Tummy Time Research Articles

Exploring the use of tummy time guidelines to improve infant development in rural primary care

BackgroundTummy time enhances motor development, improves mobility, strength, and head clearance, reduces cranial asymmetry, and decreases the risk of childhood obesity. The American Academy of Pediatrics (AAP) advises all infants, beginning at birth, partake in supervised daily tummy time during awake periods. Since 1994, when the AAP initiated the “Back to Sleep” campaign, the number of infants participating in daily tummy time has significantly declined, leading to an increase in adverse outcomes. MethodsUsing a quasi-experimental design, tummy time guidelines were implemented in a rural family primary care practice to support infant development. This three-phase intervention included educating providers, developing a smart phrase, and posting visual reminders. A convenience sample of infants who presented for well-visits at a rural family practice in southwestern Washington were included in this project. The Survey of Wellbeing of Young Children measurement tool was used to collect infant developmental outcome data. FindingsFollowing the intervention, infant developmental outcomes improved. There was a 10% reduction at two months of age and a 7% reduction at four months of age in the number of infants with below average developmental scores. DiscussionThis project demonstrates that increased provider awareness and implementation of tummy time clinical practice guidelines can benefit infant development in primary care, especially in rural populations. Application to practiceViable strategies for incorporating clinical practice guidelines into primary care are presented.

Cognitive and motor improvement by tummy time practice in preemies from low-income settings: a randomized clinical trial.

Early intervention and parental education for preemies are limited in some low-income countries. Thus, this study aimed to assess whether daily tummy time (TT) associated with usual care (UC) enhances motor and cognitive development in preemies from low-income countries. The main and secondary aim was to assess prone head elevation (PHE) and motor and cognitive functions, respectively. Thirty-one preemies with a mean gestational age at birth of 33.3 ± 1.6 weeks and weighing <2,500 g were included and 18 completed all assessments. Parents from the TT group were asked to perform TT with their preemies for at least 20 min during daily activities and playtime. Motor and cognitive functions were assessed by a blinded examiner using the motor and cognitive composite scores of Bayley-III after two and four months of corrected age. PHE was given by the angle from the tragus of the ear to the supporting surface of the infant; measurements were obtained using the Kinovea® software at baseline, after two, three, and four months of corrected age. The Bayley-III motor composite score of the TT group was higher than the UC group after two and four months of corrected age. The PHE angle increased over time but did not differ between groups. Nevertheless, TT expanded the perspective of preemies to explore their bodies and environment, favoring the stimuli for motor and cognitive patterns. The loss of participants (31%) was one of the limitations of the study, illustrating the challenge of providing continued early interventions to preemies from low-income countries. In this sense, TT practice is a home intervention that may improve motor and cognitive function of preemies immediately after hospital discharge.

Healthcare providers' perceptions of infant physical activity and communication.

Healthcare providers (HPs) play a critical role in disseminating information about infant health and development. Two key developmental areas for infants are physical activity (PA) and communication. Few studies have examined HPs views of these topics. Thus, HPs may need support to promote these early development outcomes in infants. Thus, the study explored HPs' perceptions of infant PA and communication. A total of 13 HPs with a wide variety of backgrounds were recruited. Zoom semi-structured interviews were based on the Health Belief Model. Deductive content analysis was utilized to analyze data. HPs knew little about PA guidelines. HPs were concerned about an infant's PA because of limited playtime and tummy time. Most HPs advised parents on PA and motor development milestones, with crawling, walking, and tummy time. HPs also wanted to learn about PA measurement tools. PA promotion was hindered by parents' busy schedules, lack of time, and language barriers. Most HPs advised parents on verbal and nonverbal communication. Many HPs were unfamiliar with communication assessment methods and wanted to learn more. HPs had limited knowledge about PA guidelines and communication measurement tools. Efforts are needed to identify easily accessible ways to educate HPs that could be disseminated to parents.

Tummy Time Tracking: Examining Agreement Between Parent Recall and Direct Observation in Infants.

