Infants who spend too much time on their backs have an increased risk of developing a misshapen head along with certain developmental delays, the American Physical Therapy Association (APTA) warns in a statement issued this month.
Infants need "tummy time" while they are awake to develop properly, the APTA notes.
The 1992 "Back to Sleep" campaign, which educated parents on the importance of putting their infants to sleep on their backs, rather than their stomachs, led to a dramatic reduction in the number of deaths from sudden infant death syndrome (SIDS).
"As a result though, new parents were afraid to put their babies on their bellies at all, even when awake," Colleen Coulter-O'Berry, a physical therapist at Children's Healthcare of Atlanta noted in an interview with Reuters Health.
"I see new parents all the time that, by four months of age, have never put their babies on their bellies because they are afraid the baby is going to suffocate," she said.
The combination of babies sleeping on their backs, as well as spending long periods of time in infant carriers that double as car seats, puts pressure on the head, which can flatten the skull, she explained.
"As a result, we've seen an alarming increase in skull deformation," Coulter-O'Berry said.
Babies who do not get enough time on their tummies can also develop tight neck muscles or neck muscle imbalance - a condition known as torticollis. "If a baby doesn't get early tummy time, they don't push up on their elbows, they don't get their heads up and looking around, and they don't gain strength in their neck and back muscles," she explained.
"Increasing the amount of time your baby lies on his or her tummy promotes muscle development in the neck and shoulders; helps prevent tight neck muscles and the development of flat areas on the back of the baby's head; and helps build the muscles baby needs to roll, sit, and crawl," Coulter-O'Berry added.
She said 90 percent of children with torticollis also have changes in their head shape.
Her message to new parents: "Don't be afraid to put your baby on their tummy for short periods of time while they are awake. After a nap, diaper change or feeding, roll the baby onto his or her stomach and encourage the infant to find, focus, and follow your face or a toy with their eyes looking up."
The football hold, where the baby's belly is facing down in the palm of the hand and the baby is looking up, is another good way to get extra tummy time, she said.
- Coulter-O'Berry is co-author of Tummy Time Tools - a brochure that provides caregivers ideas and activities to ensure that babies get enough tummy time. It is available on the APTA website - www.apta.org/consumer.