Let’s all move

Let’s all move
Let's all move

Early childhood is a key time to create supportive environments and practices that promote healthy behaviours in young children. While the benefits of promoting healthy food and movement behaviours are realised in the short-term (e.g. health – developing motor skills, building strong bones, achieving/maintaining adequate growth; skills relating to social interaction, communication, and thinking), they also track into later childhood and indeed adulthood. This is acknowledged in Government policies also, including First 5. Early Learning and Care (ELC) services play an important role in the education, care and development of young children, alongside parents and families and practitioners.

We often hear and think about the importance of what, how and when to feed infants and young children. This is covered by the Child Care Act 1991 (Early Years Services) Regulations 2016 and Early Years Quality and Regulatory Framework which require that adequate and suitable, nutritious and varied food and drink are available for each pre-school child attending the service. Food and drink must also be in line with the national healthy eating guidelines for 1-4-year-olds and settings are required to have healthy eating policies. What perhaps receives less attention more generally is ‘movement behaviours’, a relatively new term in public health/health promotion, which refers to physical activity, sedentary behaviour, and sleep. Each of these behaviours has independent effects on health, but they also interact with each other.

In 2019,  the World Health Organisation released guidelines on 24-hour movement behaviours for children under five years of age. These set out the amount of time that infants and children (aged 1-2 years, and 3-4 years) should spend being physically active, sedentary, and asleep in a 24-hour period; see Table below. While we don’t yet have Irish data on movement behaviours (including screen-time) in very young children, research from Australia, Canada and New Zealand has found that few children meet the movement guidelines, for physical activity, sedentary behaviour or sleep – overall and/or for individual behaviours[1],[2],[3],[4],[5].

Table: WHO 24-hour movement behaviours for children <5 years of age

Child age Physical activity Sedentary behaviour Sleep
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 the prone position (tummy time) spread throughout the day while awake. Not being 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.

 

Given the amount of time that young children can spend in ELC services, it is important that they have opportunities to be physically active, sleep, and limit the time they spend sedentary. The Child Care Act 1991 (Early Years Services) Regulations 2016 and Early Years Quality and Regulatory Framework support the provision of adequate and suitable facilities for a pre-school child to rest during the day/night, and to play indoors and outdoors during the day. While ELC services can do well in providing opportunities for very young children to be active, areas that can receive less attention include the time children spend in highchairs/equipment which restricts their movement. For example, a study conducted in Australia, Canada and the US found that early years centres were most compliant (74%–95%) with recommendations to provide daily indoor opportunities for infants to move freely under adult supervision, daily tummy time for infants less than 6 months of age, indoor and outdoor recreation areas that encourage infants to be physically active, and discourage screen time. Centres were least compliant (38%-41%) with meeting recommendations to limit the use of equipment that restricts an infant’s movement and provide education about physical activity to families.

Play is a child’s right. Good indoor and outdoor environments in early childhood settings can support play, and the range of associated benefits, for children. This requires all of us to work together to achieve this, and also the provision of resources to support ELC services, including financial and human resources, to fully implement national guidelines.

Some useful resources to support practitioners include:

Bio

Marita Hennessy holds a BSc in Nutrition, a Diploma in Youth & Community Work, a Master’s in Health Promotion and a PhD in Arts Humanities and Social Sciences. Her PhD thesis focused on early life interventions to promote healthy growth in children, particularly those delivered by health professionals/within routine care (funded by the Health Research Board SPHeRE Programme). Marita is currently a Postdoctoral Researcher within the Irish Centre for Maternal and Child Health Research at University College Cork. 

[1] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4856-9

[2] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4857-8

[3] https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4855-x

[4] https://www.nature.com/articles/s41366-019-0432-y

[5] https://doi.org/10.1016/j.infbeh.2017.11.008

 

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