How much screen time is too much for kids ages four and under? How much physical activity should they be getting? How much sleep should they get? Trying to figure out the answers is enough to make parents' heads spin.
A new set of guidelines released Monday aims to simplify matters by taking an integrative approach that sets out how much sleep, movement and time sitting are needed by kids ages four and under for healthy growth and development.
"We really need to think about a simple road map that brings it all together for parents that says, 'This is what a typical healthy day looks like,'" says Dr. Mark Tremblay, director of Healthy Active Living and Obesity Research (HALO) at the Children's Hospital of Eastern Ontario Research Institute.
The new set of recommendations, called the Canadian 24-Hour Movement Guidelines for the Early Years, was developed by HALO, the Canadian Society for Exercise Physiology, the Faculty of Physical Education and Recreation at the University of Alberta, the Public Health Agency of Canada, ParticipACTION and other researchers from Canada and around the world.
Only 13 per cent of preschoolers across the country meet the new guidelines, Tremblay says.
According to the guidelines, children less than one year old should be physically active several times a day, including at least 30 minutes of tummy time spread throughout the day. They should not spend more than an hour restrained, such as in a high chair, and should get plenty of sleep: 14 to 17 hours for children three months of age or less, and 12 to 16 hours for kids four to 11 months old. Those numbers include naps.
Kids ages one to four should move at least 180 minutes per day, including heart-pumping, energetic play, with kids three to four years old getting at least one hour of such play every day.
Toddlers one to two years old should get 11 to 14 hours of good-quality sleep, while preschoolers should get 10 to 13 hours per day, with consistent bedtimes and wake-up times for both.
Kids two years old and younger shouldn't be spending any sedentary time with screens, and two- to four-year-olds should have no more than one hour of screen time per day, according to the guidelines.
"In reality, all of these activities are completely interrelated and co-dependent on one another. And so the minute we change one it's automatically going to impact the other behaviours," says Dr. Leigh Vanderloo, an exercise scientist at ParticipACTION, a national non-profit organization dedicated to helping Canadians lead more active lives.
A tired child is more likely to slump on the couch in front of the television than play outside, after all.
"We're under this impression that kids this young are just naturally busy," Vanderloo says.
But that's not the case, with 76 per cent of preschoolers getting more than one hour of sedentary screen time per day.
There is "absolutely no scientific evidence" that screen time benefits children two and under, says Dr. Michelle Ponti, a pediatrician who chaired the digital health task force that wrote the Canadian Paediatric Society's most recent position statement on screen time for children five and under, released earlier this year. (That statement also said kids two and under should have no screen time, and kids two to five should have no more than one hour of screen time per day.)
"We know, based on TV data, that excessive screen time is associated with obesity. But it's also associated with attentional and learning problems," Ponti says.
The new 24-hour movement guidelines' integrative approach recognizes the need for a broader way of thinking about movement, Tremblay says.
"With movement, we have focused on physical activity and really, frankly, a subset of that being exercise, almost exclusively in our public-health recommendations," he says.
Tremblay stresses that of course there will be some days when parents are unable to follow the new guidelines to the letter. We all live busy lives. Sometimes kids will have sleepovers or movie nights and can't go to bed at their usual time.
There's no need to fret over these exceptions, Tremblay says. But what we do need to do is think more fully and clearly about everything in our children's lives that make up a healthy day. That's what the new guidelines are there for.
"We know some days kids are going to be excited and stay up late," Tremblay says. "But a typical healthy day should look like this."