Baby Hates Tummy Time? A Pediatric Physical Therapist Explains Why & What Actually Helps
Updated: Oct 16
If your baby cries every time you put them on their tummy, you've probably heard the same advice over and over again:
"Just keep doing it."
"They'll get used to it."
"Try to get more tummy-time minutes."
But what if your baby genuinely struggles with tummy time? What if they can't seem to lift their head, their arms get stuck underneath them, or they become upset almost immediately?
Sometimes the answer isn't more tummy time. It's figuring out why tummy time is difficult in the first place.
I'm a doctor of physical therapy who has spent more than 17 years working with babies and young children. When I evaluate an infant who struggles with tummy time, I'm looking at much more than how long they tolerate lying on their stomach.
I'm looking at their strength, head control, posture, symmetry, weight shifting, and ability to develop increasingly complex movements.
In this article, I'll explain:
what research tells us about tummy time
what motor skills babies should gradually develop
how to make tummy time easier
when difficulty with tummy time might warrant an evaluation
Why Is Tummy Time So Important?
Tummy time is more than an exercise for strengthening your baby's neck. It's one of the earliest opportunities babies have to learn how to organize their bodies against gravity.
When babies lie on their backs, the floor provides support for much of their bodies. When they're placed on their stomachs, they have to actively engage their muscles to lift their heads and upper bodies.
This position encourages the development of several important motor skills.
Neck and Trunk Strength
Lifting the head against gravity requires activation of the muscles along the back of the neck and trunk.
As babies become stronger, they're able to maintain their heads in a more upright position for longer periods.
This growing control is important for later skills, including rolling, sitting, and moving independently.
Shoulder Stability and Upper-Body Strength
When babies begin supporting themselves through their forearms, they're learning how to stabilize their shoulders and upper bodies.
Eventually, they progress toward pushing through straighter arms.
These experiences provide opportunities to develop the strength and coordination needed for reaching, weight shifting, and supporting their bodies during floor mobility.
Weight Shifting and Coordination
One of the most important developmental changes occurs when babies begin shifting their weight from one arm to the other.
Initially, babies may need both arms on the floor to maintain their position. As their control improves, they can shift their weight onto one arm and free the other to reach for a toy.
This is an important foundation for more advanced floor mobility.
Learning to Move Independently
Tummy time also allows babies to experiment with movement.
They may begin turning in circles on their stomachs, rolling between positions, pushing backward, or attempting to move toward interesting objects. Over time, these experiences contribute to the development of increasingly complex motor skills.
What Does the Research Say?
A 2020 systematic review published in Pediatrics examined 16 studies involving 4,237 infants from eight countries.
Researchers found that tummy time was positively associated with gross motor development, overall developmental measures, and several movement abilities, including rolling and crawling. However, most studies were observational. That means the research demonstrates associations, not proof that increasing tummy time directly causes every developmental improvement.
The evidence was also less conclusive for some outcomes, including sitting, standing, walking, and certain measures of head shape. [1]
The takeaway: Tummy time is an important part of early motor development, but it's one component of a much larger developmental picture. |
What Should Tummy Time Look Like at Different Ages?
One of the most helpful things parents can understand is that tummy time changes dramatically throughout infancy.
The goal isn't for a newborn to look like a four-month-old or for every baby to progress at exactly the same pace. Instead, we're looking for the gradual development of strength, control, and increasingly complex movement.
Newborn to 2 Months: Beginning to Lift the Head
During the newborn period, babies may briefly turn or lift their heads while lying on their stomachs.
Their arms are often positioned close to their bodies, and their movements may appear somewhat uncoordinated.
As they approach two months, many babies begin demonstrating more consistent head lifting.
According to the CDC, holding the head up while on the tummy is a developmental milestone that most babies demonstrate by two months. [2]
At this age, I'm particularly interested in whether a baby can begin lifting their head and move it toward both sides. I don't expect prolonged head control or sophisticated weight shifting.
