New WHO guidelines limit child screen time, sedentary activity

Children under five years old need to spend less time sitting and watching screens, get better quality sleep, and be more active to grow up healthy, according to new guidelines issued yesterday by the World Health Organization (WHO).

The new guidelines include recommendations on physical activity, sedentary behavior, and sleep for children under five years old. A panel of WHO experts developed the recommendations after they assessed the effects of inadequate sleep and time spent sitting watching screens or restrained in chairs or strollers, as well as reviewing evidence of the benefits of increased activity levels.

For infants, the experts suggest being physically active several times a day, including at least 30 minutes of “tummy time” spread throughout the day. Infants should not be restrained in a high chair or stroller for more than an hour at a time. Screen time is not recommended, though the WHO experts encourage reading and storytelling. They recommend newborns get 14-17 hours of sleep and 4-11-month-olds 12-16 hours of sleep, including naps.  

Children 1-2 years old should spent at least 180 minutes in physical activities at any intensity, and 3-4 years old should spend 180 minutes with at least 60 minutes moderate to vigorous intensity. Children 1-4 years old should not be restrained for more than one hour at a time or sit for extended periods of time, and screen time should be limited to no more than an hour, though less is better. The experts recommend 11-14 hours of sleep for 1-2-year-olds and 10-13 hours for 3-4-year-olds.  

Failure to meet current physical activity recommendations is responsible for more than 5 million deaths globally each year across all age groups, the WHO said in an announcement. Currently, over 23 percent of adults and 80 percent of adolescents are not sufficiently physically active. If healthy physical activity, sedentary behavior, and sleep habits are established early in life, this helps shape habits through childhood, adolescence and into adulthood, the WHO says.

The pattern of overall 24-hour activity is key, experts say, replacing prolonged restrained or sedentary screen time with more active play, while making sure young children get enough good-quality sleep. Quality sedentary time spent in interactive non-screen-based activities with a caregiver, such as reading, storytelling, singing, and puzzles, is very important for child development, says the WHO.

The interactions between physical activity, sedentary behavior, and adequate sleep time, and their impact on physical and mental health and wellbeing, were recognized by the Commission on Ending Childhood Obesity, which published its recommendations in a 2016 report calling for clear guidance on physical activity, sedentary behavior, and sleep in young children.

Applying the recommendations in these guidelines during the first five years of life, the WHO states, will contribute to children’s motor and cognitive development and lifelong health.