition to that, as a newborn, babies often come out, and you can almost repackage them exactly how they were in the uterus. Often times, that's an asymmetrical alignment. So they have a preference for one direction or another, so you want to be aware when you're looking at your baby and observing your baby if they are still exhibiting that asymmetry, and if you can try and help them go the other way. And so if they're really always looking right, always looking right, well then maybe place them down, have their head to the left a little bit more, and then you are always reassessing, “Ok, are they coming along symmetrically?”
Amy Askin : Criss-crossing ankles, I know El criss-crosses her ankles and she did it a certain way and so we always tried to flip them.
Wendy McKenna : Absolutely, that sort of thing. We're looking at the whole body here. You want to help with the symmetrical development. And that's what we do at our classes, teach people how to look at their babies and how to observe them and how to support them as they grow. Going back to your question, ideally, we want them to be flat on the ground on a firm surface. A lot of babies don't tolerate that.
Johner Riehl : So like a kitchen floor, or a hard wood floor is better than a carpet?
Wendy McKenna : No, a carpet is fine. What I mean by firm surface is one where they are going to be supported by the ground, not sinking into it. You don't want to do it on a pillow, not on a mattress, not a couch cushion, not on a whole bunch of blankets, where they can grab those blankets and bring them close to their face and suffocate, really, because when babies go through suffocation and die, which is horrible, and part of what SIDS is really about creating pockets of air that don't get a lot of good air exchange. And so when you're on a firm surface, there is going to be no way for that child to gather material around their face that can create that pocket. And obviously you're going to be there with them all the time. Anyway, when they're there, you can help them not do it. But I have another certain climates that have a little but more cushion to them that are great, because they don't gather, they provide enough cushion so that the babies can lye on the floor, it's comfortable for them and really comfortable for you to lay down next to them as well. But when they start to push into the ground to come away from the surface a little bit more, they actually have something to work off. Because if you're on a mattress or on a couch cushion, as soon as they push into the surface they're just going to sink into the surface, they're not going to be able to come away. So you want it to be firm enough so that they can come away from the surface, but also comfortable enough that they're going to be happy there. So on a carpet is great. If you're on a hardwood floor, you know, there are definitely playmats on the market that have a little more cushion to them that I really enjoyed. We actually sell one of them on our website. There are products out there that can help.
Amy Askin : So what if you have a child who just doesn't tolerate being on the floor, are there other exercises or positions that they can be in?
Wendy McKenna : Yes, and so, like I said in the beginning, tummy time is really about pressure of any support surface being on the baby's belly and gravity pulling them into the ground. And so the things that I like to talk about in our class is the development of the baby and how they get to work off of the ground in tummy time. We're working with two different things, we're working with gravity and we're working with range of motion. So when a baby is firstborn, their rear end is stuck up in there, and then their arms, actually their elbows are down by the rib cage. By the time they're three months, those legs stretch out, the bottom drops down, and the elbows come forward to the point where they are at the shoulder level. And so really what we're trying to do is replicate that development but not too early. So there's different exercises that you would do at different ages. You are not going to take a newborn and stretch their arms way up over head to try to do tummy time. You want them to be here and close by. So the other places that you can do it is on your chest. And then, looking at gravity, the more horizontal they are, the harder it is for them to pick up their head. The more vertical you are, the easier it is for them to pick up their head. So if you end up putting him on your chest and laying back at a 45 degree, again, it's not about exercise, I don't want to talk about it as exercise, it really is positioning and it's the position of choice that's going to give the best support for your baby development. So if you just think about it as not something to do extra, but it's just what you do when you're holding your baby.
Amy Askin : That's very helpful.
Wendy McKenna : Yeah, and then you can go at different angles, whatever's comfortable for you. If you feel like being at a 30 degree angle, great! If you feel like being at a 60 degree angle, great. And your baby is going to be able to tolerate that. Across your chest is one place, another place is holding them in a tummy-down carry, where a newborn is going to be more packaged, like that picture is on the wall.
Johner Riehl : There's a picture of an outstretched arm with the baby laying on the arm.
Amy Askin : It's almost like a guy holding a football ball.
