GROW WELL SG TO SUPPORT FAMILIES IN BUILDING HEALTHY HABITS IN CHILDREN

The Ministry of Health (MOH), Ministry of Education (MOE) and Ministry of Social and Family Development (MSF) have jointly launched Grow Well SG, a new national health promotion strategy to enhance preventive care and inculcate healthier lifestyles in children and adolescents. The multi-ministry strategy is aimed at holistically addressing children’s health and well-being in the digital age.

2.  While most children in Singapore are in good health, they face health risks from sedentary lifestyles with excessive screen time, insufficient physical activity, poor nutrition and inadequate sleep. Addressing these factors will help to reduce the risk of poor health and development in children, and build habits that enable better health later in life.

3.    Grow Well SG empowers families, with support from preschools and schools, healthcare institutions and the community, to build healthy habits in children which can continue through to adulthood, bringing long-term health benefits. Grow Well SG builds on the ministries’ various efforts over the years, including the Child and Maternal Health & Well-being Action Plan which enhances support for children and mothers. The strategy will focus on children up to 12 years old for a start, and will be extended to older age groups subsequently.

4.  Local cohort studies such as Growing Up in Singapore Towards Healthy Outcomes (GUSTO) and Singapore Longitudinal Early Development Study (SG LEADS) have shown that helping children establish healthy lifestyle habits from young will lead to better health outcomes as they grow up. Informed by these studies, Grow Well SG emphasises early intervention in four key areas:

A. Eat Well - Fuel for growth and learning. Good nutrition can support growth and enhance overall health and development.

B. Sleep Well - Rest for success. Healthy sleeping routines can improve concentration, mood and physical development.  

C. Learn Well - Engage in diverse learning experiences for holistic development. Excessive screen use and unrestricted access to digital technology may hinder our children’s learning and affect their mental well-being.

D. Exercise Well - Active bodies, active minds. Regular physical activity can strengthen bodies, sharpen minds and boost self-esteem.

5.     These four areas lay the foundation for healthy habits from a young age, paving the way for a better future for our children. An equally important area is “Bond Well”, the cultivation of strong relationships within the family and social connections with friends. Bonding well supports and reinforces healthy lifestyles, and contributes to a child’s overall well-being.

6.    Grow Well SG will help our children develop good health through three initiatives:

               I.  Purposeful screen use;

             II.   A Health Plan for every child; and

            III.   Enhanced support for schools.

I.               Purposeful Screen Use

7.     Screen use and digital technology have transformed our children’s environment and reshaped their daily routines, influencing how they play, learn and interact with others. Research indicates a strong association between screen use and cognitive development in infants and toddlers, with inappropriate and excessive screen use leading to poorer language skills and shorter attention spans. For older children, screen use displaces other activities, such as sleep, physical activity and interactions with friends, and is associated with increased obesity and poorer mental health and well-being.

8.   Grow Well SG will take a whole-of-government approach to help families and children reinforce good screen use habits, providing clearer and more actionable guidance, and adjusting practices at preschools and schools.

Clearer and more actionable guidance on screen use

9.    MOH has updated its Guidance on Screen Use in Children aged 0 to 12 years old to provide stronger advice for parents on screen use practices in children. The key changes include limiting screen use to less than one hour a day outside of school for children aged three to six years, and less than two hours a day for children aged between seven and 12 years, unless related to schoolwork. Parents should not give their children unrestricted access to mobile devices, or any access to social media services.

10.   A summary guidance for parents has been included in the advisory to help parents better understand why the recommendations are important and how they can impact their child’s health. The updated advisory can be found on MOH’s website.

Adjusting practices at preschools and schools

11.    At preschools, the Early Childhood Development Agency (ECDA) will adjust its Code of Practice to ensure appropriate management of screen use in preschools. This includes specifying that there shall be no screen use for infants up to 18 months, and that screens shall only be used for teaching and learning purposes for children aged 18 months to six years. The revised Code of Practice will take effect from 1 February 2025. In ECDA’s revised Early Years Development Framework (EYDF) Educators’ Guide, educators will also be guided to provide meaningful experiences instead of sedentary activities such as screen time and other activities involving prolonged periods of sitting down. This will be incorporated in the Educators’ Guide by March 2025. 

12.    MOE has provided more detailed guidelines on managing students’ use of smartphones and smartwatches in primary and secondary schools. School rules and routines on the management of these devices during curriculum hours are tailored according to school profile, context and curriculum efforts. Examples of school rules and routines include^[1]:

·  Dedicated handphone storage spaces at designated areas for students to deposit their phones before the start of lessons; and

·  Using of mobile devices only in designated areas at appropriate times (e.g. during recess and after school).

13.   To equip parents and caregivers with the skills and knowledge to guide their children’s online interactions and support their digital well-being, the Infocomm Media Development Authority (IMDA) offers an array of bite-sized resources on the Digital for Life (DfL) portal. These resources cover topics such as managing children’s screen use, and safeguarding children from online risks such as cyberbullying and sexual grooming. Some of these resources are also made available at the Families for Life parenting portal.