Parent recall is the primary method for measuring positioning practices such as tummy time in infants. Concerns regarding the accuracy of parent recall have been raised in the literature. To date, no study has examined the agreement of tummy time recall measures with gold-standard methods. To assess the agreement between parental recall versus direct observation of tummy time in infants, and to explore the impact of prematurity on this relationship. Cross-sectional observational study, spanning 1 yr. Participants' homes Participants: Thirty-two infant-parent dyads (19 full-term, 13 preterm), with infants ages 3 to 6 mo and caregivers ages older than 18 yr. Home-recorded videos of infant play across 3 days were used as a proxy for direct observation of tummy time and compared with a 12-item parent recall survey. Parent recall had a significant moderate correlation (ρ = .54, p = .002) with direct observation in full-term infants but was not correlated (p = .23) with direct observation in preterm infants. On average, parents of preterm infants overestimated tummy time by 2.5 times per day compared with direct observation. For full-term infants, parent recall measures of tummy time exhibit an acceptable level of agreement with direct observation and can be reliably used over shorter periods. Parents of preterm infants may display a bias in recalling tummy time, leading to overestimations. To accurately assess tummy time in this population, a combination of subjective and objective measures should be explored. Plain-Language Summary: Tummy time is an essential movement experience for infants, especially for preterm infants, who are at a higher risk for motor delays. The most common way to track tummy time is through parent reports, or recall, versus a practitioner directly observing tummy time in the home. Despite the widespread use of parent recall to track tummy time, no study has examined the accuracy of parent recall versus direct observation in the home. Accurately assessing tummy time is crucial for improving and supporting health outcomes for infants. This study found that prematurity may affect the accuracy of parent recall for assessing tummy time in young infants. The authors discuss the implications of this finding and provide suggestions to guide the selection of appropriate methods to measure tummy time in clinical practice and research studies.

A Qualitative Investigation of Parent Perceptions of Home Exercises for Congenital Muscular Torticollis.

The purpose of this qualitative study was to describe parent perceptions of the home exercise program (HEP) for infants with congenital muscular torticollis (CMT), and how these perceptions evolved over a physical therapy (PT) plan of care. Twelve participants were recruited from a pediatric PT clinic, and nine completed interviews at three time points. Qualitative description and an iterative approach for thematic analysis of 27 interviews yielded three themes that corresponded to the research questions. The participants' responses were categorized into three main themes: (1) parents' perceptions of three key exercises within the HEP, (2) internal and external sources of stress, and (3) sources of empowerment and disempowerment. Regarding the HEP, parents articulated common sentiments for three frequently prescribed exercises for the management of CMT: (1) tummy time was the fast favorite, (2) ipsilateral cervical rotation was perceived as stressful, and (3) contralateral cervical lateral flexion felt uncomfortable. Additionally, participants disclosed internal and external sources of stress (guilt, uncertainty, and the demands of returning to work) and sources of disempowerment (inconsistent messaging frompractitioners, feeling overwhelmed) and empowerment (being able to see the bigger picture and clear communication and education about the diagnosis) with respect to managing their infant's CMT. These themes provide insight into the evolution of parent perceptions over a PT plan of care for CMT. Participants' insights suggest a need for consistent messaging regarding the diagnosis and evidence-based management of CMT, addressing parent stress, and modifying how exercises are taught. This study contributes updated research on parents' experiences with physical therapy and the HEP for their infant's CMT.

