Question from a mother of a 4-month-old: Someone told me that it’s good to put babies on top of pillows (on the floor) so they can get perspective and help them develop. I am a bit hesitant but wanted to hear your thoughts on this.
Our response: Thanks for asking for our perspective – we’re happy to share our thoughts on the topic!
In short, we’re not huge fans of the practice of using pillows when positioning babies prone (on their belly). We don’t agree with what seem to be the reasons behind it – particularly focussing on strengthening muscles or getting to a higher position more quickly. For examples of these perspectives, try searching for something like “tummy time on a pillow.” It’s probably not doing harm, but we don’t think it’s necessary or necessarily helpful.
An underlying question that threads through the discussion below: how do we meet a baby where they are, create an environment that matches their sensory, perceptual, and motor capacities, and trust that their sense of safety, comfort and curiosity will best lead their learning and development? Read on for more.
One idea is that a pillow makes it easier or more comfortable for a baby to be on their tummy (prone). This perhaps assumes that being on a firmer surface is inherently uncomfortable and that’s why some babies “don’t like” tummy time. In our experience, when a baby expresses discomfort in tummy time it’s rarely a question of physical discomfort or the position itself. It’s more often a response to how we help them get there, a lack of familiarity with the position, and/or an indication of the baby’s state (e.g., tired, unsettled, hungry).
Another common conception out in the world around tummy time is that we should help (or train) babies to lift their heads up higher, to strengthen their neck and back, and to bring them up higher in the world. Yes, a baby’s neck and back will get stronger as they spend time on their belly (as is true of all of their movement as they learn to negotiate their own body weight in gravity). However, we don’t think strengthening is a main reason for or benefit of tummy time – it’s more of a by-product. And we don’t think we need to get a baby to “exercise” or entice them higher. Higher is not necessarily better, and from our perspective, it’s not a goal in itself. (Hint: for similar reasons, we’re not big fans of placing mirrors in front of babies for tummy time.)
We think it’s more supportive for a baby’s development to help them first get familiar with being on their tummy. This includes helping them roll into and out of prone from their right and left sides, rather than placing them directly on their tummy. (Read more about the value of familiarity on all four surfaces and related suggestions around handling a baby.)
It also means offering them opportunities to develop the midline, arm support and hand skills they need to eventually hold and engage with an object while on their belly. This often starts quite low to the ground, such as when a baby holds an object in their hands and brings their mouth down to it. A baby’s ability to explore an object with their hands and mouth while prone expands their capacity to engage with and explore their world. In turn, their stamina in tummy time increases, not because they’re learning to tolerate it but because they’re busy playing. (When a baby is on a pillow, it’s harder for them to use their arms and find a sense of ground for support.)
About a pillow giving a baby more perspective… We believe babies develop in a “whole person” way when their perceptual and movement skills develop together (more or less). There are many practices that can bring a baby to a higher perceptual level than their movement can support. A common example is “training” a baby to hold themselves in sitting before they can get there themselves: they’re at a higher level, their perceptual perspective is larger, and their hands are free, but they haven’t developed their gross motor skills to the same degree. Again, higher is not necessarily better.
A version of the idea of the pillow giving your baby perspective (with fewer of the downsides) would be for your baby to be on their tummy on your front while you’re reclining. Her perspective would be your face and interaction with you.
We believe this approach values and respects a baby’s process and allows them to build their capacity (including strength) gradually through their curiosity and play, and through their own engagement and agency.
We hope these thoughts help you find your way through your question, whether you agree with us or not.
Leave a comment to share your thoughts. Are you interested in our perspective on a different question? Send us an email.
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