How to Do Tummy Time When Your Baby Has Reflux
Quick Answer: When your baby has reflux, modify tummy time by waiting 20-30 minutes after feeding, starting with elevated positions like on a wedge pillow, and keeping sessions shorter initially. Use left side-lying as a rest position when baby gets fussy, and don't let fear of spit-up prevent this important developmental activity. Most spit-up is only 1-2 teaspoons even though it looks like much more.
As a pediatric physical therapist, I frequently work with parents whose babies have reflux and need guidance on how to do tummy time. With the right modifications and timing, most babies with reflux can successfully participate in this important developmental activity.
Tummy Time with Reflux
Tummy time can be challenging for babies with reflux, but it remains essential for preventing flat head syndrome (plagiocephaly) and building the strength needed for future motor milestones.
The good news is that reflux usually begins to subside around 6 months of age as your baby's digestive system matures. This means that while tummy time may be challenging initially, it often becomes easier as your baby gets older.
If you suspect your baby might have reflux, consult your pediatrician. They can help determine the best plan of care and ensure that your baby's weight and nutrition needs are being met.
Timing Your Tummy Time Sessions
Take a 20-30 Minute Break Between Feeding and Play: Give your baby a 20-30 minute break between feeding and tummy time to allow their stomach time to settle. Don't forget to burp your baby before tummy time to release any gas that might contribute to spitting up.
Practice Right After Waking Up: Try tummy time right after your baby wakes up but before their next feeding. Babies are often in a good mood after a nap and may be more receptive to tummy time during this alert, content period.
Use Pre-Feed Windows: The best time for active tummy time is when your baby is alert but not yet hungry.
Coordinate with Medications: If your baby takes reflux medication, ask your pediatrician about optimal timing relative to tummy time.
Positioning Techniques
Try Tummy Time on Inclined Surfaces: Experiment with inclined surfaces where your baby's head is slightly higher than their belly. You can use a wedge pillow, a standard pillow, a rolled-up towel, a yoga ball, or even your chest. This can help reduce the discomfort associated with reflux during tummy time.
Take Frequent Rest Breaks in Left Side-Lying Position: If your baby seems fussy during tummy time, there's no need to push through tears. Take a break and roll your baby into a side-lying position. This position is also developmentally beneficial and is usually tolerated well, even when tummy time becomes a struggle. Alternating between side-lying and tummy time can also help prepare your baby for rolling. The left side position takes advantage of the stomach's natural shape and uses gravity to help prevent food from traveling back up, which is what causes spit-up and reflux discomfort.
Start with Your Chest: Begin tummy time sessions with your baby on your chest while you're reclined. This elevated position works well for babies with reflux and still provides developmental benefits.
Making Tummy Time Manageable
Practice Tummy Time in Short Intervals: Keep trying, even if it's just for a minute or two. Building tolerance for tummy time takes time. Be sure to have plenty of burp cloths on hand. Several brief tummy time sessions throughout the day work better than one long session for babies with reflux.
It Looks Like More Than It Is: In most cases, if your baby is gaining weight well, you can continue with tummy time even when your baby is prone to spitting up. Usually, the amount that a baby spits up is only about 1-2 teaspoons (even though it looks like a lot more!). It might get messy, but the benefits are worth it.
Keep Burp Cloths Handy: Have clean-up supplies nearby in case of spit-up, but don't let fear of messes prevent tummy time.
Watch Your Baby's Cues: If your baby seems uncomfortable, try a different position or take a break in side-lying position.
The Bottom Line
Having a baby with reflux doesn't mean skipping tummy time. With proper timing and positioning modifications, most babies with reflux can successfully participate in this important developmental activity.
Focus on timing sessions appropriately, using elevated positions when needed, and taking breaks in side-lying when your baby gets fussy. Don't let fear of spit-up prevent this crucial developmental activity, as the benefits extend beyond motor skills to potentially helping with the reflux itself.
Frequently Asked Questions
Q: How long should I wait after feeding to try tummy time? Try waiting 20-30 minutes for active floor tummy time, but gentle elevated tummy time can be done sooner.
Q: What if my baby spits up during tummy time? Clean up and try again, perhaps with a longer wait time after feeding or using a more elevated position.
Q: Can I do tummy time if my baby just ate? Gentle tummy time on an inclined surface is usually fine, but avoid active floor tummy time immediately after feeding.
Q: My baby seems to love tummy time. Is this normal with reflux? Some babies with reflux do well with tummy time while others find it challenging. Every baby is different, so follow your individual baby's cues.
Q: Should tummy time sessions be shorter for babies with reflux? Start with shorter sessions and build up gradually. Some babies with reflux tolerate longer sessions while others need to keep them brief.
Related Reading
How to Be Consistent with Tummy Time
P.S. This information is for educational purposes only. It is not medical advice and is not a substitute for skilled physical therapy intervention. While I am a physical therapist, I am not your child's physical therapist. If you have questions or concerns about your child's health and/or development, please contact your pediatrician.