Reliability and validity of rapid assessment tools for measuring 24-hour movement behaviours in children aged 0–5 years: the Movement Behaviour Questionnaire Baby (MBQ-B) and child (MBQ-C)

BackgroundThe development of validated “fit-for-purpose” rapid assessment tools to measure 24-hour movement behaviours in children aged 0–5 years is a research priority. This study evaluated the test-retest reliability and concurrent validity of the open-ended and closed-ended versions of the Movement Behaviour Questionnaire for baby (MBQ-B) and child (MBQ-C).Methods300 parent-child dyads completed the 10-day study protocol (MBQ-B: N = 85; MBQ-C: N = 215). To assess validity, children wore an accelerometer on the non-dominant wrist (ActiGraph GT3X+) for 7 days and parents completed 2 × 24-hour time use diaries (TUDs) recording screen time and sleep on two separate days. For babies (i.e., not yet walking), parents completed 2 × 24-hour TUDs recording tummy time, active play, restrained time, screen time, and sleep on days 2 and 5 of the 7-day monitoring period. To assess test-retest reliability, parents were randomised to complete either the open- or closed-ended versions of the MBQ on day 7 and on day 10. Test-retest intraclass correlation coefficients (ICC’s) were calculated using generalized linear mixed models and validity was assessed via Spearman correlations.ResultsTest-retest reliability for the MBQ-B was good to excellent with ICC’s ranging from 0.80 to 0.94 and 0.71–0.93 for the open- and closed-ended versions, respectively. For both versions, significant positive correlations were observed between 24-hour diary and MBQ-B reported tummy time, active play, restrained time, screen time, and sleep (rho = 0.39–0.87). Test-retest reliability for the MBQ-C was moderate to excellent with ICC’s ranging from 0.68 to 0.98 and 0.44–0.97 for the open- and closed-ended versions, respectively. For both the open- and closed-ended versions, significant positive correlations were observed between 24-hour diary and MBQ-C reported screen time and sleep (rho = 0.44–0.86); and between MBQ-C reported and device-measured time in total activity and energetic play (rho = 0.27–0.42).ConclusionsThe MBQ-B and MBQ-C are valid and reliable rapid assessment tools for assessing 24-hour movement behaviours in infants, toddlers, and pre-schoolers. Both the open- and closed-ended versions of the MBQ are suitable for research conducted for policy and practice purposes, including the evaluation of scaled-up early obesity prevention programs.

Parental practices that influence children's development: how often are they implemented and by whom-results from the NASCITA birth cohort study.

This study aims to assess how commonly 15 parental practices, known to have positive effects on child and adult health, are carried out by families in Italy, if they are related, and which characteristics are associated with implementation. Children participating in the NASCITA Cohort, a prospective study in which family pediatricians in Italy collect data on children and their families, were included if they had sufficient data. Data on practice implementation, socio-demographic characteristics, and interrelatedness between practices were analyzed. In all, 3337 children were included. Their mothers had an average age at birth of 33years (range 17-52) and medium-high levels of education (86% of mothers) and employment (72%). No smoking or alcohol in pregnancy, supine infant sleeping position, and tummy time were the most commonly implemented practices (by over 85% of mothers, each), while the least common was exclusive breastfeeding at 6months (28%). Parental practices are related and several socio-demographic characteristics influence their implementation, with mother's educational level and geographic area of residence influencing most of the practices (each influencing 12 of 15 practices). Low educational level (OR 0.34; 95% CI 0.26-0.44), being born abroad (OR 0.43; 95% CI 0.34-0.56), and residing in the South (OR 0.49; 95% CI 0.41-0.58) most reduce the probability of implementing numerous supportive practices (all three P < 0.001). Conclusion:Socio-demographic factors contribute significantly to carrying out supportive practices. Future interventions should address the identified inequalities, prioritizing families most in need. Direct involvement of pediatricians is warranted given their favorable position for promoting positive behaviors. What is Known: • Several parental actions in the early life of a child are known to have positive effects on later child health and development. • While folic acid supplementation and exclusive breastfeeding have been promoted for years, other supporting actions are less well-known. What is New: • Rates of parental adherence to the different supportive actions varied greatly and actionswere often scantly adopted. • Socio-demographic characteristics influenced adherence, with young, unemployed mothers with low educational levels, living in the South, or who were born abroad adhering significantly less.

