Sit less, play more; WHO releases guidelines for children under five

To grow up healthy, the World Health Organisation (WHO) has said, children need to sit less, and play more. The WHO guidelines cover physical activity, sedentary behaviour and sleep for children from birth to five years of age, and were released earlier this week.

The WHO said that children under five “must spend less time sitting watching screens, or restrained in prams and seats, get better quality sleep, and have more time for active play if they are to grow up healthy”

The findings will be of interest to the Australian early childhood education and care (ECEC) sector as they seek to provide guidance to families, and also to provide quality educational programs for children in their care.

WHO Director General, Dr Tedros Adhanom Ghebreyesus, described the significance of the early childhood years in establishing a baseline of health and wellbeing for children, saying that this time period is one of rapid development, and “a time when family lifestyle patterns can be adapted to boost health gains.”

The guidelines were developed by a panel of experts chosen by the WHO, who assessed the effects of inadequate sleep and time spent sitting in chairs and prams while watching a screen. The panel also reviewed evidence around the benefits of increased activity levels.

Dr Fiona Vill, a member of the panel and program manager for surveillance and population-based prevention of noncommunicable diseases at WHO, said that improving physical activity, reducing sedentary time, and ensuring quality sleep in young children will also improve their physical and mental health and wellbeing, and aid in the prevention of childhood obesity and associated disorders later in life.

Five million deaths across all age groups globally are attributed to a failure to meet current physical activity recommendations – a figure which WHO believes can be diminished through establishing good practices early in life.

Dr Juana Willumsen, WHO focal point for childhood obesity and physical activity said the guidelines were about making the shift from sedentary time to play time, and protecting sleep, adding “what we really need to do is bring back play for children”

WHO said the key was to look at a pattern of activity over a 24 hour period, and to look for ways to replace prolonged restrained or sedentary time, especially that involving screens, with more active play, and making sure that young children get enough good quality sleep.

The organisation spoke about making sedentary time – time when children are sitting and resting – quality sedentary time, spent in interactive non screen based activities with a caregiver, such as reading, storytelling, singing and puzzles, adding that these activities are very important for child development.

The WHO recommendations highlighting the important interactions between  physical activity, sedentary behaviour and adequate sleep time, and their impact on physical and mental health and wellbeing, were recognised by the Commission on Ending Childhood Obesity, which had previously called for clear guidance on physical activity, sedentary behaviour and sleep in young children.

Recommendations at a glance:

Infants (less than one 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 one 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 14–17h (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 (three hours) 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 one 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 one-year-olds, sedentary screen time (such as watching TV or videos, playing computer games) is not recommended. For those aged two years, sedentary screen time should be no more than one hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.

• Have 11-14 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 (three hours) 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 one hour at a time (e.g., prams/strollers) or sit for extended periods of time. Sedentary screen time should be no more than one hour; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.

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

The full guidelines may be accessed here.