Around 3–4 Months: Developing Forearm Support
During this period, tummy time often begins looking much more organized.
Babies gradually develop better control of their heads and upper bodies. Many begin bringing their elbows underneath their shoulders and supporting their weight through their forearms. This creates a stable foundation for lifting the head and upper chest.
By four months, the CDC identifies pushing up onto the elbows or forearms during tummy time as a milestone demonstrated by most babies. [3]
This is also when I pay close attention to whether babies are using both arms similarly.
Around 5–6 Months: Reaching and Shifting Weight
As strength and coordination improve, babies begin experimenting with more advanced movements.
They may:
Push their chests higher from the floor
Support themselves through more extended arms
Shift their weight from one side to the other
Reach for toys while supporting themselves on the opposite arm
Roll between their stomachs and backs
Begin turning or pivoting while on their stomachs
These skills don't necessarily emerge in a perfectly predictable order.
What matters is that your baby is developing more control and beginning to explore new ways of moving.
Around 7 Months and Beyond: Tummy Time Becomes Floor Mobility
By this stage, many babies are no longer simply practicing lifting their heads.
They're using the prone position to explore their environment. They may pivot, roll, reach, push backward, belly crawl, or begin experimenting with getting onto their hands and knees. Some babies are highly motivated to move toward toys or people. Others take more time to develop these skills.
But by this stage, I'm particularly interested in whether a baby is actively exploring movement rather than remaining relatively stationary.
An important distinction: Developmental milestones are not deadlines. The CDC's milestone ages describe skills that at least 75% of children are expected to demonstrate by a particular age. They're useful screening guides, not a substitute for an individualized developmental assessment. [2, 3]
How Much Tummy Time Should Babies Get?
There are established recommendations for tummy time, but I want parents to understand how to apply them.
The American Academy of Pediatrics recommends beginning tummy time shortly after birth, using short periods of approximately 3–5 minutes, two or three times daily.
As babies grow stronger, families can gradually increase the amount of time.
The AAP recommends working toward approximately 15–30 minutes of accumulated tummy time daily by around seven weeks. [4]
The World Health Organization recommends that infants who aren't yet mobile accumulate at least 30 minutes of tummy time throughout the day while awake. [5]
These recommendations emphasize regular opportunities for movement.
They do not mean your baby needs to complete one uninterrupted 30-minute session. For a baby who is struggling, I frequently encourage parents to begin with shorter, more manageable opportunities.
For example, a baby might practice briefly after a diaper change, spend some time on a parent's chest, and have another supervised floor-play opportunity later.
As the baby's strength and tolerance improve, the sessions can gradually become longer.
Clinical perspective: I want parents to consider both the quantity and quality of tummy time. Meeting a recommended number of minutes is useful, but it doesn't tell us whether a baby is developing appropriate movement skills. |
Why Do Some Babies Hate Tummy Time?
There isn't one explanation for every baby who dislikes tummy time.
Sometimes the activity is simply challenging.
Other times, positioning, strength, mobility, or postural differences contribute to the difficulty.
1. Their Head Is Heavy Relative to Their Body
Babies have proportionally large heads. Lifting and controlling that head against gravity requires considerable muscular effort, particularly during early infancy.
For a young baby who hasn't yet developed much head control, tummy time can be physically demanding. Some grunting and brief frustration can be expected.
2. They Have Difficulty Supporting Themselves Through Their Arms
When a baby's elbows remain positioned far behind the shoulders, they may have difficulty establishing a stable base of support.
Without adequate forearm support, lifting the head and upper chest can become more challenging.
This is one reason I frequently adjust arm positioning during pediatric physical therapy sessions.
3. They Have Limited Neck Mobility
Babies who consistently prefer turning their heads toward one side may have difficulty moving comfortably in the opposite direction.
Some infants have congenital muscular torticollis, a condition involving an asymmetrical head or neck posture that may be associated with restricted neck movement.
