Adherence to Canadian 24-Hour Movement Guidelines among infants and associations with development: a longitudinal study

Abstract

Background To examine: 1) longitudinal adherence to the Canadian 24-Hour Movement Guidelines in a sample of infants and 2) associations between adherence to the guidelines over time and development. Methods Participants were 250 parent-infant dyads from the Early Movers project in Edmonton, Alberta. At 2, 4, and 6 months of age, physical activity, sedentary behaviour, sleep, and development were measured with a parental questionnaire that included items from the Ages & Stages Questionnaire (ASQ-3). Parents also reported the dates six major gross motor milestones were acquired during the first 18 months of life according to World Health Organization criteria. In a sub-sample (n = 93), movement behaviours were also measured with a time-use diary at 2, 4, and 6 months and gross motor development was measured by a physiotherapist using the Alberta Infant Motor Scale (AIMS) at 6 months. Guideline adherence was defined as: 1) ≥ 30 min/day of tummy time, 2) no screen time, some reading time, no restrained bouts > 1 h (time-use diary only), and 3) 14–17 h (2 months) or 12–16 h (4 and 6 months) of sleep per 24-h period. Generalized estimating equations were conducted as well as linear mixed models and linear regression models that adjusted for demographic characteristics. Results Few infants met the guidelines at all time-points (questionnaire: 2%; time-use diary: 0%). Infants that met a recommendation at 2 months, compared to those that did not, were 1.8–8.2 times more likely to meet that recommendation at subsequent time-points. Meeting more recommendations across time-points, according to both measures, was associated with a higher mean ASQ-3 gross motor score. Each additional time-point of tummy time recommendation adherence (questionnaire-measured) was associated with a 5–11-day earlier acquisition of independent sitting, crawling, and independent standing milestones. In the sub-sample, each additional time-point of guideline adherence was associated with a 16% higher AIMS score at 6 months. Conclusions Guideline adherence was low across the first 6 months of infancy. Overall, meeting more recommendations over this period appeared important for gross motor development. Parents and caregivers should be targeted as early as possible with guideline dissemination and activation strategies to promote healthy infant development.

Adherence to 24-hour integrated activity guidelines among infants, toddlers and preschool children in Singapore

“…Similarly, in a study involving Canadian infants, the percentages meeting all three guidelines were 12.4%, 18.0%, and 27.6% at 2 months, 4 months, and 6 months of age, respectively [ 29 ]. It is noteworthy that the primary distinction between our study and the previously mentioned studies was the notably higher compliance with the recommendation of zero screen time, which was approximately 83% in our sample, in contrast to the lower percentages reported in Australian infants (27.9% at age 3.6 months) [ 28 ] and Canadian infants (37.2% at age 6 months) [ 29 ]. In this study, infants were found to have a daily screen time exposure ranging from a median of 0.5 to 1 hour around the age of 6 months.…”

“…For instance, in a study involving Australian infants with an average age of 3.6 months, only 4% met all the overall guidelines, which included the addition of meeting infant restraint guidelines [28]. Similarly, in a study involving Canadian infants, the percentages meeting all three guidelines were 12.4%, 18.0%, and 27.6% at 2 months, 4 months, and 6 months of age, respectively [29]. It is noteworthy that the primary distinction between our study and the previously mentioned studies was the notably higher compliance with the recommendation of zero screen time, which was approximately 83% in our sample, in contrast to the lower percentages reported in Australian infants (27.9% at age 3.6 months) [28] and Canadian infants (37.2% at age 6 months) [29].…”

Leveraging nursery and early childhood education institutions for improving feeding and movement behaviours of infants and young children in China

“…Movement behaviours, including tummy time, physical activity, sedentary behaviour and sleep, are crucial for healthy development during early childhood [ 13 , 14 ]. A study in Canada showed that each additional time point of tummy time recommendation adherence was associated with five to 11 days earlier acquisition of independent sitting, crawling, and independent standing milestones [ 15 ]. However, compliance with the WHO movement behaviours guidelines remains quite low among children under two years old.…”

“…However, compliance with the WHO movement behaviours guidelines remains quite low among children under two years old. Only 30% of children met the WHO’s recommendations for tummy time (30% in the UK, 29.7% in Australia) [ 15 , 16 ], and more than half of children complied with guidelines regarding sedentary behaviour and sleep duration (57.8% and 76.2% in the UK, and 56.9% and 58.7% in Australia) [ 15 , 16 ]. As in China, limited data exists on movement behaviour practices among infants and young children.…”

Suboptimal status of tummy time for infants in early childhood education institutions in urban China: A cross-sectional study

“…Studies conducted in UK and Australia found that half of parents started tummy time until four weeks after birth and no more than one-third of infants met the recommended 30 minutes of tummy time [ 7 , 8 ]. In addition, younger infants tend to exhibit a lower preference for engaging in tummy time activities, often displaying crying, rolling or squirming [ 9 , 11 ]. However, little is known regarding tummy time practices among infants in China and other Asian countries.…”