Information about Tummy Time in infants available on the Internet

Objective: This study evaluated Tummy Time recommendations in patient education materials and informal sources found on the Internet. Methods: Patient education materials, available from health professionals online, and informal sources, found outside of healthcare, were evaluated for consistency with evidence-informed recommendations. Patient education materials were also evaluated for readability and visual presentation. Results: Twelve sets of patient education materials were included in the top 20 search results. Only one of them addressed all the evidence-informed recommendations accurately. Fifty informal sources were included in analysis, ranging from search rank #1 to #57. Nearly half of the informal sources were judged fully consistent with evidence-informed recommendations. Counter to best practice recommendations, two-thirds of the patient education materials were written above the reading level expected of a student with no more than an elementary school education. All used strategies to enhance clarity, although none met all standards for visual presentation. Conclusion: Although some good resources are available, healthcare providers should exercise caution when selecting or recommending patient education materials online, even when they are available from healthcare professionals. Parents turning to the Internet will find accurate information. However, to develop a comprehensive understanding, they may need to visit multiple sites. Practice Implications: Healthcare professionals are responsible for providing or directing their clients to reliable, comprehensive sources of information, and for being aware of the quality of information they may discover through their own searches. Healthcare websites are responsible for communicating clearly and comprehensively with their clients and the public. Some parent education materials require revision for readability, formatting and consistency with Tummy Time recommendations.

Suboptimal status of tummy time for infants in early childhood education institutions in urban China: A cross-sectional study.

Although tummy time is recommended as a form of physical activity for non-movable infants worldwide, little is known regarding the current status of tummy time practices among Chinese infants. Early childhood education (ECE) institutions provide children with rich learning experiences; however, tummy time practices among infants in these ECE institutions were unclear. This study aimed to investigate the status of tummy time among infants within the context of ECE institutions. We conducted a cross-sectional survey with primary caregivers of infants aged 0-11 months across 31 provinces of China from 1 March to 30 April 2023. To recruit participants, we collaborated with Gymboree Play & Music, an ECE institution with over 500 centres in nearly 200 cities in urban China. Our survey instrument was developed based on the World Health Organization (WHO) guidelines and literature to collect data on infants' tummy time practices, caregivers' tummy time knowledge and information sources. We used self-administered questionnaires through WeChat, in which participants scanned a quick response (QR) code to complete the questionnaire. We included 1040 infants and their primary caregivers, with 504 infants aged 0-5 and 536 infants aged 6-11 months old. Less than half of infants (48.2%) started tummy time in the neonatal period, with 20.5% starting within two weeks after birth. Only 27.2% of infants engaged in at least 30 minutes of tummy time during the last 24 hours, with infants aged 0-5 months significantly lower than those aged 6-11 months (21.6 vs 32.5%, P < 0.0001). No significant difference was found between attending ECE class and non-attending ECE class groups for the proportion of infants with tummy time ≥30 minutes per day (28.9 vs 23.4%, P = 0.0625); however, infants aged 0-5 months in the attending group engaged in longer duration of tummy time than those in the non-attending group (P = 0.0005). The compliance with the tummy time guidelines in infants receiving long-nurturing care was significantly higher than those receiving short-nurturing care (30.4 vs 22.1%, P = 0.0036). Only 42.7% of caregivers knew that at least 30 minutes daily tummy time was necessary for infant, and more primary caregivers in the attending group knew that, compared to the non-attending group (45.3 vs 36.8%, P = 0.0098). The current status of infants' tummy time practices and caregivers' knowledge are generally suboptimal within the context of ECE institutions in urban China. Longer nurturing time contributes to higher compliance with tummy time guidelines. Effectively promoting tummy time practices through multiple channels in China is crucial.

Adherence to 24-hour integrated activity guidelines among infants, toddlers and preschool children in Singapore.

