Last week, I shared all about the roller coaster of a breastfeeding journey we’ve had with our little James these last couple of months, and the amazing lactation consultant who helped us.

This week, I’ll be interviewing our lactation consultant, Allyson Wessells of Nurture Columbus, but we won’t be specifically chatting about nursing! Allyson is not only an IBCLC but also a PT, so she has a unique perspective on all things babies.

She’ll be teaching us all about tummy time – not just what it is and how often parents should do it, but also how it’s for more than just neck and shoulder strength, and why, as a lactation consultant, she puts such an emphasis on it!

Introduce yourself!

My name is Allyson Wessells, and I am a physical therapist and an International Board Certified Lactation Consultant (IBCLC) in Columbus, Ohio. I co-own a private practice, Nurture Columbus, and we provide all in-home infant feeding care and infant physical therapy care in Central Ohio.

At Nurture, we pride ourselves in listening to mothers and hearing their goals, and meeting them where they are to achieve those goals.

What is tummy time? 

Tummy time is an important position for babies and one that they need to be in naturally. For the first few weeks of life, the gold standard is for tummy time to be on the parents’ chest, but then it is on their bellies, on a firm surface on the floor.

Tummy time is a position from which babies grow and develop and practice movement that we see as lactation consultants actually simulates feeding, whether that’s at the breast or the bottle. And as both a PT and IBCLC, I have discovered over the last ten years that these two worlds intersect very interestingly.

There is a lot of strengthening and coordination that needs to happen in order for babies to learn how to crawl. And in the lactation field, we’ve discovered how being on their belly simulates movement and reflexes for feeding which, when comfortable, can inform a baby’s body on how to feed better.

How often should parents be aiming to do tummy time with their baby? 

We recommend doing tummy time 3-5 times a day, and it’s not something that should be timed – we’re looking for quality over quantity. We want to respect babies’ cues and communication, and that will get us to what’s physiologically normal for their development.

We also recommend that tummy time happens when your baby has been fed and also rested. We want them to have a fully belly and the energy to move and figure out how their body works. If they’re hungry, getting on the floor and rolling them on their side is going to be jolting and hard.

So we want to first respect their basic needs, and then let them explore their body.

As humans, we digest through movement; when we don’t move, our digestion can be impaired. For babies, their ability to move is so much more limited than ours as adults! So once your baby has been fed and burped, lay them on their back on the floor. As you gently rock them back and forth, you’re informing their digestive system to keep moving things downward.

Then as you gently roll them onto their belly, that’s giving them firm and comfortable pressure on the front of their body to keep their nervous system calm and again, to keep things moving downward. We’re helping to inform your baby’s nervous system on how to help with digestion.

And it’s okay if they spit up! Sometimes this bodywork can even help calm reflux. All of this is helping your baby figure out how their body works.

After tummy time is over, try to feed your baby again. That tummy time was like a little workout, so give them a little drink! We want to intertwine that feeding function with whole body movements and that function on the floor.

What if a baby doesn’t like tummy time?

At Nurture Columbus, we want parents to feel empowered to learn how their babies are communicating with them about how their bodies are working. So if your baby isn’t enjoying tummy time, let’s try to figure out why.

There could be some underlying reasons as to why your baby doesn’t like tummy time – maybe there’s something in their body that’s not comfortable. As a PT and IBCLC, we know what to look for as far as movement challenges in your baby’s head, neck, mouth, jaw, and even down to their hips. Any of that could impair how they enjoy or find comfort in figuring out their body when doing tummy time.

And that discomfort can translate into feeding challenges, too!

The Tummy Time Method

A lot of what I do was informed by Michelle Emanuel, an OT out of Cincinnati who created the The Tummy Time Method, which is all focused on nervous system regulation.

As humans, we want to be regulated and connected and interact with others. And so tummy time through our lens is about helping babies be comfortable in their bodies, regulate their nervous system, and interact with the people around them.

When the “back to sleep” campaign started in the 90s, while we had a notable reducation in SIDS (which is great news!), in the therapy world we saw a notable increase in subtle to obvious developmental delays associated with torticollis, plagiocephaly, brachycephaly, and cranial asymmetries.

We then fast forward a bit to research showing that babies with torticollis have less breastfeeding duration rates – when the head and neck are assymetrical, a baby’s mouth is going to have tension and will work asymmetrically.

So as a PT and IBCLC, connecting all these dots is fascinating for me and my colleagues. We want to make sure babies are moving symmetrically, are comfortable in their bodies, and are feeding functionally side to side, whether that be on the breast or on the bottle.

When should parents start tummy time, and when can parents stop focusing on tummy time?

Tummy time is important for newborns all the way to pre-crawling babies. Once they start rolling and crawling, they’ve got it and they’re doing it on their own now! For the first few weeks of life, tummy time on the parents is the gold standard.

Then tummy time looks like the baby being on a soft blanket on the floor with someone on the floor with them. As long as their basic needs have been met, they’ll likely start on the floor pretty curled up, but then they’ll start opening their chest. This mirrors how they need that chest to be opened up to come to the mom to feed, or to the bottle to feed – you want optimal posture.

While on the floor, they’re going to be practicing their reflexes, all of which are for feeding – their hand will come to their mouth and their jaw will open, their tongue will then come out, and that will repeat over and over again.

