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Table 1 Movement Behaviour Guidelines for Children and Youth (ages 0–17 years) from different authoritative organizations

From: Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

Authoritative Organization and Reference

Country

Age Group

Recommendation

PHYSICAL ACTIVITY

Recommendation

SCREENTIME/ SEDENTARY TIME

Recommendation

SLEEP

Additional Notes

American Academy of Pediatrics Council on Communications and Media. 2016 [24]

USA

0–1.5 yrs

 

Avoid digital media use (except video chatting) in children younger than 18 to 24 months.

  

1.5–2 yrs

 

Avoid solo media use in this age group.

 

For children ages 18 to 24 months of age, if you want to introduce digital media, choose high-quality programming and use media together with your child.

Avoid solo media use in this age group.

Use the Family Media Use Plan (www.healthychildren.org/MediaUsePlan) with specific guidelines for each child and parent.

2–5 yrs

 

For children 2 to 5 yrs. of age, limit screen use to 1 h per day of high-quality programming.

 

Create unplugged spaces and times in homes.

Use new technologies in social and creative ways.

Stress the importance of not displacing sleep, exercise, play, reading aloud, and social interaction with screen use.

Recommend no screens during meals and for 1 h before bedtime. Remove devices from bedrooms before bed.

For children 2–5 yrs. of age, limit screen use to 1 h per day of high-quality programming, co-view with your children, help children understand what they are seeing, and help them apply what they learn.

Monitor children’s media content and what apps are used or downloaded. Test apps before the child uses them, play together, and ask the child what they think about the app.

Keep bedrooms, mealtimes, and parent-child playtimes screen-free for children and parents. Parents can set a “do not disturb” option on their phones during these times.

Avoid fast-paced programs (young children do not understand them as well), apps with lots of distracting content, and any violent content.

Turn off TVs and other devices when not in use.

American Academy of Sleep Medicine. 2016 [20]

USA

4 months – 1 yr

  

Infants* 4 months to 12 months should sleep 12 to 16 h per 24 h (including naps).

*Recommendations for infants younger than 4 months are not included due to the wide range of normal variation in duration and patterns of sleep, and insufficient evidence for associations with health outcomes.

 

1–2 yrs

  

11 to 14 h per 24 h (including naps)

 

3–5 yrs

  

10 to 13 h per 24 h (including naps)

 
 

6–12 yrs

  

9 to 12 h per 24 h

 

13–18 yrs

  

8 to 10 h per 24 h

Australian 24-Hour Movement Guidelines for the Early Years (Birth to 5 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. 2017 [23]

Australia

0–1 yr

Being physically active several times in a variety of ways, particularly through interactive floor-based play; more is better.

For those not yet mobile, this includes at least 30 min of tummy time spread throughout the day while awake.

Not being restrained for more than 1 h at a time (e.g., in a stroller, car seat or high chair). When sedentary, engaging in pursuits such as reading and storytelling with a caregiver is encouraged.

Screen-time is not recommended.

14 to 17 h (for those aged 0–3 months) of good quality sleep, including naps.

12 to 16 h (for those aged 4–11 months) of good quality sleep, including naps.

 

1–2 yrs

At least 180 min spent in a variety of physical activities at any intensity, spread throughout the day; more is better.

Including energetic play.

Not being restrained for more than 1 h at a time (e.g., in a stroller, car seat or high chair) or sitting for extended periods. When sedentary, engaging in pursuits such as reading and storytelling with a caregiver is encouraged.

For those younger than 2 yrs., sedentary screen-time is not recommended.

For those aged 2 yrs., sedentary screen-time should be no more than 1 h per day; less is better.

11 to 14 h of good quality sleep, including naps, with consistent sleep and wakeup times.

 

3–5 yrs

At least 180 min spent in a variety of physical activities spread throughout the day,

of which at least 60 min is energetic play; more is better.