This study examined children's adherence to the Singapore Integrated 24-Hour Activity Guidelines for Early Childhood in infants, toddlers and preschoolers aged 0-6 years. A total of 901 caregivers, comprising 219 infants, 379 toddlers, and 303 preschoolers, provided information regarding their children's physical activity (PA), screen viewing time (SVT), and sleep durations on both weekdays and weekends. Meeting the 24-hour integrated activity guidelines was defined as follows: for infants ≥ 30 minutes per day of tummy time or floor-based play; zero SVT; total sleep of 14-17 hours per day for ages 0-3 months, 12-16 hours per day for ages 4-11 months; for toddlers ≥ 180 minutes of total PA per day; zero SVT under 2 years; <1 hour for ages 2 to less than 3 years; and a total sleep of 11-14 hours per day; for preschoolers ≥ 180 minutes of total PA per day; SVT <1 hour per day; total sleep of 10-13 hours per day for those aged 3-5 years, and 10-11 hours per day for 6-year-olds. Chi-squared tests were used to examine the differences in guideline adherence between weekdays and weekends. Compared to weekdays, during weekends there was a higher proportion of toddlers and preschoolers adhering to the PA guidelines (68.9% vs 50.1%; 78.9% vs 55.4%, respectively, p<0.05), and a lower proportion of toddlers adhering to SVT (38.8% vs 21.8%; p = 0.001). There was a declining adherence to all three activity guidelines as age groups progressed from infants (44.7%) to toddlers (15.8%) and then to preschoolers (9.4%). Concurrently, there was a decrease in adherence to SVT recommendations across the age groups, with adherence rates being highest among infants (83.1%), followed by toddlers (15.8%), and preschoolers (9.4%). Decreasing compliance with all three guidelines, coupled with a corresponding decline in adherence to SVT guidelines as children transition from toddlerhood to preschool age, is a cause for concern. This underscores the need for proactive efforts to educate caregivers about reducing or eliminating SVT among infants and young children.

A comparison of parental attention and preferred items during tummy time: A consecutive controlled case series evaluation.

Tummy time is an activity for infants to practice their early motor skills. Although most pediatricians recommend tummy time, parents may avoid the procedures due to indices of infant discomfort during this period. This consecutive controlled case series evaluation compared the effects of preferred items selected from a preference assessment with those of parental attention on head evaluation and negative vocalizations during tummy time. In addition, we directly evaluated parental choice by inviting parents to select which tummy time treatment they wanted to implement. We found that both preferred items and parental attention effectively increased head elevation and decreased negative vocalizations during tummy time; however, parents tended to prefer the treatment that included the preferred item.

Tummy time in infants.

Tummy time in infants.

Informing Clinical Practice Guidelines for Children and Youth With Down Syndrome: A Survey of Key Partners.

The purpose of this work was to describe input from key partners to inform the scope and priorities for a clinical practice guideline (CPG) pertaining to physical therapy services provided to children and youth with Down syndrome (DS). A 68-item survey was completed by interventionists and parents (n = 296) of children and youth with DS. The most prevalent physical therapy interventions currently being performed included tummy time, postural control activities, activity-based interventions, and play-based interventions. Key partners agreed on the importance of specific clinical outcomes, needing guidance on frequency and dosage of interventions, common barriers to physical therapy intervention, and needing information for discharge criteria in a future CPG. The results of this survey have given the CPG committee the necessary information to inform the CPG process for children and youth with DS.

The effect of tummy time and oral massage on infants' oral motor skills as an effort to receive complementary food

Introduction: Complementary foods (complementary foods) are additional nutrition for babies after the age of 6 months because breastfeeding alone cannot meet the daily needs of calories and nutrients. But it is not uncommon to find children unable to eat because of oral motor skills. This study aimed to determine the effect of oral massage stimulation and tummy time on oral motor skills which were seen from the baby's response to the first food. Methods: The design of this research was using True Experimental analysis with a post-test-control group design, the population of babies aged 4-5 months was 210 respondents with probability sampling technique with purposive random sampling for 3 months in the independent practice of Gresik East Java Indonesia midwives. The research instrument was a checklist from The Schedule for Oral Motor Assessment (SOMA). Data analysis with Kruskal-Wallis test, and Mann-Whitney test. Results: The results showed that in the group of babies who received oral massage treatment almost all (77.1%) had good oral motor skills, and in the group of babies who got tummy time stimulation most (65.7%) had good oral motor skills and in the control group almost half (34%) had good oral motor skills. The value of p = 0,0001 &lt;=0,05 means that differences in infant oral motor skills in the tummy time stimulation group, oral massage group, and control group. Oral massage has a good impact on the baby's oral motor skills. Conclusion: There are other stimulations that have a good impact on the child's motor development.