Wendy McKenna : Exactly, but as your baby grows, what you can do then is put your arm underneath your baby's chest and bring their arms in front of you arms, so that they're more at shoulder level rather than behind shoulder level, so you're starting to help facilitate that stretched out position that you want to replicate on the floor. And again, when you're holding them, you can change the angles. You can go up to a 45 degree angle, to make it easier, you can go down on the flat horizontal again to make it a little bit tougher. And dad's usually love this one, because you can go flying around the house. And flying around the house is one of the most fun things to do. And you can fly up to mirrors, you can fly down to the couch, or to the floor or whatever. And you can start getting their hands on things, so that they're really pushing into the floor a little bit more. And then one of the important things to think about with the carrying is that you want to make sure you do it both directions. We are very one sided as adults, and we do not want to impart our asymmetries on to our baby. So if you think about every time you pick your baby the first time, do it on your awkward side, so you know you'll get it in. The other way that I like to talk about is if you're going to be holding your baby in your arms, rather than in a carrier, if you're transporting from point A to point B, you hold them in your dominant side, because you don't need that dominant side, and then when you get to your destination, you have to do whatever you have to do your hand, you put them in your non-dominant part, so that your dominant hand can do what it's supposed to do. Our body is designed to walk, so when we walk, one side is doing one thing while the other side is doing the absolute opposite. And that's what makes us have reciprocal movement. And so to go through that you have to go through a stage where you actually have symmetry and everything is working together first. And so if you are imparting your asymmetries on the baby or you're not noticing that there are asymmetries and try to help them to be more symmetrical when you can, than they never get that left and the right brain working together as well. So that the reciprocal things that come later down the road work really well. So we talked about the whole thing, and really, again, then we morphed into the asymmetries, making sure you're using your dominant side and your non-dominant side with your baby. Another great place to do tummy time is on your lap. And you can do it either in a sitting position on a chair, you're sitting with your hips at 90 degrees or your knees at 90 degrees, or you can do it on the floor. And this is a great place because your lap is a large enough place to support your newborn baby, but also it's a great place for the baby to stretch out a little more, to be able to be there as well. And what you can do then is, whichever way the baby is facing on the head side, that leg can be placed a little bit higher. So again, you're putting them on an angle, not directly horizontal but an angle which makes it easier for them to do. And then from there it's lovely, because you can move, and you can impart movements with swings or rocking or whatever you want to do, so the baby is not so bored on a still flat surface. And then you can again change the angle of your leg so that the baby is more up, or down, depending on what they are going to be able to tolerate. And if you have a toy on the floor that they really want to get, they can go get it. If you do it in front of a mirror, you'll be able to see baby, 'cause one of the problems with this position is that you can't see your baby's eyes. And really what we want to be able to do is promoting happy tummy time, playful tummy time, bonding and communicating with your baby, and one of the ways that they – the way they communicate – is with their vision. And so if you can't see what their eyes are doing or if they're not connecting with you with their eye gaze, than you are not really connected with your baby. But if you do it in front of a mirror and look at them through the mirror, you can then still be connected with them.
Johner Riehl : I think that it's really interesting that, you know, when I hear tummy time traditionally it seems like, “Throw the kid on the floor, let him figure it out”
Wendy McKenna : But that's how it's told to parents, parents don't really know what it is, why we're doing it, how to do it, and it really does sound like they have to be on the floor, and ideally that's where you want them to be, you're working towards getting them there, but if they don't tolerate it, you can do these different modifications to help them eventually get there.
Johner Riehl : And I love these ideas of the contact that you're getting by holding them on your lap or your arm or all these other ideas, and those are great ways to get the tummy time and the benefit. Thanks so much for talking to us and giving more details about it, thanks to Amy and Chell for joining us, thanks for baby El for being such a sweetheart, maybe you heard her a couple of times, but she did a great job.
Amy Askin : Thank you for having us!
Johner Riehl : For more information to our listeners on Wendy or Move Play Grow, or about any of our panelists, check out or episode page on our website, we also got links to more resources about tummy time. We are actually going to continue the conversation for a little bit after the show for members of the Parent Savers Club. Wendy is going to tell us a little bit more about midline and kind of explaining some of the physical descriptions. There's a lot of words, I wish that they were simple words, even like the diseases, so we're going to talk a little bit more about that for our Parent Savers Club members.
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[Featured Segments: Ask the Experts]
Johner Riehl : Now we have a question from Fiona. Fiona writes, “I gave birth to my first baby about three months ago. Overall, I'm happy that the baby is here, although it's a lot of work. But there is the sense of feeling lonely that I just can't shake. I'm surrounded by people, so I'm not physically lonely, I'm just a little sad I'm not pregnant anymore. I got to ask, is this normal?”
Jennifer Schere : Hi everyone, this is doctor Jennifer Schere, I am a clinical psychologist, with a practice in San Diego. I think that is such a common, normal, typical experience for so many moms. And pregnancy is the period when we're doing a lot of emotional and mental preparation, so there is a lot of room for us to create our own fantasies and expectations, whether conscious or unconscious, about what we think the baby will be like, and how we think it will impact ourselves and our families. And then, when you have the baby, of course it's a blessing and a miracle, but there is a very dark contrast to the harsh reality of the work, moment to moment, of care taking. A sharp contrast again with everything that was in our own minds, before we're getting up 20 times a night and changing diapers. So that in itself can sometimes feel a little bit of a letdown and can generate feelings of loneliness or temporary sadness. But the other thing is that I think a lot of moms also experience a loneliness in the sense that there is a feeling that you're out there on your own, with this awesome responsibility of helping this new life. And even when you got people who love you, who are around you and they are keeping involved and supportive, there is still a sense of it's you, and it's on you, and that is something that I think all moms can speak to and feel it one time or another. The other thought I wanted to share with you around what it's like postpartum when you're making these adjustments is that sometimes we miss a part of our former selfs, there's a major shift in lifestyle and a big refocusing right now on care taking the baby. So not so much time for things that help us feel connected to ourselves and that's something we really got to be aware of and try to incorporate into our lives with baby. Again, I just hope you recognize that feeling is something that many many women share and I thank you for bringing it up.
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Johner Riehl : That wraps it up for today's episode of Parent Savers, we appreciate you listening very much, thank you so much for joining us, whether it was on our website, on the app or you downloaded this from the iTunes store. Don't forget to check out our sister shows, we got Preggi Palls for expecting parents and the show The Boob Group for moms who breastfeed. Next week we're going to be talking about parenting tips from around the globe. This is Parent Savers, empowering new parents!
