Q&A: Preemie Doesn’t Like Tummy Time

Tamara GuoChild Development, Child Routines, Newborns 0 - 3 Months, Tummy Time

blockquote_bgI have a 6.5 month old (she was 5 weeks early). She didn’t start lifting during tummy time until 2.5-3 months and she struggles to push herself up into supporting herself on her hands (crawling position) unless I push her up and then she can hold it for a few seconds, she had absolutely no interest in bearing weight until 3 weeks ago. She wouldn’t even put her feet flat on the floor and be completely supported by me. She started sitting unsupported around 4.5 months for a few seconds at a time and by 5.5 months she sat unsupported for a while before falling over. She didn’t roll from belly to back until 5 months and she can roll from back to belly but rarely does because she doesn’t enjoy her tummy. She rolls to her side a lot to play. We have followed up with her doctor about her development and everytime we are told it is just her preemie showing and she is stubborn to (which I think is a good chunk of late milestones).
1. Are there any exercises I can do to assist her in getting more strength? I feel like she is falling behind in some milestones.
2. Is Early intervention something we should think about getting her looked at or is she just meeting milestones late because she was a preemie and that is okay?

I would recommend since she was 5 weeks premature and you have some motor and strength concerns (and the fact that she does not like tummy time) that you follow through with an early intervention evaluation just to be sure she is on target.

As a developmentalist I like all preemies to be screened. When looking at all developmental milestones you want to give her an extra month to complete skills due to her prematurity, but some preemies lack core strength which prevents them from completing certain gross motor skills.

It’s great that she is sitting, but I would like to see her actively rolling in both directions, as well as pivoting on her tummy to reach for toys and beginning to tolerate a supported hand/knee position. I am not as concerned with weight bearing on her feet yet, as that is something we look for closer to 9 months.

To work on core strength & upper extremity strength, she needs as much tummy time as possible, even though she does not enjoy it. Try putting her tummy down on a small ball that rests under her tummy and help her place open palms and knees on the floor for a hand/knee position & rock her back and forth as you sing Row Your Boat. You can do this over your leg, thigh or calf, as well. Ideally we want her tolerating weight bearing on hands and knees before feet, since crawling comes before walking.

If you scroll down through our previous Ask A Therapist answers you may find more tips on weight bearing for upper extremities.