A guide for physical activity and screen time for preschoolers

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What’s the right balance between active time and sedentary time for young children? How many hours should your baby or preschooler be sleeping? Is it OK if my baby watches TV? If you don’t know the answers to this questions…keep reading.

The World Health Organization (WHO) has just released guidelines for children under age 5, proposing the adequate amount of physical activity, sedentary activity (including screen time), and sleep a child must get in any given day.  The reasoning behind these guidelines is that by increasing the overall time a child is being physically active while decreasing sedentary activities we can reduce their risk of developing obesity and improve well being in general. The importance of getting the proper amount and quality of sleep were also well described on the recommendations. This is the first time WHO releases guidelines on these topics for these age groups.

Here are the recommendations at a glance:

Child’s age Sleep Time Physical Activity Screen Time
Birth to 1 year old 0-3 months:
14 to 17 hours
4-11 months:
12 to 16 hours
At least 30 minutes   No screen time.
1 to 2 years old 11 to 14 hours
At least 180 minutes 1-year of age:
No screen time
2 years of age:
1 hour or less
3 to 4 years old 10 to 13 hours
At least 180 minutes 1 hour or less  

How important is sleep for children?

​​​​​​​​​​Getting the appropriate amount and quality of sleep is tremendously important. Some experts say it is as important as getting the proper nutrition and amount of physical activity. Adequate sleep duration improves a child’s level of alertness, mood, behavior, memory and learning abilities. Shorter sleep duration can affect your child’s safety (more prone to accidents), emotional regulation, growth, and weight. So, establishing healthy sleep habits for your children right from the start seems like a good idea.

Tell me again…What are the sleep recommendations just released by The World Health Organization (WHO)?

The daily recommendation for good quality sleep, including naps is as follows:

  • Infants younger than 1 year:
    • 0 to 3 months: 14 to 17 hours
    • 4 to 11 months: 12 to 16 hours
  • Children 1 to 2 years old: 11 to 14 hours, should attempt regular schedule of sleep/wake-up times.
  • Children 3–4 years old: 10–13 hours, with regular sleep/wake-up schedules

How do these recommendations compare with the  American Academy of Pediatrics (AAP) sleep recommendations?

They are pretty much the same…The AAP recommends:

  • 12 to 16 hours of sleep for infants younger than 1
  • 11 to 14 hours of sleep for children ages 1 to 2
  • 10 to 13 hours of sleep for children 3 to 5 years old.

These also reflect total of sleep in a 24-hour period and consider naps.

How important is physical activity for children?

Extremely important! We all know this but sometimes its difficult to commit to being physically active. Our schedules are packed with multiple responsibilities, but we must make time to stay active. Here are some facts that might help you make a different choice when it comes to your family.

It is well described and researched that physical activity decreases the incidence of obesity in all age groups. Alternatively, physical inactivity is a leading risk factor for global mortality. Kids who are physically active have superior motor skills, fitness, muscular strength, endurance, and bone/skeletal health. In addition to the physical benefits of increased activity, it improves psychosocial wellbeing and cognitive performance, and reduces the risk of depression. So, it seems like a no brainer to encourage not only your child but the whole family to be physically active. Remember, you should be a role model for your children, so stay active.

OK! So now that you are on board…Let’s look at the recommendations for physical activity in more detail:

  • Infants younger than 1 year of age: should be active several times a day for a total of 30 minutes…ideally through floor play while interacting with a parent or caregiver.
    • If the infant is not mobile, do tummy time several times a day (WHILE AWAKE) for a total of 30 minutes. Remember infants should NEVER sleep while on tummy time, especially if unsupervised!
  • Children 1 to 2 years old should do 180 minutes of physical activity spread through the day at any intensity (can include moderate to vigorous activity but not required).
  • Children 3 to 4 years old should do 180 minutes of physical activity spread through the day (should include at least 60 minutes of moderate to vigorous intensity activity).

How does these recommendations for physical activity compare with other agencies recommendations?

Both the Centers for Disease Control and Prevention (CDC) and the AAP recommend that school-age children get at least 60 minutes of daily moderate to vigorous physical activity that is age and developmentally appropriate. They currently don’t have formal recommendations for preschool age kids.

Why is sedentary time a big deal?

In the previous section I pointed out that being physically active is essential in order to stay healthy. There’s nothing wrong with allowing children to have some quiet time or resting time; but we must make sure we are not allowing them to spend most of the day being sedentary.

For the purpose of the guidelines, sedentary behavior was defined as any passive behavior which didn’t involve active movement including time spent restrained in car seat, high-chair, stroller, or in a carrying device or on a caregiver’s back ; while screen time was defined as time spent passively watching screen-based entertainment (TV, computer, mobile devices).

Remind me…what are the recommendations for sedentary behavior?

  • Infants younger than 1 year old:
    • Should not be restrained for more than 1 hour at a time
    • No screen time
    • When sedentary, reading and storytelling with parent or caregiver is preferred
  • Children 1 to 2 years old:
    • Should not be restrained or sit for more than 1 hour at a time
    • No screen time for 1-year old children; 1 hour of screen time for 2-year-old children
    • When sedentary, reading and storytelling with parent or caregiver is preferred
  • Children 3 to 4 years old:
    • Should not be restrained or sit for more than 1 hour at a time
    • Screen time 1 hour or less
    • When sedentary, reading and storytelling with parent or caregiver is preferred

How do these recommendations compare to the American Academy of Pediatrics (AAP) screen time recommendations?

They are very similar to the AAP guidelines on screen time. In general, the AAP similarly recommends avoiding digital media use for children younger than 24 months and to limiting screen time to an hour a day for children 2 to 5.

However, the AAP guidelines are not as strict, for example the use of video-chatting for the 18- 24-month age group is allowed. They highlight that if parents choose to introduce digital media to their 18-24-month children, they should only pick high-quality programming and use the media with their children.

These recommendations are quite strict…how do I put them to practice?

I know!  Remember the recommendations are just a guide to provide parents with some parameters to follow when planning their children’s daily routines and schedules. Sometimes stern rules can produce guilt or frustrations for the parents, but it is ultimately your job to decide what works best for you and your family. Most families are so busy, and over-scheduled that it is easy to overlook how much TV our children watch or for how long they sit around.

I think the key to success is to find a balance that allows your family to function. Ultimately, be kind to yourself …if you must finish dinner, or finish doing homework with one of your older kids, it’s probably OK if your toddler or preschooler gets an extra 15 or 20 minutes of screen time.

Let’s promote healthy habits right from birth!

I like this is a great family media plan  resource for parents…check it out.

Resources:

www.washingtonpost.com-WHO-Infants-under-Year-Old-shouldn ‘ t-be-exposed to-any-Electronic-Screens/

www.nytimes.com-health/screen-time-kids

www.usatoday.com-phone-tv-screen-time-not-healthy-babies-some-toddlers-

https://apnews.com

www.cnn.com-health/child-recommendations-exercise-sleep-screens

www.aap.org

https://slate.com/technology/2019/04/screen-time-world-health-organization-limits.html

WHO guidelines

www.aap.New-Recommendations-for-Childrens-Media-Use.aspx

https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx
https://pediatrics.aappublications.org
https://www.healthychildren.org/Healthy-Sleep-Habits-How-Many-Hours-Does-Your-Child-Need
https://www.uptodate.com/physical-activity-and-strength-training-in-children-and-adolescents-
https://pediatrics.aappublications.org

Disclaimer: The content in this blog is not to be considered medical advice and it is not intended to replace the relationship you have with your primary care provider. If you have specific questions, please contact your physician.