Children under five must spend less time sitting watching screens, or restrained in prams and seats, get better quality sleep and have more time for active play if they are to grow up healthy, according to new guidelines issued by the World Health Organisation (WHO).

Failure to meet current physical activity recommendations is responsible for more than 5 million deaths globally each year across all age groups. Currently, over 23% of adults and 80% of adolescents are not sufficiently physically active. If healthy physical activity, sedentary behaviour and sleep habits are established early in life, this helps shape habits through childhood, adolescence and into adulthood.

Applying the recommendations in these guidelines during the first five years of life will contribute to children's motor and cognitive development and lifelong health.

Recommendations at a glance

Infants (less than 1 year) should:

• Be physically active several times a day in a variety of ways, particularly through interactive floor-based play. For those not yet mobile, this includes at least 30 minutes in prone position (tummy time) spread throughout the day while awake.

• Not be 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.

• Not be restrained for more than 1 hour at a time 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.

• Not be restrained for more than 1 hour at a time 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.