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The importance of promoting ‘Active Play’ during COVID-19 Lockdown

17th June 2020

A Voices blog by Natasha James, a health visitor in Bristol, on championing the importance of promoting physical activity with families, especially during lockdown.

Natasha James, health visitor, Bristol

As a health visitor, I have always championed the importance of promoting physical activity with families.  During the COVID-19 ‘lockdown’, this is just as important if not more so.  A recent study in Verona, Italy, found that during the COVID-19 lockdown, for children, levels of activity reduced, screen time increased, and consumption of processed unhealthy food increased significantly (Pietrobelli et al. 2020).

Physical activity in the early years not only contributes to healthy weight but improves bone health, cognitive function, motor skill development, muscle fitness and mental health (Department of Health and Social Care 2019). Gross motor skill development plays an important role in the development of fine motor skills, including gaining the ability to write.  There is an increasing body of evidence supporting an association between activity levels in the early years and improved academic achievement (Department of Health and Social Care 2019, Carson et al. 2016).

Physical activity for the under 5s takes the form of ‘Active Play’.  Active play includes activities such as tummy time, crawling, running, jumping, dancing, role play games, throwing and climbing.   Active play is crucial for positive physical and emotional development and promotes positive social skills which lead to improvements in areas such as speech and language development (Public Health England 2014).  Research has also shown that infants who have 30 minutes a day or more of ‘tummy time’ are more likely to reach their motor development milestones at an earlier age (Carlson et al.2017).

However, statistics show that only 1 in 2 children aged 2 to 4 are achieving the recommended amount of physical activity a day (Public Health England 2018, National Statistics 2016). With 1 in 5 children already overweight or obese before they start school, these figures are concerning (National Statistics 2018).

There is also social gradient for activity levels, with children living in areas of high deprivation being less likely to have exposure to home and community environments that are conducive to active play than those living in areas of low deprivation (Noonan and Fairclough 2018, Department of Health 2011).

Promoting activity in the early years is something I feel very passionate about in view of the long-term benefits for child development and health.  The early years high impact area 4 states that, as Health Visitors, we should be promoting physical activity at all mandated visits.  This is something that I talk about with all families. Initially, I often discuss it alongside discussions around early communication and interaction.

Some parents may struggle to think of activities to do with their children.  ‘Play’ can mean different things to different people depending on their own experiences of play as a child.  For example, ‘water play’ is very different to ‘playing’ a computer game. Therefore, some parents may struggle to think of activities they can do with their children at home.

I have listed some resources that I have found really helpful and that parents can be signposted to:

I hope I have inspired you to talk more to families about the importance of active play.  I am doing a piece of research which will be starting this autumn time.  The research will explore the barriers to physical activity for 2 to 4 year olds living in areas of high deprivation.  I hope to be able to share the findings of this in the future.

Natasha James – Health Visitor – Bristol


Carson, V.  Lee, EY.  Hewitt, L.  Jennings, C.  Hunter, S.  Kuzik, N.  Stearns, J.  Powley Unrau, S.  Poitras, V.  Gray, C.  Adame, K.  Janssen, I.  Okely, A.  Spence, J.  Timmons, B.  Sampson, M.  Tremblay, M.  (2017) Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years).  BMC Public Health17(suppl5): 854

Carson, V.  Hunter, S.  Kuzik, N.  Wiebe, S.  Spence, J.  Friedman, A.  Tremblay, M.  Slater, L.  Hinkley, T.  (2016) Systematic review of physical activity and cognitive development in early childhood.  Journal of Science and Medicine in Sport19 pp 573-578.

Department of Health and Social Care.  (2019) UK Chief Medical Officers’ Physical Activity Guidelines.  London:  Department of Health and Social Care.

Department of Health.  (2011) Start Active, Stay Active, A report on the physical activity for health from the four home countries chief medical officers [Online].  London:  Department of Health.  Available from: [Accessed 31 January 2019].

National Statistics.  (2018) Health Survey for England 2017 Adult and Child overweight and Obesity [Online].  London:  NHS Digital.  Available from: [Accessed 7th November 2019].

National Statistics.  (2016) Health Survey for England 2015 Physical Activity in Children [Online].  London:  NHS Digital.  Available from: [Accessed 7 November 2019]

Noonan, R.  Fairclough, S.  (2018) Is there a deprivation and maternal education gradient to child obesity and moderate-to vigorous physical activity?  Findings from the Millenium Cohort Study.  Paediatric Obesity.  (13) pp 458-464.

Pietrobelli, A.  Pecoraro, L.  Ferruzzi, A.  Heo, M.  Faith, M.  Zoller, T.  Antoniazzi, F.  Piacentini, G.  Feranbach, N.  Heymsfield, S.  (2020) Effects of Covid-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy:  A Longitudinal Study.  Obesity, doi:10/1002/oby.22861.

Public Health England.  (2018) Early years high impact area 4:  Healthy weight, healthy nutrition.  Health Visitors leading to the Healthy Child Programme [Online].  London.  PHE Publications.  Available from:  [Accessed 20 May 2019].


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