Is your one-year-old child sitting in a pram for long periods of time? Is your preschooler spending too much time on digital screen activities? Unhealthy lifestyle habits start early. Children below five years of age must spend less time in sedentary activities such as watching digital screens, restrained in prams and child-seats. They need good quality sleep and more time for active play to enable them to develop into healthy adults, says the World Health Organisation (WHO) in its new guidelines on “physical activity, sedentary behaviour and sleep for children under five years of age” issued in April.

“Achieving health for all means doing what is best for health right from the beginning of people’s lives. Early childhood is a period of rapid development and a time when family lifestyle patterns can be adapted to boost health gains,” says Dr. Tedros Adhanom Ghebreyesus, director-general of WHO.

The Geneva-based WHO estimates that over 23 percent of adults and 80 percent of adolescents are insufficiently active. In its new guidelines prepared by a highly-qualified panel of experts, it strongly recommends increased physical activity, playtime and healthy sleep habits for under-five children. “Improving physical activity, reducing sedentary time, ensuring quality sleep for youngest children to improve their physical, mental health and well-being, and prevent childhood obesity and associated diseases later in life,” says Dr. Fiona Bull, programme manager for surveillance and population-based prevention of non-communicable diseases, WHO.

Prameetha Kappiarath, principal of Ken Montessori, a preschool in Bangalore, welcomes WHO’s “very relevant and timely” guidelines. “In India’s cities and urban homes, children have few personal and public spaces for free play. Moreover with both parents often working, children are not getting enough person-to-person interaction. Caregivers and even parents, are allowing young children to spend too much time on digital devices. This lack of free play and digital dependence is having disastrous consequences on children’s physical well-being and cognitive development. For instance we have observed delayed speech in a rising number of children. WHO’s guidelines to parents of under-five children to increase children’s play time and reduce digital time are critical to developing healthy adults,” says Kappiarath.

WHO guidelines

WHO’s new guidelines on physical activity, sedentary behaviour and sleep for under-5 children recommend the following:

Infants (less than 1 year)

• Encourage physical activity several times a day, particularly through interactive floor-based play. For infants not yet mobile, ensure at least 30 minutes in prone position (tummy time) spread through the day while awake.

• Don’t seat infants for more than an hour time in prams/strollers, high chairs.

• No screen time for infants below one year. Instead, engage in reading and storytelling.

• Sleep: 14-17 hours (0-3 months); 12-16 hours (4-11 months), including naps.

Toddlers (1-2 years)

• One-two-year-olds need at least 180 minutes of moderate-to-vigorous-intensity physical activity, spread throughout the day.

• Toddlers should not remain seated for more than an hour at a time. For one-year-olds, sedentary screen time such as watching TV or videos and playing computer games is harmful. For those aged two years, screen time should be no more than one hour.

• Sleep: 11-14 hours of good quality sleep, including naps, with regular sleep and wake-up times.

Preschoolers (3-5 years)

• Preschoolers should spend at least 180 minutes in a variety of physical activities, of which at least 60 minutes is moderate-to vigorous intensity, spread throughout the day.

• Sedentary screen time should be no more than one hour; less is better.

• Encourage reading and storytelling.

• Sleep: 10–13 hours of good quality sleep, including naps, with regular sleep and wake-up times.

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