[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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Episode Transcript
Parent Savers
Tummy Time for Infant Development
Please be advised, this transcription was performed by a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[00:00:00]
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Wendi McKenna : In just a few short months from the time they are born, babies must transform their bodies weak muscles into fully functioning and responsive tools, that can help them explore and understand the world. Giving babies time on their tummies is one of the most important things parents can provide for their transition from womb to world. How can tummy times and other daily routines increase your babies' positive learning experiences and help their development? I'm Wendi McKenna, founder of Strides Physical Therapy and Move Play Grow, and today we're talking about tummy time. This is Parent Savers, episode 51.
[Theme Music/Intro]
Johner Riehl : Welcome everybody to Parent Savers, broadcasting from the Birth Education Center of San Diego. Parent Savers is your weekly on the go support group for parents of newborns, infants and toddlers. I'm your host, Johner Riehl, and I want to thank all our loyal listeners who joined the Parent Savers Club. Our members get all our archived episodes, bonus content after each new show plus special give aways and discounts. Subscribe for our saver monthly newsletter for a chance to win a free membership to our club each month. It's free to do and it's all on our website. Another way for you to stay connected is by downloading our free Parent Savers app, which is available on Google Play and on App Store, and it's a free way to listen to our shows as they come out and be kept up with all the latest that's going on with Parent Savers. I'm Johner Reihl, I have three young boys, six, four and almost two, three boys club for me, and I'm joined here in the studio by a couple of parents along with Wendi.
Chelle Roman : Hi! I'm Chell, I'm 28, I own the The Swaddled Sprout, a natural parenting resource here in San Diego, and I have two boys, two and a half, and 14 months.
Amy Askin : And I'm Amy, I am mother of three mermaids, Olivia - 8, Serene - 3 and a newborn, El. And I also blog at belovedatmosphere.com.
Wendi McKenna : And I'm Wendi, I'm a Pediatric Physical Therapist and mother of three beautiful children, two girls, Martha – 6, Madelene – 4, and a baby boy, Calin, of five months.
[Theme Music]
Johner Riehl : Before we start today's show, we're going to take a closer look at a new app called “Alert ID”. It's something that you can download for free on your phone and it's also a service that you can sign up for. It's kind of tight together, you need to register so it knows your location, and then you download the app and it's for free. And a few of us here in the studio have checked it out, so we're going to talk about it a little bit and tell you guys what we think. So I downloaded it, it was free, I was able to sign up through the app, you can also do it, and I recommend doing it through our website, you go to alertid.com/newmommy and then you register your email address to set up an account. Once you do that, you're able to see, from your location, crime reports from the area, sex offenders that live in the area, and also track your family with something called “my family wall”. What did you guys think when you checked it out, Chell?
Chelle Roman : I downloaded it from my iPad and it was pretty easy to use, but the first thing that I noticed was all the alerts of sex offenders that lived in my area, it was kind of alarming. But it was definitely cool to know that my immediate neighbors are...
Johner Riehl : It's what of those things that that information is out there and I think we all kind of in our back it reminds that there's a website where I can check that out, but I know that we never did. I think I did once at a house that we moved in, but I have never really checked it for this house. And that app made it really easy to do that.
Chelle Roman : And then the other thing I noticed was that you can put in family members information and store it, and then if something happens, they go missing, you can immediately send that profile with their picture to the... I'm not sure, to the Police Department.
Amy Askin : Imagine you can send it to whomever, because it's linked to all the authorities, even to the homeland security, so I mean it's broad.
Johner Riehl : Yeah, it is broad, and my understanding is that it's a one way connection, they're not tracking you by using it, but it offers you an easy way to be in touch with them. And you get updates from them as well, updates about crime reports or if there is any police activity in the area. It was actually started by, the founder, she was an amusement park, she lost her kids for an hour and couldn't find them. Well, it happened to us at Sea World too, we...
Chelle Roman : I was lost at Sea World as a child.
Johner Riehl : Were you, really?
Chelle Roman : Yes, I was.
Johner Riehl : Were you found by the right people?
Chelle Roman : My parents found me, but everyone was looking for me and I didn't know I was lost. I was playing.
Johner Riehl : But it's a scary thing if don't know the right things to do, but so they created this, I think that was the original intent, to have all that information handy, and then it expended to have all this other really cool functionalities. So overall I definitely would recommend this for all parents and families, you should check out Alert ID, sign up for it, like I said, go to alertid.com/newmommy and you can sign up for your account there and head on over to the app store or Google Play for whatever device you have, and download it for free. Would you guys agree?
Chelle Roman : Yeah!
Amy Askin : Yep!
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Johner Riehl : Alright, today's topic is tummy time, and it's something every parent of a newborn should be interested in, I knew it was something that we are definitely interested in as soon as our babies were born, and getting them on their tummies instead of their backs. So today we're talking with Wendy McKenna, who is a pediatric physical therapist, she's the founder of Strides Physical Therapy, Inc., which developed the Baby and Child Wellness program called Move Play Grow. Welcome Wendi!
Wendy McKenna : Thank you, thanks for having me!
Johner Riehl : So what exactly is tummy time that we're talking about? Let's start with a very basic question, and I know it's a broad topic, but what exactly is tummy time and why is it so important?
Wendy McKenna : Tummy time is any awake time where your baby has pressure from a surface, any support surface, on their tummy. And gravity is actually pulling them into that surface.
Johner Riehl : So gravity is a key part of that.
