RCPCH responds to WHO physical activity guidelines

New guidelines from the World Health Organisation (WHO) for children under 5 are “useful benchmarks” but require cautious interpretation, says RCPCH's Dr Max Davie.

According to new guidelines from the World Health Organization (WHO), children under five must spend less time sitting watching screens or restrained in prams and seats if they are to grow up healthy. WHO also advise they get better quality sleep and have more time for active play.

In response to the guidelines on physical activity for children under 5, Dr Max Davie, Officer for Health Improvement for the Royal College of Paediatrics and Child Health (RCPCH) says:

We welcome the WHO's focus on these important health issues and hope that this attention can lead to more research and interventions to help children and families live healthy lives.

However, recommendations alone can have a number of unintended consequences, and simply proposing standards without providing the right support could discourage families rather than motivate.

While it is important for children to be as active as possible, the barriers are more frequently to do with housing, work patterns, family stress, and lack of access to play spaces rather than actively choosing to be sedentary.

Likewise, the restricted screen time limits suggested by the WHO do not seem proportionate to the potential harm. Our research has shown that currently there is not strong enough evidence to support the setting of screen time limits, and that screen use should be considered alongside a range of activities to assess its impact. Also, it is difficult to see how a household with mixed-age children can shield a baby from any screen exposure at all, as is recommended. 

Similarly, comparing an individual child’s sleep to the quantities recommended by the WHO should be done with caution. All children have unique needs – some sleep relatively little with no ill effects while others need much more. Individual assessment is paramount.

Overall, these WHO guidelines serve as useful benchmarks to help steer families towards active and healthy lifestyles, but without the right support in place, striving for the perfect could become the enemy of the good.