Not being restrained for more than 1 h at a time (e.g., in a stroller or car seat). Avoid sitting for extended periods. When sedentary, engaging in pursuits such as reading and storytelling with a caregiver is encouraged.

Sedentary screen-time should be no more than 1 h per day; less is better.

10 to 13 h of good quality sleep, which may include a nap, with consistent sleep and wakeup times.

 

Australian Department of Health. Australian 24-Hour Movement Guidelines for Children and Young People (5–17 years) - An Integration of Physical Activity, Sedentary Behaviour and Sleep. 2019. Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-24-hours-phys-act-guidelines [25]

Australia

5–13 yrs

Accumulating 60 min or more of MVPA per day involving mainly aerobic activities.

Activities that are vigorous, as well as those that strengthen muscle and bone should be incorporated at least 3 days per week.

Several hrs of a variety of light physical activities.

Limiting sedentary recreational screen-time to no more than 2 h per day.

Breaking up long periods of sitting as often as possible.

An uninterrupted 9 to 11 h of sleep per night for those aged 5–13 yrs.

Consistent bed and wake-up times.

For greater health benefits, replace sedentary time with additional MVPA, while preserving sufficient sleep.

14–17 yrs

8 to 10 h per night for those aged 14–17 yrs.

Consistent bed and wake-up times.

Canadian 24-Hour Movement Guidelines for the Early Years (0–4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. 2017 [2]

Canada

0–1 yr

Being physically active several times in a variety of ways, particularly through interactive floor-based play; more is better.

For those not yet mobile, this includes at least 30 min of tummy time spread throughout the day while awake.

Not being restrained for more than 1 h at a time (e.g., in a stroller or high chair). Screen-time is not recommended.

When sedentary, engaging in pursuits such as reading and storytelling with a caregiver is encouraged.

14–17 h (for those aged 0–3 months) or 12–16 h (for those aged 4–11 months) of good-quality sleep, including naps.

 

1–2 yrs

At least 180 min spent in a variety of physical activities at any intensity, including energetic play, spread throughout the day — more is better.

Not being restrained for more than 1 h at a time (e.g., in a stroller or high chair) or sitting for extended periods.

For those younger than 2 yrs, sedentary screen-time is not recommended. For those aged 2 yrs, sedentary screen-time should be no more than 1 h; less is better.

When sedentary, engaging in pursuits such as reading and storytelling with a caregiver is encouraged.

11–14 h of good-quality sleep, including naps, with consistent bedtimes and wake-up times.

 
 

3–4 yrs

At least 180 min spent in a variety of physical activities spread throughout the day, of which at least 60 min is energetic play —more is better.

Not being restrained for more than 1 h at a time (e.g., in a stroller or car seat) or sitting for extended periods.

Sedentary screen-time should be no more than 1 h; less is better.

When sedentary, engaging in pursuits such as reading and storytelling with a caregiver is encouraged.

10–13 h of good-quality sleep, which may include a nap, with consistent bedtimes and wake-up times.

 

Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. 2016

[1]

Canada

5–13 yrs

An accumulation of at least 60 min/day of MVPA involving a variety of aerobic activities.

Vigorous physical activity and muscle and bone strengthening activities should each be incorporated at least 3 days/wk.

Several hours of a variety of structured and unstructured light physical activities.

No more than 2 h/day of recreational screen-time.

Limited sitting for extended periods.

9–11 h

Preserving sufficient sleep, trading indoor for outdoor time, and replacing sedentary behaviours and light physical activity with additional MVPA can provide greater health benefits.

14–17 yrs

8–10 h

Canadian Pediatric Society. Screen-time and Young Children: Promoting Health and Development in a Digital World. 2017 [26]

Canada

0 - < 2 yrs

 

Screen-time for children younger than 2 yrs. is not recommended.

 

Ensure that sedentary screen-time is not a routine part of childcare for children younger than 5 yrs.

Maintain daily ‘screen-free’ times, especially for family meals and book-sharing.