Wendy McKenna : Gravity is a key part of it. In the literature they talk about how it's important for the gross motor development, so babies will be able to roll over and to crawl, and to basically move around their environment. They also talk about in terms of head control and decreasing the incidence of torticollis, which is a crooked neck, as well as plagiocephaly and brachycephaly, which is the misshapen heads. And really over time, since the Back to Sleep program, plagiocephaly has increased from 1 in 300 to up to 1 in 6 children, so
Johner Riehl : Oh, wow! And which one, plagiocephaly?
Wendy McKenna : Plagiocephaly.
Amy Askin : Flat head.
Wendy McKenna : Flat head on an obliquity. Flat head on a diagonal, where you have flatness on either the left side, or the right side, and it causes the head to look like a parallelogram. And the brachycephaly is when you have a broad flatness on the back of the head.
Johner Riehl : And that's increased by what is that, a factor of...
Wendy McKenna : Head shapes are created by pressure. Pressure from an internal brain growing and external pressure from gravity. And your head being placed on surfaces or whatever. So what happens is that when babies are on their backs too often, or on their sides too much, on one side versus another, the external gravity, the external pressure from gravity is really what helps shape that head. And then the problem is, because babies don't have very good head control, if you get a really flat spot, that's where they're going to be comfortable. It's going to keep going there, because then you created the ridge on the side, that they don't have control to get over the ridge, to the other side. So that flatness just becomes bigger and bigger and bigger.
Johner Riehl : They're just this soft little malleable features. And then it starts and they kind of built on it.
Wendy McKenna : Right, because the sutures between all of the bones of the skull are open until about 18 months of life. It's why babies are able to be birth, because they have to have their bones to be able to shift so that they can get through the birth canal, and so it makes sense that they need to have softer heads, but it also makes them very vulnerable to gravity once they get out there, because gravity is a new experience for them, from day one.
Johner Riehl : I'm picturing poor little cave babies back in the day,
Wendy McKenna : But they were held, they were held, and that's the big thing, because that's the other thing that we're not... tummy time doesn't really directly address our container culture, and that's something else I want to really address today, because babies are in things all the time, they're in car seats, they're in swings, they're in strollers, they're not being held. And you can hold you're baby and also have that pressure off their heads.
Chelle Roman : Does baby carry count for...
Wendy McKenna : ...Absolutely, well it doesn't count for tummy time, but it's just as important as tummy time.
Johner Riehl : Let's talk a little bit more about our container culture, as you put it, and this idea that we have swings and we're putting them in there, does that have a really negative effect on a baby's development?
Wendy McKenna : Yes! Yes, it does, and I almost think it has more of a negative effect than the Back to Sleep program itself, because really starting even earlier than Back to Sleep, all these big box baby stores where coming up with containers to make our lives as parents easier, not to help support the development of the baby.
Johner Riehl : Right.
Wendy McKenna : But it was really touted as, “This is going to be great for your baby”, but really is great for the parent. So you don't need all of those containers, and what a container does, it's a plastic device that holds your baby in one position. A lot of them are sleep crouches, absolutely, but the problem is that more often or not they place the baby in a position that their bodies cannot support developmentally yet, because babies, especially when they are newborns, do not have the muscle control to be able to hold themselves up against gravity, but yet all of these containers put them on an angle up, rather than being supported flat on the ground. And so what ends up happening is that your baby, and I'm sure all of you have seen this, is that you put your baby in, they may look great when they first get in, but they slide down and they slump over and their head falls to the left or right, and you're always repositioning, even in the car seat, they're head falls to one side and you're always reaching back, trying to get it back in the middle again, where they fall asleep and so really, all these containers, they have straps in them to contain your baby and to make sure that he doesn't fall out. But they don't align your baby correctly. So there is a product out there that helps to align your baby, if you're going to be using containers, to help support the alignment of your baby so they don't have so much stress and strain on their joints and limbs. But really, in general, a container is just that, a container contains, and it does not allow your child to explore their world, to explore the myriad of movement options that are out there, because it's blocked. It's blocked by the container. And especially in a car seat, because a car seat now has a base that can be left in the car, you click it in and out, you put in the snap and go, you click it in and out, and more often I've seen a lot of babies in their car seats being carted around everywhere. And the designers are coming out, “Oh, it's easier to hold this one, it's easier to hold that car seat”, it's more about the handle than why is our baby in a car seat.
Amy Askin : I was going to say, I do leave with this one, with my second one, we were in a living situation where we didn't have a car, and so I would wear her. And a- it's more comfortable, because in order for these car seats to be safe, they have to be a certain weight, and for them to be a certain weight it's killing you. And so we started baby wearing and I keep hearing how much better developmentally it is, so we're huge advocates, and in Asia, where we were living, everyone wears their babies, and it is better overall. The other thing I was going to point out is that you're saying these things about the containers, it's interesting to me, having lived in Asia and then coming back to the US, the container thing is a phenomenon. They're trying to put things on the container, little thing that entertains the baby, so it makes you think, “Oh, well, she's being stimulated”, because she's looking at herself in the mirror, there's a little mirror on it, and we love our swing. But, there is a big “but”.
