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KKH unveils 24-hour activity guidelines for infants, toddlers and pre-schoolers

To avoid promoting sedentary behaviour in their children, parents should not develop a habit of watching TV with their young babies, or leaving them unattended for more than an hour at a time, if they want their offspring to adopt habits that will give them better health as adults.

These are among the recommendations found in Singapore's first set of integrated 24-hour activity guidelines for early childhood that was launched today.

The guidelines standardise advice in four main areas - physical activity, sedentary behaviour, sleep, as well as diet and eating habits - for young children, within a 24-hour period.

They may be advice that some people are aware of, but as Dr Koh Poh Koon, Senior Minister of State at the Ministry of Health pointed out at the virtual launch of the guidelines, a recent survey done by KK Women's and Children's Hospital (KKH) showed that many parents are not aware of the impact of physical activity and screen time on their children.

Half of the parents, who claimed to know the existing guidelines, were unable to articulate them correctly.

Two in five infants spend an average of one hour on screen time a day while four in five toddlers spend an average of 30 minutes, he said.

"For these two age groups, screen time is not recommended, and should be kept to a minimum," said Dr Koh.

KKH also found, after surveying 340 parents and caregivers in September to October last year, that some babies had not been sleeping enough right from the day they were born. Thirty-five per cent of infants in the first three months of life slept an average of 8 to 11 hours a day, instead of the recommendation of at least 14 hours.

When it came to pre-schoolers, excessive screen time was an issue, as 95 per cent of them had an average of two hours of recreational screen time a day on weekends, when the advice is to keep it to below an hour a day.

Most of the respondents are mothers (80 per cent) and had a university education (63 per cent).

Dr Koh said a child's health in early childhood has a lasting impact on health and well-being later in life. For instance, obesity in childhood predisposes the child to adult obesity and chronic conditions like diabetes and high blood pressure.

"A fat child can become a fat adult, that adage is true," he noted. It is thus essential to adopt healthy lifestyle habits from young.

Dr Benny Loo, a consultant at KKH's general paediatrics service and sport and medicine service, acknowledged the child-minding challenges that parents have, particularly in this pandemic.

Dr Loo, who is also chairman of the guidelines' workgroup, said the key is in integrating the various advice as much as possible for the best results.

For instance, in a day, an infant aged four to 11 months should have at least 30 minutes of tummy time, zero screen time, and 12 to 15 hours of sleep.

He or she should also not be restrained or left unattended for more than an hour at a time.

The set of guidelines was developed by the KKH-led Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children. It is one of the main programmes by the SingHealth Duke-NUS Maternal and Child Health Research Institute.

The recommendations go beyond the existing national activity guidelines for children aged below seven, which were released in 2013 by the Health Promotion Board.

A summary of the integrated 24-hour activity guidelines for early childhood can be found at bit.ly/33U8Bz4

Earlier in the year, the integrated platform launched the 24-hour activity guidelines for older children and teenagers aged 7 to 18.

HEALTH AND WELLBEINGKK Women's and Children's HospitalbabiesCHILDREN AND YOUTH