Avoid screens for at least 1 h before bedtime, given the potential for melatonin-suppressing effects.

Be present and engaged when screens are used and, whenever possible, co-view with children.

Be aware of content and prioritize educational, age-appropriate and interactive programming.

Use parenting strategies that teach self-regulation, calming and limit-setting.

Choose healthy alternatives, such as reading, outdoor play, and creative, hands-on activities.

Turn off devices at home during family time.

Turn off screens when not in use and avoid background TV.

2–5 yrs

 

For children 2 to 5 yrs., limit routine or regular screen-time to less than 1 h per day.

 

Children and Screens: Institute of Digital Media and Child Development, 2017 https://www.childrenandscreens.com/findings/ [27]

USA

  

Limiting TV exposure (especially background TV) before the age of 2 yrs.

 

Plan a bedtime that allows for adequate sleep.

Use a bedtime routine that includes calming activities and avoids electronic media use.

Limit media use in the hour or two before bedtime.

Turn off electronic media devices in the evening and charge them in a central location outside bedrooms.

Be a healthy sleep and media role model for your child or adolescent.

Remove all electronic media from your child or teen’s bedroom, including TVs, video games, computers, tablets, and cell phones.

Turn mobile devices off during class and other learning activities.

Turn TV off during schoolwork time.

Turn TV off when no one is watching.

4–13 yrs

 

Limit total screen-time, TV watching, video game playing, and computer use (excluding computer use for school homework, when applicable) no more than 7 h per week.

 
  

Newborns 0–3 months

  

14–17 h

 

National Sleep Foundation’s updated sleep duration recommendations: final report. 2015 [21]

USA

Infants (4–11 months)

  

12–15 h

 

Toddlers (1–2 yrs)

  

11–14 h

Preschoolers (3–5 yrs)

  

10–13 h

School-aged children (6–13 yrs)

  

9–11 h

Teenagers (14–17 yrs)

  

8–10 h

New Zealand Ministry of Health. Sit Less, Move More, Sleep Well: Active Play Guidelines for Under-Fives. 2017 [29]

New Zealand

0–1 yr

 

Discourage screen-time

Babies (birth to 3 months) should have 14 to 17 h good-quality sleep every day, including daytime sleeps centred around their physical and emotional needs.

Infants (4–12 months) should have 12 to 15 h good-quality sleep every day, including daytime sleeps, which will tend to decrease as they get closer to 1 yr of age.

Provide regular activity breaks to limit the amount of time a child spends sitting.

Discourage screen-time for under-2-yr-olds and limit screen-time to less than 1 h. every day for children aged 2 yrs. or older – less is best!

Limit time in equipment that restricts free movement.

From birth, encourage regular, unrestricted floor-based play (tummy time), on a safe surface.

Be a role model: reduce your own screen use.

Replace TV time with reading time, story time or doing jigsaw puzzles together.

Avoid having the TV playing in the background.

Remove the TV completely or limit having it on until the children have gone to bed.

Do not have screens in (any) bedrooms.

Set limited viewing times for all screens.

Store DVDs, consoles, tablets and electronic games out of sight.

Break up long car journeys with regular stops (preferably at least once an hr), removing under-fives from their capsule/car seat at each stop.

Encourage toddlers and preschoolers to walk instead of being in a pushchair.

1–2 yrs

At least 3 h every day for toddlers and preschoolers, spread throughout the day.

Discourage screen-time.

Toddlers (1 to 2 yrs. inclusive) should have 11 to 14 h of good-quality sleep every day, including at least one daytime sleep.

 

2 yrs. and older

At least 3 h every day for toddlers and preschoolers, spread throughout the day.

Less than 1 h every day

Preschoolers (3 to 4 yrs. inclusive) should have 10 to 13 h of good-quality sleep every day, with consistent bedtimes and wake-up times.

 

U.K. Chief Medical Officers’ Physical Activity Guidelines, 2019 [22, 30].