THE RELATIONSHIP OF TUMMY TIME WITH NORMAL BABIES' GROSS MOTOR DEVELOPMENT IN THE DENPASAR ASI COMMUNITY IN 2022

Introduction: Infant motor development is crucial because it bridges the movements that occur during life, produces perceptual information, provides a means to gain knowledge about the world, and allows social interaction. If the basic motor stage is not passed, then there will be obstacles in motor development. Early stimulation will be needed to optimize the growth and development of children according to their stages naturally. Tummy time is one obvious form of early stimulation for muscle tone, posture, and later development. Objective: To determine the relationship between tummy time and gross motor development of normal infants in the breastfeeding community in Denpasar. Methods: An observational study using an analytical cross-sectional study, involving 30 respondents from the breastfeeding mother community in Denpasar. Primary data was obtained through a google form using the WhatsApp blast. Data analysis used Spearman rank correlation test. Results: Showed a significant relationship between the variable doing tummy time and the variable gross motor development sitting in normal infants, whether it was seen from the strong or not the correlation (with very strong results because the correlation coefficient was close to 1), the significance of the correlation results was 0.000 (less than 0.01 and 0.05) and the direction of the correlation is positive. So, Ho is rejected and H1 is accepted. Conclusion: Tummy time is proven to have a close relationship with the achievement of normal infant gross motor development with reference to the ability to sit at the age of six months. Based on the results of the study, it is recommended to do tummy time as a form of stimulation to achieve gross motor development of babies that the public needs to know.

Validation of Parent Recall &amp; Accelerometer Measure for Tracking Tummy Time at Home in Term &amp; Preterm Infants

Abstract Date Presented 04/21/2023 To validate the use of wearable sensors in measuring tummy time, recorded play sessions were compared with parent recall and sensor data. Significant correlations indicate that sensors can accurately report infant movement experiences with reduced bias. Primary Author and Speaker: Jessica Manning Additional Authors and Speakers: Ketaki Inamdar, Virginia W. Chu Contributing Authors: Dhriti Thakur, Kayla Bowler

Theoretical Context for a Wakeful Prone and Vestibular Infant Movement Program to Support Early Infancy Motor Development

ABSTRACT A growing awareness and encouragement of the need for infants to spend more awake time in the prone position suggests that the provision of information about infant movement activities that encourage and reassure parents and carers in undertaking daily tummy time incorporating vestibular actions with young infants, is important and timely. There are indications that lack of daily infant tummy play time may be associated with low infant rudimentary skills and with the potential of positional plagiocephaly. This paper presents information on infant motor development in relation to the factors that may be shaping infants’ movement maturity and outlines the relationship of the infant’s developing sensory system (vestibular, tactile, proprioceptive) to attaining typical motor development. This acts as a detailed theoretical basis for a neurological designed infant movement program to contribute to overall infant motor development. The paper provides background information for the creation, format, and design of an infant development movement program (the ‘Back to Sleep, Tummy to Play program) that may be suitable and appropriate for families and early years therapists such as maternal and early childhood nurses, occupational therapists, and physical therapists, to interact with in supporting and developing both infant tummy and vestibular time.

"I Am Afraid of Positioning my Baby in Prone": Beliefs and Knowledge about Tummy Time Practice.