14.   The above measures will support families in building a balanced and healthy relationship with technology and screens in their children's daily lives.

II.             A Health Plan for Every Child ​

15.          MOH will enhance support to families to help them be more aware of and adopt the key healthy behaviours from birth to the schooling years.

Personalised Health Plans

16.          From 2025, MOH will introduce personalised Health Plans for children in Primary 1 to 3. The Health Promotion Board (HPB) will guide each child to consider key health behaviours as part of its annual School Health Screening programme. Every child will receive a Health Plan that consists of a lifestyle prescription, school health screening results, vaccination reports, and referrals to public healthcare institutions when necessary. The key features of the Health Plan include:

       i.         Pre-screening: A Lifestyle Questionnaire for parents to complete at the beginning of the school year, providing insights into their child’s current habits.

     ii.         During screening: Healthcare personnel will engage with each student on adopting potential lifestyle changes based on their habits, health status and interests, focusing on areas identified for improvement from the Lifestyle Questionnaire. This information will form the lifestyle prescription within the Health Plan.

    iii.         Post-screening access and support: Parents can view their child’s Health Plan and lifestyle prescriptions via HealthHub. Additional resources, practical strategies and links to healthy lifestyle programmes can be accessed through the Parent Hub website and HPB’s Healthy 365 application. Later this year, parents will be able to create a profile page for each child on Healthy 365 and receive personalised recommendations on building healthy habits.

    iv.         Action-oriented approach: The Health Plan includes actionable steps and resources for children and families to build healthy habits at home, complemented by support measures in school.

17.          MOH is studying the progressive rollout of the Health Plan to children of other age groups and more details will be released when ready.

Childhood Health Behaviours Checklist

18.          MOH is introducing a new Childhood Health Behaviours Checklist to be used as part of the Childhood Development Screenings (CDS). CDS are conducted as part of routine preventive care for younger children, with the aim of identifying children at risk of developmental delay who may require early intervention. There are seven recommended CDS visits that should be completed in the first six years of life.

19.          The new Childhood Health Behaviours Checklist provides parents with guiding questions on health behaviours, to be completed prior to or during each CDS visit. This will help to raise and sustain parents’ awareness of healthy behaviours that children should adopt from an early age. It also provides a common and systematic base of questions for their doctor or nurse to consistently review critical health behaviours with families, and guide them to better health. More details will be released in the next few months.

20.          A strong parent-child relationship enables parents to build and sustain healthy habits in their children. Additional resources for parents will be made available. For example, the Parenting for Wellness website on Parent Hub enables parents to conveniently access personalised tips and strategies to build strong relationships with their child and support their mental well-being.

21.          We will work with the Families for Life Council, healthcare and community partners to deepen the impact of Grow Well SG.

III.            Enhanced Support for Schools

22.          MOH and MOE are taking a data-driven approach to improve student health. All primary schools will have a comprehensive Student Health Status Card which includes lifestyle data for their student population. This will complement schools’ current efforts to identify the health needs and interventions required for their students, and educate them on appropriate healthy behaviours.

23.          Recognising that consuming well-balanced meals from a young age is crucial for good health and optimal development, we are enhancing nutritional support in schools. This includes ensuring children have access to healthier food options, including those that are higher in whole grains, lower in sodium, and with adequate amounts of fruits and vegetables.

24.          In 2022, HPB updated its Healthy Meals in Schools Programme guidelines to reflect the latest nutritional recommendations for sodium and Nutri-Grade for sugar-sweetened beverages. In addition to providing training and healthier recipes to support the canteen vendors in providing healthy meals, HPB will step up efforts in helping canteen vendors purchase lower cost healthier ingredients directly from manufacturers participating in HPB’s Healthier Ingredients Development Scheme.

25.          MOH and MOE are also exploring partnerships with the healthcare clusters to provide additional support to schools, such as working with canteen vendors to make healthier food options more appealing, and expand their range of healthy recipes. Through these comprehensive measures, we aim to create an environment in schools to positively influence children’s dietary habits and support their health and development.

A Whole-of-Society Approach to Child Health

26.          Ultimately, a whole-of-Singapore effort is required to create supportive environments where our children can thrive and sustain healthy living habits. Grow Well SG will work hand-in-hand with families, educators, healthcare professionals and community partners to nurture a generation of children who are active, sociable, well-nourished and rested, and capable of engaging with technology in healthy and productive ways. The full details of Grow Well SG are available on go.gov.sg/growwellsg.

MINISTRY OF HEALTH

MINISTRY OF EDUCATION

MINISTRY OF SOCIAL AND FAMILY DEVELOPMENT

21 JANUARY 2025

^[1] The guidelines include good practices that are already in place in some schools.