These babies may find certain tummy-time positions more challenging. [6]
4. They Have Lower Muscle Tone
Muscle tone refers to the passive resistance present in muscles at rest. Babies with hypotonia, or low muscle tone, may have more difficulty maintaining stable positions against gravity.
Some babies with low tone need additional support or more gradual progression when developing head control, forearm support, and trunk stability.
Low muscle tone isn't the same thing as muscle weakness, although the two can occur together.
And importantly, low muscle tone is a clinical finding rather than a diagnosis by itself.
5. The Activity Is Poorly Timed
A baby who is tired, hungry, uncomfortable, or has just finished a large feeding may be less willing to participate.
For babies with reflux or feeding discomfort, tummy time immediately after eating may be particularly unpleasant.
Finding a comfortable time can make practice much easier.
How to Make Tummy Time Easier: Three Pediatric PT Strategies
When I work with babies who struggle with tummy time, I often begin by modifying the activity.
The goal is to make the movement achievable while still allowing the baby to practice.
These are practical pediatric physical therapy strategies. Although they are consistent with principles of positioning and motor learning, the precise effectiveness of each modification hasn't been established through large clinical trials.
Strategy 1: Begin With Tummy Time on Your Chest
You don't have to start with your baby completely flat on the floor.
Try leaning back into a comfortable, semi-reclined position and placing your baby tummy-down against your chest.
Keep your baby supported, awake, and closely supervised, with their nose and mouth unobstructed.
Your baby can practice lifting their head to look at your face.
Because the body is positioned at an angle, the demands of lifting the head may be easier than when lying completely flat.
As your baby develops more strength, gradually progress toward a more horizontal position.
Strategy 2: Use a Small Rolled Towel Under the Upper Chest
This is one of my favorite modifications for babies who struggle to lift their heads.
Roll a small receiving blanket or towel and position it beneath your baby's upper chest. Bring the arms forward so the elbows are approximately underneath or slightly in front of the shoulders.
The towel provides a little support beneath the upper body, allowing the baby to practice lifting the head and bearing weight through the forearms.
As the baby becomes stronger, you can gradually decrease the amount of support.
Always use this technique during awake, directly supervised play on a firm surface. Make sure the baby's face remains unobstructed, and never use the towel or other positioning supports during sleep.
Strategy 3: Improve Elbow Positioning
One of the first things I look at during tummy time is the position of the baby's arms.
If the elbows are positioned far behind the shoulders, I may gently bring them forward. This allows the forearms to provide a more effective base of support.
A baby who has been struggling to lift the upper body may suddenly have a much easier time maintaining the position.
This isn't a guarantee, and positioning should always be comfortable and appropriate for the individual baby.
But sometimes a small change in alignment can make a meaningful difference.
Why Forearm Support Matters for Later Development
Forearm support is about more than strengthening the shoulders. It provides a foundation for increasingly complex movements.
Initially, a baby may rely on both forearms to support the upper body.
As postural control improves, the baby can begin shifting weight toward one side. This allows the opposite arm to move more freely.
Eventually, babies can reach for toys, rotate their trunks, and experiment with moving their bodies in different directions.
These are important components of motor development because independent movement requires babies to stabilize some parts of their bodies while moving others.
For example, reaching toward a toy during tummy time requires a baby to maintain enough stability through the supporting arm and trunk to free the reaching arm.
This ability to coordinate stability and movement becomes increasingly important as babies learn to roll, pivot, and crawl.
Pediatric PT insight: When I see a baby beginning to shift weight and reach during tummy time, I'm seeing much more than upper-body strength. I'm seeing the development of coordinated movement. |
What About Tummy Time and Flat Head Syndrome?
Tummy time is frequently recommended as part of preventing positional head flattening.
There are two related conditions parents may hear about:
Plagiocephaly refers to asymmetrical flattening of the head, often more noticeable on one side.