UK

0–1 yr

Infants should be physically active several times every day in a variety of ways, including interactive floor-based activity, e.g. crawling.

For infants not yet mobile, this includes at least 30 min of tummy time spread throughout the day while awake (and other movements such as reaching and grasping, pushing and pulling themselves independently, or rolling over); more is better.

Tummy time may be unfamiliar to babies at first, but can be increased gradually, starting from a min or two at a time, as the baby becomes used to it. Babies should not sleep on their tummies.

   

1–2 yrs

Toddlers should spend at least 180 min (3 h) per day in a variety of physical activities at any intensity, including active and outdoor play, spread throughout the day; more is better.

   

3–4 yrs

Preschoolers should spend at least 180 min (3 h) per day in a variety of physical activities spread throughout the day, including active and outdoor play. More is better; the 180 min should include at least 60 min of MVPA.

   

5–18 yrs

Children and young people should engage in MVPA for an average of at least 60 min per day across the week. This can include all forms of activity such as physical education, active travel, after-school activities, play and sports.

  

Children and young people should engage in a variety of types and intensities of physical activity across the week to develop movement skills, muscular fitness, and bone strength.

Children and young people should aim to minimize the amount of time spent being sedentary, and when physically possible should break up long periods of not moving with at least light physical activity.

U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans. 2nd ed. 2018 [31]

USA

3–5 yrs

Although the specific amount of activity needed to improve bone health and avoid excess fat in young children is not well defined, a reasonable target may be 3 h per day of activity of all intensities: light, moderate, or vigorous intensity.

  

The Advisory Committee did not review evidence for children younger than age 3 yrs.

6–17 yrs

Children and adolescents ages 6 through 17 yrs. should do 60 min (1 h) or more of MVPA daily.

Aerobic: Most of the 60 min or more per day should be either moderate- or vigorous-intensity aerobic physical activity and should include vigorous-intensity physical activity on at least 3 days a week.

Muscle-strengthening: As part of their 60 min or more of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days a week.

Bone-strengthening: As part of their 60 min or more of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days a week.

   

World Health Organization. WHO Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children Under 5 Years of Age. 2019 [18]

Global

0–1 yr

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 min in prone position (tummy time) spread throughout the day while awake.

Not be restrained for more than 1 h at a time (e.g. prams/ strollers, highchairs, 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 14–17 h (0–3 months of age) or 12–16 h (4–11 months of age) of good quality sleep, including naps.

 

1–2 yrs

Spend at least 180 min in a variety of types of physical activities at any intensity, including MVPA, spread throughout the day; more is better.

Not be restrained for more than 1 h at a time (e.g., prams/ strollers, highchairs, or strapped on a caregiver’s back) or sit for extended periods of time.

For 1-yr-olds, sedentary screen-time (such as watching TV or videos, playing computer games) is not recommended.

For those aged 2 yrs., sedentary screen-time should be no more than 1 h; less is better.

When sedentary, engaging in reading and storytelling with a caregiver is encouraged.

Have 11–14 h of good quality sleep, including naps, with regular sleep and wake-up times.

 

3–4 yrs

Spend at least 180 min in a variety of types of physical activities at any intensity, of which at least 60 min is MVPA, spread throughout the day; more in better.

Not be restrained for more than 1 h at a time (e.g. prams/ strollers) or sit for extended periods of time. Sedentary screen-time should be no more than 1 h; less is better. When sedentary, engaging in reading and storytelling with a caregiver is encouraged.

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

 

World Health Organization. Global Recommendation on Physical Activity for Health. 2010 [19]

Global

5–17 yrs

At least 60 min of MVPA daily.

Most of daily physical activity should be aerobic.

Vigorous-intensity activities should be incorporated, including those that strengthen muscle and bone, at least 3 times per week.

   
  1. Note: Min minutes; Hrs hours; Yrs years; MVPA moderate-to-vigorous intensity physical activity