Wendy McKenna : And all those things that help to entertain or stimulate your baby, are usually overstimulating, the best place that a baby can be is with you, corresponding with your eyes as you're looking at them, and really not you trying to get them look a certain way, but really, when you approach your baby for the first time, look where they are looking, and the go to where they are, explain what they're looking at, and really talk to them about where they are. They'll hear your voice and come look at you. And then, rather than say, “I'm over here!”, or, “Look at me, over here!”, testing them by, “Oh, let's see if you can turn your head this way”, don't do that, go where they are, respect them as an individual and then expand on their play and communication from there. And by approaching your baby in all instances throughout the day, even when you're changing their diaper, let them know, “We're going to take off your diaper, it's going to get pretty cold here as soon as we do it”, or, “I'm going to pick you up now”, rather than just doing it quick. And that's another thing that we teach in our class, how to transition babies from surfaces so that it's an easy transition for them to make as well as something that's developmentally appropriate.
Chelle Roman : I have a question about the containers, because I definitely use the swing a lot more with my second than with my first, because it was difficult for us to do as much constant tummy time as I could do with my oldest, because I had a 17-month-old running around. What would your recommendations be for that? I was either holding my son, or he was in the swing for months.
Wendy McKenna : And I had the same situation, my second baby, I had a 2-year-old running around and so the baby's not quite safe anymore, because the 2-year-old is running around. What you can do though is if again you start day one usually they'll tolerate tummy time a little bit more, you can put a play yard around your baby.
Chelle Roman : Sure, that's a great idea!
Wendy McKenna : So keep the dog away, keep the cat away, keep other kids away, so you can definitely get away from the containers, and really, when you think about swings and you mention them being sleep aids, we trained our babies with what we do with them, they don't come out knowing, “Oh, I need a swing to sleep”. They fall asleep in the swing because we put them in a swing, and they fall asleep there and it's like, “Oh, great, they're asleep, let's do it again” , until finally they learn that that's what they need, that's how they go to sleep. Versus being able to put your baby down where they are still awake, helping them to learn how to get into that sleep pattern by themselves. We swaddle a lot more to really help with the sleep thing because babies are unable to sleep on their tummies anymore, because the ground before used to be the swaddle, 'cause that's what blocked them, but now they're on their backs, the swaddle really helps. And just one comment about swaddling – a lot of people do teach swaddling with either the arms down, by the sides, or across the chest, you really want the arms up, so the hands are close to the mouth and out a little bit, you don't want the swaddle to be tight and the baby can't move, they should be able to move a little bit. But one of the reasons why you want those hands by the mouth is so that if they turn their head they can self-soothe.
Johner Riehl : So really tummy time then is part of the importance of keeping pressure of the head.
Wendy McKenna : Part of that. It is also gross motor development. Really what we're looking at is the development of the baby's body, as well as their sensory system as well. When they first get out, babies are born with sensory receptors and so they are taking in information all day long, from all the different parts of their bodies, and that's giving information up to their brain and then motorically they move to respond and explore. And so when babies are on their tummies, when they're first born, they are used, especially in a new term, full-term baby, as used to being smashed. They've been smashed in utero, you put them on their tummy from day one, they're being smashed. It's comfortable for them, it's familiar to them. And so a lot of parents look at their babies on the ground, it's like, “Oh, that looks terrible”, they would never want to put a baby there like that, because they can't themselves being smashed on the floor, but that's where they're comfortable, because that's where they've been. And so if you start day one, it brings them back, it gives them self-soothing skills as well, because it brings them back to what they're familiar with. In addition, when they're on their tummy, babies have a lot of random movements that can scare them and startle them, but if they happen to move or startle, and they're on their tummy, they move into the floor, which blocks their movements, so they don't have a big wide range of motions that scare them and startle them. In addition to that, the way the babies are positioned in full flexion when they first come out it's a great position for them to be able to get their hand to their mouth immediately, without having the motor control to be able to do it. Because if you're on your back you have to have motor control to be able to get your hand up and try to get it to your mouth and just hitting your face, but on the floor, because the floor is supporting them so much, that hand can go right to the mouth and they start that really very important self-soothing skill that it's so important for them to be able to do.
Amy Askin : I was going to ask you when is it ok to start tummy time, because we started straight away with El and with each child I've done it sooner and sooner, and I'm hearing from, how shall we say, the older guard, that, “She's crying! It's upsetting!”, so we literally set a timer in how long is appropriate for a newborn. She was three weeks early and we did all the things that you're talking about. We in fact kind of swaddled her to keep her limbs a little, not tight swaddled like you would place her to sleep, but kind of a looser swaddle and put her arms in, so she could push up, and she has really good neck control, she's already lifting her head. She's not even two months, or she is just over two months old, but she can move, she can roll. She rolled over, and we were like, “Oh my gush, it's too early!”, she rolled over at a week.
