The Developmentally Supportive Baby Position You’re Forgetting–It’s Not All About Tummy Time!

September 19, 2020

I'm katie, OTD, OTR/L, NTMTC, CNT & founder of blooming littles

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Learn all about an important (but often forgotten!) position to incorporate into your baby’s day. Get positioning ideas and tips for engaging your baby in developmentally supportive play in sidelying. Sidelying not only provides new movement opportunities for your baby, but it also helps build your baby’s chest wall. Have a NICU baby who was on a ventilator or needed oxygen support…prioritize sidelying during playtime! Plus, get a free positioning chart to help track where your baby spends their time during the day once they have discharged home.

As a parent, you hear a LOT about tummy time. 

And yes, it really is important. BUT, that means you may be forgetting to put your baby down for playtime on their side.

Was your baby born premature?

Did they have open heart surgery?

Sidelying is EXTRA important for these populations of babies. 

They may have rested for a really long time with their hands away from their face, which can cause shortening of certain muscles and tightness that may make it harder for them to bring their hands together.

Let’s get into…

  1. Why sidelying is important for your baby’s development (hint: it actually helps round out your baby’s ribs!)
  2. 6 amazing ways you can play with your newborn in sidelying

Plus, get my positioning log for FREE!

The positioning log makes it easier to track where your baby has been spending their time—one less thing for your mom brain to remember.

Everything here is NICU baby approved. Even if your baby has a colostomy bag, tracheostomy, G-tube, nasal cannula, or any other home medical equipment.

If you are a NICU parent, you are probably used to seeing your baby in a sidelying position.

Let’s carry that habit over to home after discharge.


Sidelying is laying your baby on the floor with either their left side down or right side down, so that they are laying on their side.

Newborns can’t stabilize in a sidelying position without any support—they haven’t developed a balance of their flexor and extensor muscles yet.

That’s one reason why it’s important for your babe to practice balancing and playing on their side.


It goes beyond “it’s just good for them”.


This isn’t something the average parent thinks about, but it’s incredibly important.

We want your baby to develop a rib cage that allows for large deep breaths and good lung expansion.

Sidelying is really supportive for the development of your baby’s chest wall!

For example: When your baby is laying on their right side for play, gravity is pulling their right ribs down towards the floor, so it’s creating a wider rib cage.

If your baby has ever needed oxygen support, been on a ventilator, or maybe even discharged home from the NICU with some supplemental oxygen, sidelying is an extra important position.


Your baby has groups of muscles on the front of his body and on the back.

Babies strengthen the muscles on the front of their body when they’re on their back moving, kicking, and flexing their abs.

When your baby is spending time on their tummy, they are working on strengthening the muscles on the back of their body.

Letting your baby play in sidelying is one of the best ways to teach their body to co-contract their flexor and extensor muscles—balancing the muscles on the front and back.


When your newborn is on their side, they may end up rolling to their tummy or flop onto their back by accident.

These are good learning experiences for your baby as they learn to move in space and eventually roll over when they are ready.

It also provides them with important vestibular input (movement) as they build sensory processing skills and learn where their body is in space.


Putting your baby in sidelying takes the pressure off your baby’s skull bones. That’s important, because too much pressure on one side of your baby’s head is what causes it to become flat.

Proactively positioning your baby during the day is the best way to prevent flat head syndrome

If you want more positioning recommendations for flat head syndrome based on the side of your baby’s head that may be flat, check out WONDERING IF YOUR BABY HAS A FLAT HEAD?—HERE’S WHAT YOU NEED TO KNOW ABOUT FLAT HEAD SYNDROME.


What happens when you lay down on your side?

Your hands fall together and your knees fall together. 

That is midline.

Building midline movement in newborns supports later attempts at reaching for toys, bringing toys to their mouth, or even using a spoon to self feed.


Similar to promoting midline movement, when a baby is on their side, it is a lot easier for them to reach their face. 

Encouraging hands to face is important for supporting self-regulation, self-soothing, and oral motor exploration in preparation for feeding.

If I am working with a NICU baby who is having a difficult time soothing themselves, I always place them on their side. 

I want to make it as easy as possible to support hands to face movement and support their self-regulation


  1. Place your baby on their side and use a towel roll behind their back to keep them propped up.
  2. Sit on the floor with your legs straddled and place your baby in the inside curve of your leg on their side.
  3. Have a Boppy pillow? Place your baby on their side in the boppy pillow.

When positioning your newborn baby for play, remember the importance of safe sleep! Your baby should only nap and sleep on their back in a crib. If your baby falls asleep in sidelying, roll them to their back and let them sleep on their back safely!


  • Place an O ball, or any other easy-to-grab rattle near your baby’s hands. Let them explore hitting it, shaking it, or tapping it with their hands. 
  • Lay down on your side in front of your baby and talk or sing to them— your face is your newborn’s favorite thing to look at. Looking and observing faces is one of the best ways to develop early social emotional skills.
  • Prop up a book 8 to 10 inches from your baby’s face and read to them. You could also use the popular black and white contrast cards with your newborn. If you choose to use the black and white cards, be sure to watch for any signs of overstimulation (especially if your baby was in the NICU or premature!).

Signs of overstimulation may include looking away from you, wide eyes, not being able to look away (like they’re hyper focused), going from wide awake to asleep quickly, or turning away from the input you’re showing them. If you see those signs, just move the objects from their visual field, give them some time to reorganize, and try again another time.

  • Let them explore their own expressions in a mirror. Place a baby-friendly floor mirror 8 to 10 inches from your baby’s face. Try sitting behind them, so that they can see mommy or daddy‘s face in the mirror. You’re not only increasing their tolerance to sidelying, but building visual skills, social emotional development, and spatial awareness.
  • Give your newborn a massage. Slowly and gently rub their arms and legs. If your baby shows any signs that they don’t enjoy it, or are uncomfortable, stop.
  • Place different textures in front of your baby when they’re on their side. Take their hand and help them reach out to feel the different textures. Your newborn won’t be able to initiate reaching themselves yet, but you can take their hand and let them explore what each object feels like. You could include items like a stuffed animal, blocks, jumbo legos, or rattles.

Need ideas for some developmentally supportive toys perfect for promoting gross motor skills, sensory exploration, and early social interactions during the newborn period??

Head on over to THE ONLY 10 TOYS YOU NEED FOR YOUR BABY FROM BIRTH TO 6 MONTHS to see some of my recommendations.

Does your baby have a flat head? Chronic lung disease? Difficulty learning to roll?

Give sidelying a try.

What’s your favorite sidelying activity?

Does your NICU baby like being on their side for play?

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