The digital age has put parenting on a new frontier: managing screen time use in our kids, who are on a new frontier all their own: growing up in front of screens.  And while the the smartphone temptation is real, in a statement released earlier this week, the WHO came right out and said it: for children under 5 to grow up healthy, they must spend less time sitting watching screens and/or restrained in strollers and seats, get better quality sleep, and have more time for active play.  What does this mean for the screen? For children under 2, it means no screen time at all, and ideally less than one hour for children 2-4.

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

According to the WHO, the new guidelines were developed by a panel of experts who assessed the effects on young children (under 5) of inadequate sleep and time spent sitting watching screens or restrained in chairs and strollers. They also reviewed evidence around the benefits of increased activity levels.  The resulting recommendations illustrate what a healthy relationship between sedentary time, active time, and sleep should look like as it pertains to a child’s short term and long term health. 

While the general consensus is a less-is-more approach to screen time is in the best interest of the health of young children, doctors and researchers agree that as technology advances, the grey area widens.  For example, the American Academy of Pediatrics expanded their guidelines to allow video chat for the otherwise screen-forboden under 18-month crowd.  And as evidenced in this piece from the Washington Post, researchers call into question the validity of emerging research (is watching strangers unbox toys on YouTube the same as viewing an interactive, educational game?) and the lack of long term research (anyone want their baby to join a longitudinal screen time study?) on the effects on screen time. 

WHO Recommendations 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 14–17h (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 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 11-14 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 10–13h of good quality sleep, which may include a nap, with regular sleep and wake-up times.

Source: The World Health Organization