Wendy McKenna : Their heads are so big that a lot of times that they get themselves in a position, their body is going to follow, not only that, but because they don't have the segmental mobility in their spine, when one part goes, they all go together. So those are all really great questions, the important thing is to know that you already start as soon as the baby is born, because the first place the baby goes is right on your chest, on their tummy, that's their first tummy time. So really when you don't hear it from nurses and doctors saying it's important, they're already doing it, they're already helping to facilitate it without knowing it, and so really one of the first best places to do tummy time is on your chest. The idea with tummy time is not exercise time, I don't want to say, “Oh, we have to do tummy time to increase all their abilities to do all those gross motor skills”, if you just think about it as – it's the place to be when you're going to put your baby down. Then you don't have to set a timer, you're just going to know that whenever you put your baby down, it's going to be on their tummy first, and if they like it, and they're happy there, that's great. And if they don't like it, you can make a couple modifications and we'll go over some of those a little bit later, and if they don't like it after one or two modifications, take them off their tummy. Because really what we want is we want them to learn, and to be in a state of mind where they can learn, and if a baby is upset or crying, they're not learning. So there is no need to set a timer and say, “No no no, you have to do it five minutes here”, or “You have to do ten minutes here”. But if you think about it as if it is the place to put your baby, when you're going to put them down, rather than put them in a car seat or swing or stroller, you don't need any of that stuff. At home right now, I have a car seat to transport my baby, and I have a playmat on the floor, and that's it. I don't have a swing, I don't have an infant seat, I don't have one of those rockers, I don't have any of that stuff. You don't need it. All you need is a playmat, that's really good on the floor, that's transportable, washable. And really one of the other things that we'll talk about later on is doing naked tummy time, which is best.
Chelle Roman : I did a lot of that, not on purpose, my son likes to take his diaper out.
Amy Askin : What about Back to Sleep? We hear that a lot.
Wendy McKenna : Right. So Back to Sleep started in about 1992, and than the public relations campaigns started in 1994 from the American Academy of Pediatrics. They called it Back to Sleep because what they really wanted to do is decrease the incidence of SIDS, which is Sudden Infant Death Syndrome. There were actually in a lot of those literature articles 11 different recommendations to help decrease the rate of SIDS. However, what really got the media attention was the tummy sleeping versus the back sleeping. Now, remember, before SIDS and Back to Sleep program, babies were routinely put on their tummies to sleep, and were told to, so because of the medical opinion that if a baby were to spit up, they would choke on in if they were on their back, so you'd better put them on their tummy. So it switched, in 1994, 50% of babies were sleeping on their backs. By 2005, literature shows that 85% of babies were now put on their backs. So it totally flip-flopped. And in the same time, SIDS rates decreased by 50%, which is huge, it's a great clinical finding. So SIDS and Back to Sleep program is here to stay, and really it's not called Back to Sleep anymore, it's now called Safe to Sleep, which I think is great, because they're bringing in more of the warnings and cautions and things that you can do, like no bumpers in the bad, no blankets in the bad, no stuffed animals in the bad. There is a higher incidence of SIDS when there's smoking or drinking in the house, you know. So all of these other elements are now coming in in Safe Sleep. But everyone knows Back to Sleep, and hopefully the next slogan is Safe to Sleep and Tummy to Play. Tummy to Play is actually part of Safe to Sleep, but they added it later, it really took about ten years for pediatricians to notice that there was a really problem with babies not meeting their milestones, and so it went from Back to Sleep to now Back to Sleep, Tummy to Play. The problem is, and the literature also shows this, that pediatricians don't have a really good guideline for when to tell parents to start, how long it should be, what it should really look like, what tummy time is, and all of those things, so that's why we created Move Play Grow and these baby wellness classes, to really talk about tummy time, the importance of it, but also understanding how it fits into your daily routine, not something like extra-extra-exercise.
Johner Riehl : I think that after the break we'll talk a little more about specific ways that we can do it, and I want to hear a little more about Move Play Grow as well, so thanks, we'll be right back.
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[00:23:52]
Johner Riehl : Welcome back to Parent Savers, we are talking to Wendy McKenna, pediatric physical therapist, who is the founder of Move Play Grow. Tell me a little more about Move Play Grow and how it fits into the tummy time movement.
Wendy McKenna : Move Play Grow really started with my colleague, Rachel Griffin and I, and we started about two years ago, and the reason that we started it was because we were getting more and more referrals for babies who needed physical therapy because they weren't meeting their gross motor milestones, because they had torticollis, which is a medical diagnosis where you have a crooked neck, or plagiocephaly, which is the flat head that we talked about earlier. And these are all preventable. And really no one was talking about how do we prevent these, so that's why we are out there, trying out to educated people how to prevent this stuff, but also supporting your baby the best way that we can, the best way that we know how, in their development as a whole child. And so our classes go beyond tummy time, into more of bonding and communication and supporting the gross motor and sensory motor development of the baby. Tummy time being a large part of that, but by all means not the only thing.
Johner Riehl : Is that something that's just local here in San Diego?
Wendy McKenna : It is right now, and hopefully it will grow over time, but right now yes, it is just local in San Diego. However, we do on our website have online consultations available, so anyone can sign up for that, we can Skype or chat or do video consultations.
Johner Riehl : That's a nice service.
Amy Askin : So what are some specific exercises that we want to focus on with tummy times or like other any props, things that we can use to facilitate and help?
Wendy McKenna : The ideal place to do tummy time is on a firm surface on the floor, without props. However, there are a lot of babies out there who do not like tummy time on the floor. And when you are starting with a newborn, it's not about trying to get them to lift their head and turn their head, it's about giving them an experience where they are calm. And again, smashed into the ground, like we talked about before, the idea is for you to get down to their level, get on the floor, don't just sit in front of them, lye down next to them, get on their eye level, your head into their range, right on the floor with them, between eight to ten inches away from them. And you can talk to your baby, they can see you, you can tell them about their body, you can tell them about what they're doing and how they're moving and tell them about you and who you are, you know, just keep talking to your baby with that wonderful, nice voice that we all adopt. Just be there with them. In addition to that, as a newborn, babies often come out, and you can almost repackage them exactly how they were in the uterus. Often times, that's an asymmetrical alignment. So they have a preference for one direction or another, so you want to be aware when you're looking at your baby and observing your baby if they are still exhibiting that asymmetry, and if you can try and help them go the other way. And so if they're really always looking right, always looking right, well then maybe place them down, have their head to the left a little bit more, and then you are always reassessing, “Ok, are they coming along symmetrically?”
