Tummy Time in the NICU: What’s it Look Like?

March 26, 2022

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

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There is a lot of developmental advice out there! One of the BIGGEST things parents hear from developmental experts is the importance of TUMMY TIME!

“Make sure you’re putting your baby on their belly!”

“If you want your baby to have a strong neck, they need tummy time.”

“To avoid getting a flat head, your baby needs tummy time!”

Tummy time, tummy time, tummy time! Ah!

But, what about babies who are born and head straight to the neonatal intensive care unit (NICU)? What if they have lines, wires, and tubes?

Well, the truth is…most babies in the NICU get lots of tummy time!

Especially preemies. 

It’s important to remember that tummy time in the NICU doesn’t always look like you may have imagined.

Babies often sleep on their bellies in the NICU, spending 3 to 4 hours there before getting positioned somewhere else.

Remember to always follow the ABCs of safe sleep once your baby is discharged home!

Since it can be surprising to learn about tummy time in the NICU, here are 4 ways babies spend time on their bellies during their time in the NICU.  

1. Tummy time in their positioning device/nest.

It’s a common NICU practice to rotate babies through different positions during the day. Your baby may start off the day on their tummy, spend the afternoon on their sides, and then spend some time positioned on their back. Every nurse and NICU have their own positioning routine they follow, but one thing they all have in common is putting babies on their tummy while they’re in their positioning aids!

Positioning aids and nests are specially created to support your baby’s body position during their NICU stay. It’s an important part of being proactive in helping your baby’s body develop.

There are a lot of different types of aids, from rolled up blankets, to specially manufactured products that swaddle your baby up nice and tight.

Getting good belly time helps support your baby’s development from the start, whether they’re a preemie or full-term!

If you want to learn about how to get your baby positioned on their belly, watch and talk with your baby’s neonatal therapist!

They’ve got a lot of tips and encouragement to share.

2. Chest-to-chest holding with mom and dad.

The coziest tummy time position is….chest-to-chest with mom or dad, especially if that means skin-to-skin.

Holding your baby skin-to-skin, also called kangaroo care, not only helps you feel connected to your baby, but it also helps stabilize their heart rate, breathing rate, and supports weight gain. When your baby is placed on your chest for skin-to-skin, they are placed on their tummy on your bare chest.

It’s a beautiful position for some high-quality tummy time. I always let parents know that tummy time doesn’t have to be a formal set-up with a playmat on the floor or a tummy time mat. When your baby’s in the NICU, spending time on their belly during skin-to-skin is exactly what they need!

After your sweet babe gets discharged, you can start some of those more traditional tummy time positions.

3. Tummy time in a Boppy®

The Boppy pillow! It’s that half-donut-shaped nursing pillow that is commonly used to support your arm during breastfeeding or even just holding your baby.

BUT, there’s another awesome use for the Boppy pillow…tummy time!

Now, this is a tummy time support that is used in the NICU when a baby is older and big enough to fit appropriately in it. Usually, a baby has passed their due date before these are used.

Boppy pillows are a great tool for tummy time, especially if your baby has lines and tubes entering the stomach, like a gastrostomy tube (g-tube) or ostomy. The hole in the middle allows space for those wires and tubes to rest.

It’s also a great option for babies with tracheostomies who are getting used to being on their belly.

The Boppy pillow is also great for sidelying play. You can read more about the benefits of sidelying for your baby’s development here.

4. Tummy time on a mat on the floor.

And the last NICU tummy time position is tummy time on a mat on the floor! Like using a Boppy pillow, this isn’t as common in the NICU space.

A baby has to reach a certain place of medical stability, as well as developmental readiness to attempt this position. This is the most difficult position for your baby as they learn to strengthen those neck and back muscles, so it should be guided by a neonatal therapist. 

Sometimes, there are babies in the NICU for 6, 8, or even 12+ months! Babies with longer stays may be working through some of those big developmental milestones like pushing up in tummy time, propping on their arms on their belly, reaching for their toes, rolling over, or sitting up. Skills that require a lot of good strengthening and therapeutic support!

When doing formal tummy time on the floor, you can use different toys like mirrors, rattles, or sensory objects to engage your little one.


It’s easy to think of tummy time as something that looks like this…

Instead of this….

If you’re in the NICU, you may find yourself experiencing tummy time in an entirely new way.

As your baby grows and starts to meet their medical goals and eventually discharge home…they will also progress through these tummy time positions.

  1. Tummy time in their nest or positioning device 
  2. Tummy time while they’re held skin-to-skin
  3. Tummy time over a Boppy pillow
  4. Tummy time on a mat on the floor

Some of these moments will happen in the NICU, and others will happen once you’re home with your babe!

No matter where your baby is on their journey, tummy time is an important opportunity as your baby works towards some important milestones, from breathing on their own to touching their toes.

Did your baby spend time on their belly in the NICU? 

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