Screens aren't the enemy in new WHO health guidelines for kids. Here's the new problem

SALT LAKE CITY — The World Health Organization is encouraging parents to rein in toddlers' screen time — but not for the reasons you might think.

Rather than saying screens are inherently problematic, the WHO report says any time spent in front of a screen is time not spent in "energetic play," a major deterrent to childhood obesity.

Across the globe, 41 million children under 5 are considered overweight or obese, while in the United States, 14 percent of preschoolers have unhealthy body weights, a jump from 5 percent in 1980.

That's why the WHO recently recommended more physical activity, better sleep and less sedentary time (read: screen time) for kids under 5.

"What we really need to do is bring back play for children," Dr. Juana Willumsen, WHO focal point for childhood obesity and physical activity, said in a WHO press release. "This is about making the shift from sedentary time to playtime while protecting sleep."

“What we really need to do is bring back play for children. This is about making the shift from sedentary time to playtime while protecting sleep.”

Dr. Juana Willumsen, WHO focal point for childhood obesity and physical activity

Some have argued the WHO report unfairly blames screens because it doesn't distinguish between types of screen use — is a child learning letters with Elmo, watching a violent cartoon or Skyping with grandma? (Which, by the way, most experts agree is OK at any age).

Others say setting specific screen limits may increase guilt among parents trying to raise young children in a tech-soaked environment.

The report, however, highlights the need to recognize the "synergistic effects" of sleep, activity and sedentary behavior on kids' health.

Scott G Winterton, Deseret News

Nina Sanchez looks at a National Geographic magazine at home on Wednesday, May 1, 2019. The World Health Organization recently recommended more physical activity, better sleep and less sedentary time for kids under 5, hoping to combat childhood obesity.

Less time on screens means more time for active play, and the more kids play, the more hungry and tired they'll be, leading to better eating and a better night's sleep, says Becky Hurst-Davis, clinical nutrition manager at Intermountain Primary Children's Hospital.

"It all ties into being a healthy family and learning healthy behaviors, which are best learned young," she said.

And when kids can learn good habits young, the WHO hopes they will continue those through adolescence and adulthood, reversing the trend of inadequate physical activity which leads to more than "5 million deaths globally each year across all age groups," according to the WHO.

Here's what you need to know about the recommendations:

Sedentary (screen) time

• Infants and 1 year olds: Screen time is not recommended.
• Children ages 2 to 4: "Sedentary screen time" should be no more than an hour, but less is better.
• For all ages: When kids are sedentary, reading books, playing games, doing puzzles, storytelling and interacting with caregivers is encouraged.
• The WHO recommends that all young children not be restrained for more than one hour at a time, whether in a stroller, high chair, car seat or worn on a caregiver's body.

These new guidelines echo the American Academy of Pediatrics' 2016 policy statement, "Media and Young Minds," which recommends "time limitations on digital media use for children 2 to 5 years to no more than 1 hour per day," leaving plenty of time for other healthy activities and a chance to develop "media viewing habits associated with lower risk of obesity later in life."

Scott G Winterton, Deseret News

Aaron Sanchez and his wife Emily Clifford spend time with their three kids, Nina Sanchez, Sloane Sanchez and Cruz Sanchez, at their home on Wednesday, May 1, 2019. The World Health Organization recently recommended more physical activity, better sleep and less sedentary time for kids under 5, hoping to combat childhood obesity, which impacts more than 41 million children ages 2 to 5 around the globe.

Alden and Heidi Thorpe have avoided the screen time battles by not having a TV, computer or tablet in their North Salt Lake home. She has a smartphone, he has a simple phone.

Most days, Heidi and son, 4, and daughter, 18 months, are at the park, on a walk or instigating playdates with other families — hoping to teach the kids the importance of getting outside and connecting with people in real life.

"That's the biggest thing that kids are missing when you just hand them a screen or turn on a show," Heidi says.

However, that doesn't mean screens have nothing to add to childhood.

After age 2, high-quality programming can help children learn foundational concepts like letters, numbers, colors and shapes, although social-emotional lessons still may require some adult explaining, says Marie-Louise Mares, a professor of communication arts at the University of Wisconsin-Madison who studies pro-social and educational outcomes in media.

In fact, screen time becomes most useful when adults extract the lesson and use it as a teaching moment later, perhaps during a toddler's meltdown in the grocery store.

"What does Daniel Tiger say when we feel so mad that we want to roar?" the parent might ask. "Take a deep breath ... and count to four."

“We need to make it clear to early childhood caregivers ... that their role is to be playing with the kid, talking with the kid, rather than sort of parking them in front of the TV.”