Amy Askin : Criss-crossing ankles, I know El criss-crosses her ankles and she did it a certain way and so we always tried to flip them.
Wendy McKenna : Absolutely, that sort of thing. We're looking at the whole body here. You want to help with the symmetrical development. And that's what we do at our classes, teach people how to look at their babies and how to observe them and how to support them as they grow. Going back to your question, ideally, we want them to be flat on the ground on a firm surface. A lot of babies don't tolerate that.
Johner Riehl : So like a kitchen floor, or a hard wood floor is better than a carpet?
Wendy McKenna : No, a carpet is fine. What I mean by firm surface is one where they are going to be supported by the ground, not sinking into it. You don't want to do it on a pillow, not on a mattress, not a couch cushion, not on a whole bunch of blankets, where they can grab those blankets and bring them close to their face and suffocate, really, because when babies go through suffocation and die, which is horrible, and part of what SIDS is really about creating pockets of air that don't get a lot of good air exchange. And so when you're on a firm surface, there is going to be no way for that child to gather material around their face that can create that pocket. And obviously you're going to be there with them all the time. Anyway, when they're there, you can help them not do it. But I have another certain climates that have a little but more cushion to them that are great, because they don't gather, they provide enough cushion so that the babies can lye on the floor, it's comfortable for them and really comfortable for you to lay down next to them as well. But when they start to push into the ground to come away from the surface a little bit more, they actually have something to work off. Because if you're on a mattress or on a couch cushion, as soon as they push into the surface they're just going to sink into the surface, they're not going to be able to come away. So you want it to be firm enough so that they can come away from the surface, but also comfortable enough that they're going to be happy there. So on a carpet is great. If you're on a hardwood floor, you know, there are definitely playmats on the market that have a little more cushion to them that I really enjoyed. We actually sell one of them on our website. There are products out there that can help.
Amy Askin : So what if you have a child who just doesn't tolerate being on the floor, are there other exercises or positions that they can be in?
Wendy McKenna : Yes, and so, like I said in the beginning, tummy time is really about pressure of any support surface being on the baby's belly and gravity pulling them into the ground. And so the things that I like to talk about in our class is the development of the baby and how they get to work off of the ground in tummy time. We're working with two different things, we're working with gravity and we're working with range of motion. So when a baby is firstborn, their rear end is stuck up in there, and then their arms, actually their elbows are down by the rib cage. By the time they're three months, those legs stretch out, the bottom drops down, and the elbows come forward to the point where they are at the shoulder level. And so really what we're trying to do is replicate that development but not too early. So there's different exercises that you would do at different ages. You are not going to take a newborn and stretch their arms way up over head to try to do tummy time. You want them to be here and close by. So the other places that you can do it is on your chest. And then, looking at gravity, the more horizontal they are, the harder it is for them to pick up their head. The more vertical you are, the easier it is for them to pick up their head. So if you end up putting him on your chest and laying back at a 45 degree, again, it's not about exercise, I don't want to talk about it as exercise, it really is positioning and it's the position of choice that's going to give the best support for your baby development. So if you just think about it as not something to do extra, but it's just what you do when you're holding your baby.
Amy Askin : That's very helpful.
Wendy McKenna : Yeah, and then you can go at different angles, whatever's comfortable for you. If you feel like being at a 30 degree angle, great! If you feel like being at a 60 degree angle, great. And your baby is going to be able to tolerate that. Across your chest is one place, another place is holding them in a tummy-down carry, where a newborn is going to be more packaged, like that picture is on the wall.
Johner Riehl : There's a picture of an outstretched arm with the baby laying on the arm.
Amy Askin : It's almost like a guy holding a football ball.
