I have a son who just turned 4 months. He hates tummy time and due to acid reflux, will often spit up. The problem is that he doesn’t do the mini push up or roll. He’s rolled belly to back twice, but not consistently and it happened almost a month ago by accident. Should I be worried? While on his back, he’ll roll to his side but not on his belly.
Since your son just turned 4 months I would not be worried that he is not consistently rolling yet or pushing up on extended forearms, although I would try to increase his tolerance to belly time as much as possible since this is the position that will most benefit him in developing the neck and trunk strength that he needs to complete these skills. Many babies do first roll by accident and then eventually they begin to do it consistently. You can also place your son in a side lying position on his left and right sides several times throughout the day (you may need to roll up a blanket behind him to keep him in this position if he already rolls on and off his side), this is another nice play position which encourages him to bring his hands together and is a position you can use alternately with belly time. You can review motor milestones for 3-6 months and red flags in motor development at this link.
I realize that many babies with reflux dislike tummy time, but remember, tummy time doesn’t have to always mean lying flat on the floor and it doesn’t have to be done all at once. For example, instead of 20 minutes straight of tummy time, try doing 3-5 minutes of tummy time several times throughout the day. For alternate ways to practice tummy time, have your son lie on your stomach facing you so you can distract and entertain him with face to face time, singing, etc. You can roll up a receiving blanket or use a boppy pillow and place it under his armpits to relieve some direct pressure on his belly as well as encourage him to lift his head and push up on his elbows. You can also carry your son across your arm, supporting his chest with your forearm, belly down. This printable PDF link gives many wonderful ideas that promote tummy time during play, carrying, diapering, etc.