Brachycephaly refers to flattening across the back of the head, which may make the head appear relatively wide.
Babies who spend substantial amounts of time resting with pressure against the back of their heads may be more likely to develop positional flattening. Awake tummy time provides opportunities to reduce that pressure while also encouraging active movement.
However, it's important not to overstate the evidence.
The 2020 systematic review by Hewitt and colleagues found an association between tummy time and reduced brachycephaly, but the relationship with plagiocephaly was less conclusive. [1]
Tummy time is still a valuable part of a broader approach to positioning and movement.
If your baby consistently turns their head toward one side or has noticeable head flattening, it's worth discussing with their pediatrician.
And remember: Back sleeping remains the recommended position for infant sleep, even when a baby has positional head flattening. [4]
Tummy Time, Torticollis, and the Importance of Early Evaluation
One reason I pay so much attention to head position during tummy time is that it can reveal consistent movement asymmetries.
Congenital muscular torticollis commonly presents with a head tilt toward one side and rotation toward the opposite side.
Some babies also demonstrate a strong preference for looking in one direction.
The American Physical Therapy Association's updated 2024 clinical practice guideline emphasizes early identification, examination, caregiver education, positioning, and individualized physical therapy management. [6]
This is important because torticollis can affect more than neck position. It may influence how a baby interacts with their environment, uses their arms, and develops symmetrical movement patterns.
Physical therapy management may involve assessing neck mobility, posture, strength, motor development, and other relevant findings.
Treatment is individualized and may include positioning strategies, active movement, caregiver education, and specific exercises when indicated. [6]
What I want parents to understand: A persistent head tilt or strong head-turning preference is worth evaluating. You don't need to wait until your baby misses a major milestone before asking for help.
Should You Let Your Baby Cry During Tummy Time?
There is a difference between a baby experiencing a challenging activity and a baby becoming significantly distressed.
Some grunting, effort, and mild frustration may occur as babies practice new movements. But tummy time doesn't need to become a prolonged crying session. If your baby becomes very upset, pick them up, comfort them, and try again later.
You can also modify the activity by changing the position, offering more support, or shortening the session.
I frequently encourage parents to build tummy time into ordinary daily interactions rather than treating it as a separate exercise that has to be completed all at once.
The goal is to provide repeated opportunities for movement and gradually build the baby's ability to participate.
There isn't strong evidence that allowing prolonged crying during tummy time produces better motor outcomes.
More distress doesn't necessarily mean more progress.
When Should You Be Concerned About Tummy Time?
I don't want parents worrying about every grunt, head movement, or difficult session.
But there are patterns that deserve closer attention.
Consider discussing your baby's development with their pediatrician or a pediatric physical therapist if you notice:
A persistent preference for turning the head in one direction
A consistent head tilt
Difficulty moving the head toward one side
Noticeably different use of the right and left arms
Persistent difficulty lifting the head or supporting the upper body
Increasing head flattening
Very limited progress despite regular opportunities for practice
Loss of a motor skill your baby previously demonstrated
Age matters when interpreting these findings.
For example, the CDC identifies holding the head up during tummy time as a two-month milestone and pushing through the forearms as a four-month milestone. [2, 3]
A baby who hasn't demonstrated these skills at the expected age deserves an individualized discussion, rather than an assumption that they simply need more practice.
Persistent pain-like distress, breathing difficulty, unusual weakness, or loss of previously acquired skills warrants prompt medical attention.
Early evaluation isn't about assuming something is wrong. It's about understanding how your baby moves and identifying whether additional support would be helpful.
What I Want Parents to Remember
If your baby hates tummy time, I want you to remember six things.
Tummy time is about developing movement skills, not just accumulating minutes.
Progress matters. Look for improving head control, forearm support, reaching, weight shifting, and movement.
Positioning can make a difference. Your chest, a small towel, or better elbow alignment may help.
Short sessions are useful. Build opportunities into your baby's daily routine.
