New health guidelines for children under 5: more activity, less screen time, better sleep

According to new guidelines issued by the World Health Organization (WHO), children under five years old could face negative health consequences as they grow up if they continue to spend too much time watching screens, are restrained in prams and seats, fail to get quality sleep and are not actively playing.  

The new guidelines on physical activity, sedentary behavior and sleep for children under 5 years of age were developed by a WHO panel of experts that analyzed the effects poor sleep, time spent sitting watching screens or restrained in chairs and prams have on health, along with the outcomes associated with increased activity.  

“Improving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and wellbeing, and help prevent childhood obesity and associated diseases later in life,” says Dr. Fiona Bull, program manager for surveillance and population-based prevention of noncommunicable diseases, at WHO. 

WHO says failure to meet current physical activity recommendations is responsible for more than 5 million deaths globally each year across all age groups and that over 23 percent of adults and 80 percent of adolescents are not physically active enough to achieve good health.  

“What we really need to do is bring back play for children,” says Dr. Juana Willumsen, WHO focal point for childhood obesity and physical activity. “This is about making the shift from sedentary time to playtime, while protecting sleep.” 

The Commission on Ending Childhood Obesity, which called for clear guidance on physical activity, sedentary behavior and sleep in young children, supports the new guidelines. Here they are at a glance: 

Infants (less than 1 year) should: 

·    Be physically active several times a day in a variety of ways, particularly through interactive floor-based play; more is better. For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake.  

·    Not be restrained for more than 1 hour at a time (e.g. prams/strollers, high chairs, or strapped on a caregiver’s back). Screen time is not recommended. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.   

·    Have 14 to 17 hours (0–3 months of age) or 12–16h (4–11 months of age) of good quality sleep, including naps. 

Children 1-2 years of age should: 

·    Spend at least 180 minutes in a variety of types of physical activities at any intensity, including moderate-to-vigorous-intensity physical activity, spread throughout the day; more is better. 

·    Not be restrained for more than 1 hour at a time (e.g., prams/strollers, high chairs, or strapped on a caregiver’s back) or sit for extended periods of time. For 1-year-olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended. For those aged 2 years, sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged. 

·    Have 11 to 14 hours of good quality sleep, including naps, with regular sleep and wake-up times. 

Children 3-4 years of age should: 

·    Spend at least 180 minutes in a variety of types of physical activities at any intensity, of which at least 60 minutes is moderate- to vigorous intensity physical activity, spread throughout the day; more is better. 

·    Not be restrained for more than 1 hour at a time (e.g., prams/strollers) or sit for extended periods of time. Sedentary screen time should be no more than 1 hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.  

·    Have 10 to 13 hours of good quality sleep, which may include a nap, with regular sleep and wake-up times.