To identify beliefs and knowledge about tummy time (TT) practice and its repercussions on motor development. Longitudinal study carried out with parents/caregivers of infants older than 30 days of life. Two assessments were performed. A structured interview was conducted, while the babies were between one and six months old to identify beliefs, knowledge about TT, and the motor milestone achievement expected for the age. At six to 12 months, the risk of motor development delay was tracked using the survey of well-being of young infant questionnaire (SWYC). 41 families responded to the SWYC questionnaire (21 were allocated to the TT group). 31.70% reported that it was not important to put the infants in a prone position while awake, and 70.70% said they are afraid their babies would become breathless when positioned in a prone position. 85.70% of infants from the TT group showed typical development, while 55% of the control group showed atypical development for their age (p = 0.01). Only three infants from the control group were at risk of delayed motor development (p = 0.10). Most of the families feel insecure about proning their babies and fear breathlessness when positioned. Acquisition of motor milestones prevailed in the TT group, suggesting an association between TT practice and motor milestone achievement.

Adherence to Canadian 24-Hour Movement Guidelines among infants and associations with development: a longitudinal study

BackgroundTo examine: 1) longitudinal adherence to the Canadian 24-Hour Movement Guidelines in a sample of infants and 2) associations between adherence to the guidelines over time and development.MethodsParticipants were 250 parent-infant dyads from the Early Movers project in Edmonton, Alberta. At 2, 4, and 6 months of age, physical activity, sedentary behaviour, sleep, and development were measured with a parental questionnaire that included items from the Ages & Stages Questionnaire (ASQ-3). Parents also reported the dates six major gross motor milestones were acquired during the first 18 months of life according to World Health Organization criteria. In a sub-sample (n = 93), movement behaviours were also measured with a time-use diary at 2, 4, and 6 months and gross motor development was measured by a physiotherapist using the Alberta Infant Motor Scale (AIMS) at 6 months. Guideline adherence was defined as: 1) ≥ 30 min/day of tummy time, 2) no screen time, some reading time, no restrained bouts > 1 h (time-use diary only), and 3) 14–17 h (2 months) or 12–16 h (4 and 6 months) of sleep per 24-h period. Generalized estimating equations were conducted as well as linear mixed models and linear regression models that adjusted for demographic characteristics.ResultsFew infants met the guidelines at all time-points (questionnaire: 2%; time-use diary: 0%). Infants that met a recommendation at 2 months, compared to those that did not, were 1.8–8.2 times more likely to meet that recommendation at subsequent time-points. Meeting more recommendations across time-points, according to both measures, was associated with a higher mean ASQ-3 gross motor score. Each additional time-point of tummy time recommendation adherence (questionnaire-measured) was associated with a 5–11-day earlier acquisition of independent sitting, crawling, and independent standing milestones. In the sub-sample, each additional time-point of guideline adherence was associated with a 16% higher AIMS score at 6 months.ConclusionsGuideline adherence was low across the first 6 months of infancy. Overall, meeting more recommendations over this period appeared important for gross motor development. Parents and caregivers should be targeted as early as possible with guideline dissemination and activation strategies to promote healthy infant development.

A Systematic Review of Positional Plagiocephaly Prevention Methods for Patients in Development

Positional plagiocephaly is an asymmetrical skull deformation caused by various factors. Although it is not responsible for abnormal brain development in infants and is not related to the onset of neurophysiological problems, it is critical to prevent skull deformity to avoid aesthetic and functional consequences. The purpose of the study is to investigate the relevance of preventive procedures to the onset of positional plagiocephaly, such as the use of passive mattresses, which is primarily correlated with the need for newborns and infants to sleep and rest in proper posture. PubMed, Web of Science, Google Scholar, Scopus, Cochrane Library, and Embase were searched for papers that matched our topic, dating from January 2012 to 22 October 2022, with an English language restriction, using the following Boolean keywords: (“positional plagiocephaly” AND “prevention”). A total of 11 papers were included as relevant papers matching the purpose of our investigation. According to the research results, inadequate vitamin D and folic acid intake during pregnancy may increase the risk of skull deformation. Furthermore, babies should sleep on their backs and spend at least 30 min in tummy time. Using a passive sleep curve mattress has several advantages such as low cost, easy handling, no compliance system, and a marked improvement in head shape, allowing harmonious skull growth guided by normal brain expansion.