Marie-Louise Mares, a professor of communication arts at the University of Wisconsin-Madison

"Rather than expecting media to function all on its own, the media content can be kind of a useful tool for parents," says Mares.

This approach highlights a theme many experts encourage: parents should take an active role in choosing, managing and discussing their child's media use, rather than than falling into a "passive, babysitting model" of screen use in the early childhood years, says Mares.

"We need to make it clear to early childhood caregivers ... that their role is to be playing with the kid, talking with the kid, rather than sort of parking them in front of the TV," she says.

But for parents of young children who may want to shower or cook dinner, 20 minutes on the iPad is not the end of the world, says Jordan Shapiro, senior fellow for the Joan Ganz Cooney Center at Sesame Workshop and author of the new book, "The New Childhood: Raising Kids to Thrive in a Connected World."

Rather than obsessing about rigid rules, Shapiro encourages parents to consider themselves guides and mentors, helping kids develop their own "reflective voice" that prompts "moral reckoning" when using screens.

Parents can do that by labeling positive and negative behaviors in shows for younger kids (or turning off something inappropriate) and by asking open-ended questions of older kids.

"Screen time is just not optional anymore," he says. "It's such a part of our lives and the question is no longer how much screen time, but how to make sure the screen time is integrated in a holistic, healthy, moral, ethical way."

Physical activity

• Infants under 1: caregivers should engage with children in floor-based play; at least 30 minutes of tummy time spread throughout the day.
• Kids ages 1 to 2: 180 minutes of "energetic play" each day, more is better.
• Kids ages 3 to 4: 180 minutes of "energetic play," 60 minutes of that being moderate-to-vigorous play; again, more is better.

"It's not about enrolling your 3-year-old in gymnastics, but (encouraging) unstructured, energetic play time," says Dr. R. Neal Davis, a pediatrician and executive medical director of community-based care for Intermountain Primary Children's Hospital (no relation to Hurst-Davis). "Put on the dance music, chase them around the house. Those types of things, especially when it's relationship-based, are very, very valuable."

And maintain perspective and balance, Davis says. Yes, a three-hour car ride may go beyond the recommended sedentary time, but if it's a precursor to a family camping trip, "that sure seems like a good thing to do."

Scott G Winterton, Deseret News

Emily Clifford looks at a National Geographic magazine with two of her kids, Cruz Sanchez and Nina Sanchez, as they spend time at home on Wednesday, May 1, 2019. The World Health Organization recently recommended more physical activity, better sleep and less sedentary time for kids under 5.

Mallory Hughes, 31, isn't too worried about her 4-year-old son falling short of the physical activity benchmarks, as he's "moving non-stop," throughout the day, she says with a chuckle.

When the weather is nice, he and his 6-year-old brother are outside their Bountiful home, swinging in the backyard or jumping on the trampoline. When it's cooler, they're inside playing dress up, Legos or BeyBlades.

"When they stay in a sedentary position for too long, they have way more energy than they do have naturally," Hughes says. "But when they're constantly moving all day, hopefully they'll just crash before bed."

Sleep

• Newborns to 3 months: 14-17 hours of sleep
• Babies ages 4 to 11 months: 12-16 hours of good sleep, including naps
• Kids ages 1 to 2 years: 11-14 hours of good sleep, including naps, with regular sleep and wake-up times.
• Kids ages 3 to 4: 10-13 hours of good sleep, which may include a nap, with regular sleep and wake-up times.

Emily Clifford, 37, calls her family "pretty hard-core bed timers," because she knows how sleep impacts the amount of energy and even creativity displayed by her kids, ages 6, 4 and 2.

“I can tell when (the kids have) been watching too much TV, they get grumpy and we self-correct.”

Emily Clifford

The family aims for an 8 p.m. child bedtime, and tries to avoid media right before that, as the blue light from screens can interfere with sleep. (Because of that, experts strongly discourage televisions or other screens in children's bedrooms.) Instead of a show, the Clifford kids straighten up their bedrooms or play area, and read a few books with mom and dad.

Not only does a consistent bedtime routine mean good sleep and fewer attitudinal meltdowns from tired kids, says Clifford, who lives in Holladay, but it also means quality kid-free time for tired parents.

Recommendations like those from the WHO are helpful, says Clifford, but she finds the best guide is her kids themselves.

"I can tell when (the kids have) been watching too much TV, they get grumpy and we self-correct," she said. "Paying attention to my kids and how they're responding to things always gives me a better sense of where we need to rein things in and change."

from Deseret News http://bit.ly/2LlvtO5