Wendy McKenna : Exactly, but as your baby grows, what you can do then is put your arm underneath your baby's chest and bring their arms in front of you arms, so that they're more at shoulder level rather than behind shoulder level, so you're starting to help facilitate that stretched out position that you want to replicate on the floor. And again, when you're holding them, you can change the angles. You can go up to a 45 degree angle, to make it easier, you can go down on the flat horizontal again to make it a little bit tougher. And dad's usually love this one, because you can go flying around the house. And flying around the house is one of the most fun things to do. And you can fly up to mirrors, you can fly down to the couch, or to the floor or whatever. And you can start getting their hands on things, so that they're really pushing into the floor a little bit more. And then one of the important things to think about with the carrying is that you want to make sure you do it both directions. We are very one sided as adults, and we do not want to impart our asymmetries on to our baby. So if you think about every time you pick your baby the first time, do it on your awkward side, so you know you'll get it in. The other way that I like to talk about is if you're going to be holding your baby in your arms, rather than in a carrier, if you're transporting from point A to point B, you hold them in your dominant side, because you don't need that dominant side, and then when you get to your destination, you have to do whatever you have to do your hand, you put them in your non-dominant part, so that your dominant hand can do what it's supposed to do. Our body is designed to walk, so when we walk, one side is doing one thing while the other side is doing the absolute opposite. And that's what makes us have reciprocal movement. And so to go through that you have to go through a stage where you actually have symmetry and everything is working together first. And so if you are imparting your asymmetries on the baby or you're not noticing that there are asymmetries and try to help them to be more symmetrical when you can, than they never get that left and the right brain working together as well. So that the reciprocal things that come later down the road work really well. So we talked about the whole thing, and really, again, then we morphed into the asymmetries, making sure you're using your dominant side and your non-dominant side with your baby. Another great place to do tummy time is on your lap. And you can do it either in a sitting position on a chair, you're sitting with your hips at 90 degrees or your knees at 90 degrees, or you can do it on the floor. And this is a great place because your lap is a large enough place to support your newborn baby, but also it's a great place for the baby to stretch out a little more, to be able to be there as well. And what you can do then is, whichever way the baby is facing on the head side, that leg can be placed a little bit higher. So again, you're putting them on an angle, not directly horizontal but an angle which makes it easier for them to do. And then from there it's lovely, because you can move, and you can impart movements with swings or rocking or whatever you want to do, so the baby is not so bored on a still flat surface. And then you can again change the angle of your leg so that the baby is more up, or down, depending on what they are going to be able to tolerate. And if you have a toy on the floor that they really want to get, they can go get it. If you do it in front of a mirror, you'll be able to see baby, 'cause one of the problems with this position is that you can't see your baby's eyes. And really what we want to be able to do is promoting happy tummy time, playful tummy time, bonding and communicating with your baby, and one of the ways that they – the way they communicate – is with their vision. And so if you can't see what their eyes are doing or if they're not connecting with you with their eye gaze, than you are not really connected with your baby. But if you do it in front of a mirror and look at them through the mirror, you can then still be connected with them.
Johner Riehl : I think that it's really interesting that, you know, when I hear tummy time traditionally it seems like, “Throw the kid on the floor, let him figure it out”
Wendy McKenna : But that's how it's told to parents, parents don't really know what it is, why we're doing it, how to do it, and it really does sound like they have to be on the floor, and ideally that's where you want them to be, you're working towards getting them there, but if they don't tolerate it, you can do these different modifications to help them eventually get there.
Johner Riehl : And I love these ideas of the contact that you're getting by holding them on your lap or your arm or all these other ideas, and those are great ways to get the tummy time and the benefit. Thanks so much for talking to us and giving more details about it, thanks to Amy and Chell for joining us, thanks for baby El for being such a sweetheart, maybe you heard her a couple of times, but she did a great job.
Amy Askin : Thank you for having us!
Johner Riehl : For more information to our listeners on Wendy or Move Play Grow, or about any of our panelists, check out or episode page on our website, we also got links to more resources about tummy time. We are actually going to continue the conversation for a little bit after the show for members of the Parent Savers Club. Wendy is going to tell us a little bit more about midline and kind of explaining some of the physical descriptions. There's a lot of words, I wish that they were simple words, even like the diseases, so we're going to talk a little bit more about that for our Parent Savers Club members.
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[00:36:58]
[Featured Segments: Ask the Experts]
Johner Riehl : Now we have a question from Fiona. Fiona writes, “I gave birth to my first baby about three months ago. Overall, I'm happy that the baby is here, although it's a lot of work. But there is the sense of feeling lonely that I just can't shake. I'm surrounded by people, so I'm not physically lonely, I'm just a little sad I'm not pregnant anymore. I got to ask, is this normal?”
Jennifer Schere : Hi everyone, this is doctor Jennifer Schere, I am a clinical psychologist, with a practice in San Diego. I think that is such a common, normal, typical experience for so many moms. And pregnancy is the period when we're doing a lot of emotional and mental preparation, so there is a lot of room for us to create our own fantasies and expectations, whether conscious or unconscious, about what we think the baby will be like, and how we think it will impact ourselves and our families. And then, when you have the baby, of course it's a blessing and a miracle, but there is a very dark contrast to the harsh reality of the work, moment to moment, of care taking. A sharp contrast again with everything that was in our own minds, before we're getting up 20 times a night and changing diapers. So that in itself can sometimes feel a little bit of a letdown and can generate feelings of loneliness or temporary sadness. But the other thing is that I think a lot of moms also experience a loneliness in the sense that there is a feeling that you're out there on your own, with this awesome responsibility of helping this new life. And even when you got people who love you, who are around you and they are keeping involved and supportive, there is still a sense of it's you, and it's on you, and that is something that I think all moms can speak to and feel it one time or another. The other thought I wanted to share with you around what it's like postpartum when you're making these adjustments is that sometimes we miss a part of our former selfs, there's a major shift in lifestyle and a big refocusing right now on care taking the baby. So not so much time for things that help us feel connected to ourselves and that's something we really got to be aware of and try to incorporate into our lives with baby. Again, I just hope you recognize that feeling is something that many many women share and I thank you for bringing it up.
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Johner Riehl : That wraps it up for today's episode of Parent Savers, we appreciate you listening very much, thank you so much for joining us, whether it was on our website, on the app or you downloaded this from the iTunes store. Don't forget to check out our sister shows, we got Preggi Palls for expecting parents and the show The Boob Group for moms who breastfeed. Next week we're going to be talking about parenting tips from around the globe. This is Parent Savers, empowering new parents!
[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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