Pediatrician Dr. Jen Trachtenberg's guide to screen time and play time during a child’s first 5 years of life based on WHO recommendations & AAP guidelines
Being a parent is tough. Especially now. I get it, I have 3 kids of my own. It’s exhausting and rewarding all at the same time. The struggle to both work and accomplish ordinary household activities such as folding laundry, unloading the dishwasher, or enjoying a peaceful family meal can seem daunting when kids are whining and seeking attention. And so we moms, and dads, are tired a lot. I know I am. So it’s not surprising, we are often too quick to give our kids a “digital pacifier”, a tablet or screen to watch to keep quiet and occupied during dinner or to avoid tantrums in public or while we are grocery shopping.
We do this because it’s easy and it works. But this needs to change. We need more activities in our toolbox to deal with a fussy, free spirited or “misbehaving” child. Why? Because digital habits formed in childhood are the building blocks for long term physical and mental health. So much of our health is built on our behaviors and lifestyle. Chronic diseases like obesity, heart disease, diabetes, cancers, anxiety and depression often start in childhood and can be prevented with changes in our daily health habits.
Currently over 23% of adults and 80% of teens are not getting the physical activity they need. And we parents may inadvertently be adding to this sedentary lifestyle right from infancy by keeping baby restrained and in “containers” such as strollers, bouncy seats, and recliners while additionally having them transfixed to screens to keep them entertained and quiet.
The research shows that kids who exercise are more likely to be adults who exercise and kids who sleep well are more likely to sleep better as adults too. Don’t just take my word for it, in fact, the World Health Organization (WHO) just came out with new guidelines for children under 5 years old for physical activity, sedentary behavior and sleep for optimal health. Implementing the WHO recommendations during the first five years of a child’s life will help improve cognitive, fine and gross motor skills as well as set them up for improved lifelong health.
Here is my daily play guide for under fives based on WHO recommendations & AAP guidelines:
Infants less than 1 year
- Be physically active several times a day in various ways ( crawling, reaching, rolling, walking, playing )
- Floor based play on mat/blanket (the more the better)
- Tummy time at least 30 minutes spread throughout day while awake more if possible
- Unswaddle while awake to foster movement of extremities
- Avoid restraining in “containers” for more than one hour at a time (loungers, recliners, strollers, chairs, etc.)
- Screen time is not recommended
- Read and sing to your baby, listen to music and allow them to at grasp at objects
- Sleep 14-17 hours/day (newborns )and 12-16 hours/day (4-11 months)
Children age 12-24 months
- At least 180 minutes of physical activity at varying intensity, including moderate to vigorous, (walking, climbing, dancing, ) spread throughout the day
- Not to be restrained for more than1 hour at a time( stroller, high chair,) or sitting for extended period of time without moving around
- Screen time no more than one hour maximum. (AAP recommends no screen time except for video chatting with family members).
- Sedentary activities including reading, puzzles, simple cause and effect toys, scribbling, blocks,
- Sleep 11-14 hours including naps
Children 3-4 years old
- At least 180 minutes of physical activity at varying intensity , with at least 60 minutes is moderate to vigorous (heart-pumping) physical activity throughout the day ( running, jumping, playing ,sports, playground, indoor gym)
- Not to be restrained for more than 1 hour at a time (strollers) or sit for extended periods of time (couch)
- Screen time no more than 1 hour (good quality educational programming)
- Reading with caregiver, blocks, coloring, dolls, balls, puzzles, pretend play
- Sleep 10-13 hours including naps
Next time you take your child for their check up, your pediatrician may hand you a prescription not for an antibiotic or vitamins but instead a prescription, Rx to play. A reminder of the importance of getting enough physical activity daily to ensure improved health now and in the long run.
I also add a reminder that it’s not just about heart pumping physical activity but changing our mindset and limiting excess digital media. Rather than having “well behaved” zoned out children playing video games, focus more on sedentary activities like puzzles, books, building blocks or drawing that still requires some movement but also fosters brain development much more so in young kids than excess screen time. In addition, following these guidelines will absolutely help your child sleep better, a win-win for the whole family.
Additional onlines safety and digital wellbeing articles and resources:
- One of the best ways to keep screen time rules consistent is to use a parental control tool like Qustodio to set time limits, blockout times (like at least one hour before bedtime) and block or monitor apps or websites you are concerned about.
- A good screen time tip is for every hour of screen time to get one hour of fresh air. There is a biological reason for this. Find out more in the blog: For Every Hour of Screen-time, One Hour of Fresh Air
- You may also like my post on protecting children’s eyes: Is screen time hurting your child’s eyes?