Children raising hands

Healthy Activity, Screen Time, and Sleep in the Early Years

Young children should spend most of the day being active, not sitting or watching television. During nap times, children need peaceful and television-free places to sleep, both in the child care setting and at home.

Here is a summary of early child care activity, screen time, and sleep recommendations for obesity prevention, based on a review of expert guidance from the American Academy of Pediatrics, the National Resource Center for Health and Safety in Child Care and Early Education, the Institute of Medicine, and others. Though these recommendations are written for child care providers, parents can follow these same guidelines at home. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source listand the links to other resources.

Encourage daily physical activity among children in child care

  • Offer at least two to three outdoor opportunities for daily active play, weather permitting (1,2,3)
  • Remove barriers to outdoor play, for example, by keeping a change of clothes at the center and providing shade (1,2,3)
  • Ensure that restricted playtime (for example, limiting outdoor play) is never used as a punishment for children who misbehave (1,2,3)
  • Provide child care staff with ongoing training on age-appropriate activities (1,2,3)
  • Maintain a written policy on promoting physical activity and share these policies with parents (1,2,3)
Facilitate age-appropriate activity in short, regular bursts throughout the day

  • Give infants supervised time in the prone position (“tummy time”) every day (1,2,3)
  • Limit the time that infants spend in restricted seating (swings, strollers, exersaucers, high chairs) (1,2,3)
  • Give toddlers 60 to 90 minutes per 8-hour day for vigorous physical activities (activities that get them breathing deeper and faster than typical activities), spread out in short, regular bursts throughout the day (1,2,3)
  • Give preschool-age children 90 to 120 minutes per 8-hour day for vigorous physical activities (activities that get them breathing deeper and faster than typical activities), spread out in short, regular bursts throughout the day (1,2,3)
Model active play

  • Lead at least two structured games or activities that require movement each day, such as Simon Says (1,2,3)
  • Encourage children through positive words, such as “Nice catch!” (1,2,3)
  • Energetically participate in indoor and outdoor play throughout the day (1,2,3)
  • Reduce barriers to adult caretakers being active with children (for example, make sure caretakers wear appropriate shoes, and remove outdoor seating for adults) (1,2,3)
Minimize television/screen time and sedentary time

  • Keep screen media turned off at all times around children under the age of 2 (1,2,3)
  • Limit any media viewing (television, cell phone, or digital media) in the child care setting to no more than 30 minutes per week for children age 2 and older, since many children are already exposed to excessive levels of screen time in their homes (1,2,3)
  • Ensure that children of all ages are not sitting longer than 15- to 30-minute intervals, unless during meals or naptime (1,2,3)
 Support healthy sleeping habits

  • Remove any screen media from children’s sleeping areas (3)
  • Maintain calming naptime routines such as reading a book (3)
  • Put infants to sleep while they are drowsy but still awake, so that they can learn to fall asleep without assistance (3)

Healthy Activity, Screen Time, and Sleep—Source List

1. American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education. Preventing Childhood Obesity in Early Care and Education: Selected Standards from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs3rd EditionOpens in New Window; 2010.

2. National Resource Center for Health and Safety in Child Care and Early Education, University of Colorado Denver. National Resource Center for Health and Safety in Child Care and Early Education: Achieving a State of Healthy Weight: A National Assessment of Obesity Prevention Terminology in Child Care Regulations 2010Opens in New Window. Aurora, CO; 2011.

3. Institute of Medicine (IOM).  Early Childhood Obesity Prevention PoliciesOpens in New Window. Washington, DC: The National Academies Press; 2011.

4. Position of the American Dietetic Association: Benchmarks for Nutrition in Child Care. J Am Diet AssocOpens in New Window2011;111:607-615.

Terms of Use

The aim of the Harvard School of Public Health Obesity Prevention Source Web site is to provide timely information about obesity’s global causes, consequences, prevention, and control, for the public, health and public health practitioners, business and community leaders, and policymakers. The contents of this Web site are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Web site. The Web site’s obesity prevention policy recommendations are based primarily on a review of U.S. expert guidance, unless otherwise indicated; in other countries, different policy approaches may be needed to achieve improvements in food and physical activity environments, so that healthy choices are easy choices, for all.

Terms of Use

The aim of the Harvard School of Public Health Obesity Prevention Source Web site is to provide timely information about obesity’s global causes, consequences, prevention, and control, for the public, health and public health practitioners, business and community leaders, and policymakers. The contents of this Web site are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Web site. The Web site’s obesity prevention policy recommendations are based primarily on a review of U.S. expert guidance, unless otherwise indicated; in other countries, different policy approaches may be needed to achieve improvements in food and physical activity environments, so that healthy choices are easy choices, for all.