Symmetry matters. Consistent head-turning preferences, head tilts, or differences between the arms deserve attention.
You don't have to wait for a major delay to ask questions. Pediatric physical therapy can help identify movement difficulties and provide individualized guidance.
Above all, remember that your baby's reaction to tummy time isn't the milestone.
What matters is what their body is learning to do while they're there.
Frequently Asked Questions
Does Tummy Time on My Chest Count?
Yes. Awake, supervised tummy time on a parent's reclined chest provides opportunities for head lifting and active movement. As your baby becomes stronger, gradually introduce more floor-based tummy time.
Can Tummy Time Help Prevent a Flat Head?
Tummy time reduces the amount of awake time spent with pressure on the back of the head and is commonly recommended as part of positional head-shape prevention. However, research findings differ by head-shape outcome, and tummy time alone doesn't prevent or treat every case. [1, 4]
Is It Normal for a Three-Month-Old to Dislike Tummy Time?
Some babies continue to find tummy time challenging at three months. However, by this age, I'd expect to see developing head control and increasing ability to participate. Persistent difficulty, asymmetry, or limited progress is worth discussing with a healthcare professional.
What if My Baby Won't Lift Their Head During Tummy Time?
Age is important. Very young babies may only lift their heads briefly. By two months, most babies can hold their heads up during tummy time according to CDC milestones. If your baby isn't demonstrating expected progress, seek individualized guidance. [2]
Does My Baby Need to Crawl on Hands and Knees?
Hands-and-knees crawling is a valuable movement pattern that provides opportunities for coordinated arm and leg movements, weight shifting, and postural control. However, babies demonstrate variation in how they become mobile, and crawling style alone doesn't establish whether development is typical. A pediatric physical therapist can evaluate the overall movement pattern when concerns arise.
When Should Tummy Time Become Easier?
Many babies become more comfortable as their head control, strength, and coordination improve. There isn't one universal age when every baby begins enjoying tummy time. The important consideration is whether your baby is developing new skills and making progress.
Want More Practical Baby & Toddler Development Information?
After more than 17 years working with infants and young children, I've learned that parents don't need more reasons to worry about development.
They need practical information that helps them understand what they're seeing. And if something doesn't seem right, you don't have to figure it out alone.
My goal is to help families understand their children's movement and development with practical, evidence-informed guidance.
Watch the full video that goes with this article, and like, follow, and subscribe to Dr. Cyndi on YouTube, Facebook, and Instagram for more pediatric physical therapy and developmental education.
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References
1. Hewitt L, Kerr E, Stanley RM, Okely AD. (2020). Tummy Time and Infant Health Outcomes: A Systematic Review. Pediatrics, 145(6), e20192168.https://doi.org/10.1542/peds.2019-2168
2. Centers for Disease Control and Prevention. Milestones by 2 Months. Learn the Signs. Act Early.https://www.cdc.gov/act-early/milestones/2-months.html
3. Centers for Disease Control and Prevention. Milestones by 4 Months. Learn the Signs. Act Early.https://www.cdc.gov/act-early/milestones/4-months.html
4. American Academy of Pediatrics. Back to Sleep, Tummy to Play. HealthyChildren.org.https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Back-to-Sleep-Tummy-to-Play.aspx
5. World Health Organization. (2019). Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children Under 5 Years of Age.https://www.who.int/news/item/24-04-2019-to-grow-up-healthy-children-need-to-sit-less-and-play-more
6. Sargent B, Coulter C, Cannoy J, Kaplan SL. (2024). Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatric Physical Therapy, 36(4), 370–421.https://doi.org/10.1097/PEP.0000000000001114
Educational Disclaimer
This article is for general educational purposes only and is not intended to diagnose or treat any child or replace individualized medical or physical therapy advice. Reading this information does not establish a physical therapist-patient relationship. If you have concerns about your child's development, discuss them with your child's pediatrician or an appropriately licensed healthcare professional.
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