To grow up healthy, keiki younger than 5 years old should have little to no sedentary screen time, more physical activity and get better quality sleep, according to new guidelines released Wednesday by the World Health Organization.
This is the first-ever guidance the WHO has issued regarding how much screen time children younger than 5 should get.
Screen time, such as watching TV or videos or playing computer games, is not recommended for children younger than 2 years old and should be limited to one hour for children ages 2-4, although less is better, according to the WHO, the United Nations’ health agency.
Lauren Stuart, a pediatrician with Hawaii Island Family Health Center, located at Hilo Medical Center, said the number of children she sees using screens has increased dramatically.
“I rarely see a child in (the) clinic without a screen,” she said. “… I started practicing 15-plus years ago. At that time, parents would pull out a book or toy and play with their child while they waited. Now I come, (and) parents are on the phone, and the kids are watching a video.”
Such use can have negative effects.
“The consequences that we see mostly in the really young children (are that) parents use screen time to calm them down or distract them when upset, instead of interacting (or) socializing with them,” Stuart said.
As a result, children don’t learn how to soothe themselves, and as an adult, “you need to calm yourself down and function when you’re upset,” she explained. “So these kids aren’t able to learn that because they’re automatically given a distraction.”
Extended screen time also can affect language and communication skills of young children.
“They tend to speak later, and they don’t communicate as effectively,” Stuart said. “So if a parent reads a book to a child, shows them the picture … the child has a chance to respond. If a parent hands a YouTube video to a child, there’s no interaction.”
One of the important elements of the guidelines is that instead of screen time, children should be playing, moving and using their imaginations, which is important for the younger-than-5 age group, she said.
“They have a lot of energy to burn, they need to develop coordination and learn how to play with other kids in a fair way, and mostly just the social interaction of play and running around is different from the interaction of sitting down and playing a video game.”
Stuart said she follows guidelines set forth by the American Academy of Pediatrics, which are similar to those issued by the WHO.
According to the WHO, which also issued guidelines for sleep:
• Screen time is not recommended for infants younger than 1 year old. They should have at least 30 minutes of physical activity, which includes at least 30 minutes of “tummy time” for infants not mobile.
• Children ages 1-2 should spend three hours doing a variety of physical activities at any intensity spread throughout the day, but more is better. Screen time is not recommended for 1-year-olds, and for children who are 2 screen time should be no more than one hour, although less is better.
• Children ages 3-4 should spend three hours doing a variety of physical activities. Screen time should be no more than an hour, but less is better.
With all children younger than 5, reading and storytelling with a caregiver is encouraged during sedentary times.
Likewise, the AAP, which offers a number of tips and suggestions for families regarding children and media, suggests parents should set limits on media use and make unplugged playtime a daily priority, especially for very young children. Unstructured and offline play stimulates creativity.
Parents should also co-view, co-play and co-engage with children when they’re using a screen because it encourages social interactions, bonding and learning, according to the AAP
The AAP also recommends avoiding digital media for toddlers younger than 18-24 months other than video chatting. Screen time should be limited to just one hour of high-quality programming for preschool children ages 2-5. Co-viewing is best when possible.
The state Department of Health’s guidelines and best practices regarding screen time for children also largely aligns with the WHO recommendations.
The DOH also recommends screen time not being allowed during meals or snack times, that media is always reviewed before children use it to ensure it is appropriate for their age and understanding, that media reinforces positive health behaviors and is free of advertising and brand placement, among other suggestions.
Exemptions for screen time apply to children with special health care needs who require assistive technology, the DOH said.
“Achieving health for all means doing what is best for health right from the beginning of people’s lives,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus in a news release. “Early childhood is a period of rapid development and a time when family lifestyle patterns can be adapted to boost health gains.”
However, according to the Associated Press, some groups have said WHO’s screen time guidelines failed to consider the potential benefits of digital media,
WHO’s screen time advice “overly focuses on quantity of screen time and fails to consider the content and context of use,” said Andrew Przybylski, director of research at the Oxford Internet Institute at the University of Oxford. “Not all screen time is created equal.”
WHO did not specifically detail the potential harm caused by too much screen time, but said the guidelines were needed to address the increasing amount of sedentary behavior in the general population, the Associated Press reported. It noted that physical inactivity is a leading risk factor for death and a contributor to the rise in obesity.
View the full WHO report and guidelines at bit.ly/WHOguidelines.
Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.
