Should I prop up my baby for tummy time?

What the evidence says

Yes, you can prop your baby up a bit for tummy time. This is a normal and often recommended trick, not something to avoid. Many babies find lying flat on their tummy tiring or annoying at first, so a small prop can help.

Canadian guidance from AboutKidsHealth suggests placing your baby's chest on a rolled towel, cushion, or over your knees during tummy time. This can make the position more comfortable and can even help build upper body strength and head control. The UK's NHS gives similar advice, suggesting a small rolled-up towel under the arms if your baby is not keen on tummy time on the floor.

There is one very important difference to understand. Propping is fine and helpful while your baby is awake and you are watching them. It becomes dangerous if the same kind of prop, wedge, or positioning pillow is used to hold your baby in place for sleep. Health Canada and Canadian paediatric sources are clear that sleep positioners and wedges should never be used, because babies can suffocate on them. This rule applies even if the device looks like it is meant for tummy time or head shape.

Tummy time itself, propped or not, has real benefits. A large systematic review from the American Academy of Pediatrics found tummy time is linked to better gross motor development, help with rolling and crawling skills, and lower rates of a flattened head shape at the back or side, called plagiocephaly. Most of this research comes from observational studies rather than strict experiments, so the link is strong but not proven the way a drug trial would prove something.

If your baby has reflux, meaning milk often comes back up, propping can help even more. Australian guidance from the Royal Children's Hospital suggests keeping baby more upright during tummy time, such as over your chest, your legs, or a gym ball, and waiting 20 to 30 minutes after a feed before tummy time to reduce spit-up and discomfort.