Child & Family Development Child & Family Development

January 26, 2017

Rethinking tummy time, expert advice from Ann Guild MACCCSLP C/NDT

Posted by: childandfamily

Ann Guild MA CCC-SLP C/NDT is a speech therapist at Child and Family Development- Midtown in Charlotte.  Ann is our most tenured and experienced speech- language pathologist on staff.  She has much advanced training including Neurodevelopmental Treatment‚Ñ¢ (NDT) certification, which qualifies her to incorporate neuromotor components into her evaluation and treatment of children and teens.

Ann has prepared a helpful guide for families of little ones that is all about gravity and includes important body positions for holding, eating and resting. She shares:

A lot has been written about tummy time and how to help parents be more comfortable putting their infants on their tummies. Despite all the advice, parents remain reluctant to leave their crying infants on their tummies for very long.  The problem is not the importance of tummy time, but in the name itself. Tummy time implies that infants need to be put down on their tummies for extended periods during the day. The more important consideration is the need to provide options during the day that counteract or balance the extended period of time spent on their backs at night.

When the force of gravity is coming at an infant’s face and mouth during back lying, the tongue is pulled back into the throat. If during the day, the child stays on their back or reclined in a carrier, the tongue cannot come forward into the mouth for eating and later for talking. They become overwhelmed by gravity.

blog_ann1.1.jpg BACK TO SLEEP

blog_ann1.2.jpg SUPINE IN A CARRIER

Babies in daycare are especially at risk. Helping parents advocate for positioning options for their babies can be big step in helping these children thrive.

More common positioning and carrying that keeps the child vulnerable to the effect of gravity are pictured below. These positions allow gravity to pull the tongue back in the mouth making eating difficult.

ANN2.1.jpg CARRYING IN SUPINE

ANN 2.2.jpg FEEDING IN SUPINE

ANN 2.3.jpg SUPINE IN BASSINET FOR NAPS

ANN 2.4.jpg SUPINE IN PILLOW FOR NAPS

In my practice as a Speech-Language Pathologist, the children I see most are otherwise typical babies who have difficulty taking the bottle or breast or later making the transition to solid food. Their difficulty comes from the force of gravity pulling the tongue back in the mouth during their many hours of back lying at night and sitting reclined in a carrier or lying on their backs during the day. We can eliminate this feeding difficulty for many typical infants by simply focusing on positioning, carrying, holding, and feeding them in positions that minimize or balance the effect of gravity on the mouth.  When we see otherwise typical babies at 3-4 months, who are not eating well, we can tell the moms that there is no food aversion or eating problem. We can say that their baby is overwhelmed by gravity.

If the feeding issues have already begun, they can be reversed by concentrating on positioning. The need to focus on positioning is most important for the first 3-4 months. Once children start to move and roll, they learn to manage gravity by themselves. If they have been left in supine, this may not happen without help.

Here are some examples of positioning and carrying options that allow the tongue to come forward in the mouth for eating and eventually for talking.

ANN 3.2.jpg CARRYING ON SHOULDER

ANN 3.3.jpg PRONE IN LAP

ANN 3.4.jpg PRONE IN LAP

ANN 3.5.jpg PRONE ON QUILT IN LAP

ANN 3.6.jpg ON MOM’S SHOULDER

ANN 3.7.jpg CARRYING IN SIDE LYING OVER MOM’S ARM

ANN 3.8.jpg ON MOM’S CHEST

ANN 3.9.jpg IN CARRIER WRAP

ANN 3.10.jpg NAP ON BOPPY

ANN3.11.jpg NAP ON MOM’S CHEST

ANN3.12.jpg FEEDING IN SITTING

When parents understand the process and are successful and creative in carrying, holding, positioning, and feeding their babies in a way that balances the time spent on their backs at night; they are empowered and their infants thrive.

Read more about Ann Guild’s expertise and services here.