In the PT field, that’s essentially the foundation of what we do; we repeat functional movements over and over again until a functional goal is achieved. All of those little movements practiced during tummy time are informing a baby’s body on how to feed and how to use those reflexes for what they’re there for.

What should tummy time look like age to age?

When moving a baby into tummy time, we don’t want to help them onto their belly too much. We want to lay them on their back and then slowly help them roll, doing so from as low on their body as possible. We then roll them very incrementally until they’re on their side, then slowly over to their belly. And if they need help getting their arms out a bit, we’ll do so.

At first, try not to do a lot of propping up. We want the baby’s shoulders to stretch out at the top and see that the baby can clear their airway, and turn their head symmetrically to one side, and then the other side.

As the parent, you should try to entice your baby with your face and smile, and maybe a favorite toy. Their movement is going to be guided by their senses, specifically toward what they see, hear, and smell, so as parents, we are trying to guide those sense.

By the time a baby is 10-14 weeks old, they might not need as much help getting onto their belly – you might roll them halfway and then they finish out the rest.

By the time they’re 3-5 months old, they might be rolling on their own now. If you notice they’re just rolling one way and not the other, this is a good time to probem-solve what’s going on to help make their movement more symmetrical.

Then by 6 months, your baby might be sitting up. And then they’re likely starting to crawl somewhere between 8-10 months old.

Having that repetitive opporutnity on a baby’s belly over and over again from the beginning encourages this very progression. Our muscles rule our bones, so if a baby’s muscles aren’t activated properly, their bones will adapt to assymetrical movement.

Without those regular opportunities to be on their bellies, a baby’s body can get stuck in certain positions and we then have to undo that. So it’s important to give babies the opportunity to move a lot; our goal is for good feeding, good sleeping, and good movement.

As a lactation consultant, why do you care so much about tummy time? Why is it important?

I’ve already alluded to it a bit, but when you think about a baby’s feeding position when nursing, they’re essentially doing tummy time on mom. So as an IBCLC and a PT, I think about the posture of a baby’s body and how it needs to be in order to optimally breastfeed.

We want the baby’s arms to be out, hugged around mom. We want their head to be extended back just a bit so their jaw and tongue have room for the full range of motion. We want the front of the baby’s body to be belly to belly with mom. And we want their lower body angled down and flexed around mom so as to not put undo tension on top of their body and to be opened up and extended to feed.

Now take that picture of a breastfeeding baby and transfer that to the floor. It’s important to observe tummy time as it gives us a better idea of where the struggle might be, where there’s ease, and how all of that could be impacting feeding.

If we find that a baby is struggling to nurse on one side versus the other, let’s see what their body does on the floor. All of that gives us clues as an IBCLC to guide you to help your baby move more symmetrically and hopefully feed better, as well.

We’ll occasionally do some craniosacral therapy, as well, as it compliments all of this. But it has to be in combination with empowering parents to help them discover how to help their babies move symmetrically.

Tell us about the tummy time classes Nurture does at Columbus libraries!

We have been doing free tummy time group classes for years now, and these classes are community outreach from Nurture Columbus. We take the first five minutes to talk all about the importance of tummy time, like I’ve done here. The library then provides yoga mats, high contrast toys, and Oball toys for oral motor skills so we can do some tummy time together!

We have all of the moms introduce themselves and their babies, and then once we’re settled into tummy time, I go around for 15-20 minutes to answer any questions moms might have. The babies range from about two weeks old to seven months old, so it’s also helpful for newborn moms to see what’s ahead, as well as for those with older babies to look back and encourage the other moms with what’s to come.

It’s a really sweet time with the overarching goal of bringing parents together who are in a similar phase of life, to help them make connections and feel more normal in their day to day, to understand their highs and lows, and to encourage them!

We now have a weekly (free!) tummy time class at the Upper Arlington Public Library, Tremont Branch, every Friday from 10:15-11 am. A colleague of mine also hosts a monthly (free!) tummy time class at the Westerville Library on the fourth Monday of the month, from 11-11:45 am. We welcome parents with newborns to pre-crawling, and all emotions and feeding methods are welcome! (There is also a pre-recorded virtual version of this tummy time class.)

We’ve actually done research and have qualitative research published on maternal confidence and breastfeeding outcomes based on participation in these tummy time groups.

The research shows that moms had improved confidence in how to understand infant movement, and breastfeeding outcomes were upwards of six months. And the research was not just done here in Columbus, but also in Oregon and in the Southeastern United States, with others who had similar training to mine.

Is there anything else you’d like to share?

This is an exciting time of life for people, and we always want you to remember to give yourself grace and so much credit for all that you’re doing.

Parenting is the hardest job that there is for humans – we have the privilege of bringing humans into the world and nurturing them into their best self. And we get to help them find their strength to take into the rest of the world.

About Allyson Wessells

Allyson Wessells is a physical therapist and International Board Certified Lactation Consultant (IBCLC) with Nurture Columbus, in Columbus, Ohio.  As a PT and IBCLC, she focuses on optimizing nourishment and growth for lifelong health. Other services include presentations emphasizing the importance of breastfeeding and infant neurodevelopment as foundations for preventive healthcare.