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Published on: February 5, 2019
Tummy Time and Infant Health Outcomes: A Systematic Review
Lyndel Hewitt1, Erin Kerr2, Rebecca M Stanley2
1Early Start, Faculty of Social Sciences, University of Wollongong and Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia llh966@uowmail.edu.au.
Insights
Tummy time is recommended for infants to improve motor skills and prevent plagiocephaly. This review found tummy time is linked to better gross motor development and reduced BMI-z scores, but evidence for other outcomes is mixed.
Area of Science:
- Pediatrics
- Infant Health
- Developmental Science
Background:
- The World Health Organization recommends tummy time for infants.
- Benefits include improved motor development and reduced plagiocephaly.
- Poor uptake necessitates further investigation into tummy time's health associations.
Purpose of the Study:
- To review existing evidence on tummy time's association with infant health outcomes.
- Examined associations with adiposity, motor, psychosocial, cognitive, and cardiometabolic health.
- Assessed risks and harms related to tummy time.
Main Methods:
- Systematic review of peer-reviewed English-language articles.
- Searched electronic databases from June 2018 to April 2019.
- Included studies on healthy infants (0-12 months) with tummy time measures and health outcomes.
Main Results:
- Sixteen articles (4237 participants) were included.
- Tummy time positively associated with gross motor development, total development, reduced BMI-z score, and prevention of brachycephaly.
- Indeterminate associations found for social, cognitive domains, plagiocephaly, walking, standing, and sitting; no association for fine motor development and communication.
Conclusions:
- Tummy time is beneficial for gross motor development and preventing brachycephaly.
- Evidence for other health outcomes is mixed or inconclusive.
- Findings support prioritizing interventions to encourage infant physical activity guidelines.
Context:
The World Health Organization recommends tummy time for infants because of the benefits of improved motor development and reduced likelihood of plagiocephaly. Because of poor uptake of these recommendations, the association of tummy time with other health outcomes requires further investigation.
Objective:
To review existing evidence regarding the association of tummy time with a broad and specific range of infant health outcomes.
Data Sources:
Electronic databases were searched between June 2018 and April 2019.
Study Selection:
Peer-reviewed English-language articles were included if they investigated a population of healthy infants (0 to 12 months), using an observational or experimental study design containing an objective or subjective measure of tummy time which examined the association with a health outcome (adiposity, motor development, psychosocial health, cognitive development, fitness, cardiometabolic health, or risks/harms).
Data Extraction:
Two reviewers independently extracted data and assessed their quality.
Results:
Sixteen articles representing 4237 participants from 8 countries were included. Tummy time was positively associated with gross motor and total development, a reduction in the BMI-z score, prevention of brachycephaly, and the ability to move while prone, supine, crawling, and rolling. An indeterminate association was found for social and cognitive domains, plagiocephaly, walking, standing, and sitting. No association was found for fine motor development and communication.
Limitations:
Most studies were observational in design and lacked the robustness of a randomized controlled trial. High selection and performance bias were also present.
Conclusions:
These findings guide the prioritization of interventions aimed at assisting parents meet the global and national physical activity guidelines.
