Moving, Sleeping and Keeping Clean

You use energy whenever you move your body. This is called physical activity. It includes biking, dancing, swimming, walking and active chores. You can be active without joining a team.

Your body gets to work

Imagine running across a playground. Your leg muscles work harder and need more oxygen and energy. Your heart beats faster to send them more blood. You breathe faster and deeper to take in more air. You feel warmer, and you may sweat. Sweat helps cool your body.

As you slow down and rest, your heartbeat and breathing slow too. Faster breathing during hard play is an ordinary sign of effort.

Moving helps you grow strong

Your heart is a muscle. Active play gives it a workout. With regular activity, everyday jobs such as climbing stairs can feel easier.

Different movements help your body in different ways:

• Climbing, pushing and pulling make your muscles work hard.
• Running, hopping and jumping help strengthen your bones. Your bones carry your weight as you move and land.
• Activity that makes you breathe harder gives your heart and lungs a workout.

One game can help more than one part of your body. Jumping rope, for example, makes you breathe harder and helps build strong bones.

Your mind benefits too

Moving can help you feel happier and calmer. It can also help you pay attention and fall asleep at night. A movement break after sitting at a desk can help you feel ready to learn again.

Rosa says, "I'm not active because I don't play a sport." Think about her day. She dances before school, climbs at recess and helps rake leaves. Each activity uses energy, so each is physical activity.

Fuel and water

Food gives your body energy for play. Water replaces water you lose, including through sweat. Drink before, during and after active play, especially when it is hot. Take a water bottle so a drink is easy to reach.

Aim for at least 60 minutes of moderate or vigorous activity every day. This is the US guideline for children your age. The World Health Organization gives a similar goal: an average of at least 60 minutes daily across the week.

Check your effort

The talk test helps you tell how hard you are working. Use your breathing, not just the name of the game.

A bike ride might be easy on one day and hard on another. A brisk walk can be moderate. A slow stroll is light movement. Light movement is useful, but the 60-minute goal calls for moderate or vigorous effort.

Short chunks count

You do not have to be active for one whole hour at once. Add up active time from different parts of your day.

Ben walks briskly for 20 minutes, plays a running game for 15 minutes and swims hard for 20 minutes. He adds 20 + 15 = 35, then 35 + 20 = 55 minutes. He needs 5 more minutes to reach 60. A five-minute lively dance would bring his total to 60.

Count the time you spend moving at the right effort. Sitting beside the pool waiting for your turn is not swimming time.

Build a varied week

Most of your active minutes should make you breathe harder. During the week, also include:

• Vigorous activity on at least 3 days, such as fast running games.
• Muscle-strengthening activity on at least 3 days, such as climbing or tug-of-war.
• Bone-strengthening activity on at least 3 days, such as hopping or jumping.

These days can overlap. A lively jumping-rope game can be vigorous and strengthen bones on the same day.

Choose activities you enjoy. You do not have to be the fastest runner for movement to help you. If you are not very active yet, begin with what you can do. Add a few more active minutes each week as you work toward the daily goal.

Good activity habits begin before a game and continue after it. They help you move safely and avoid spending too long sitting still.

Begin and end gently

A warm-up is a few minutes of easy movement before harder play. March, jog slowly or make arm circles. Your muscles warm up, and your heartbeat rises gradually.

After hard play, cool down with slower movement. Walk for a few minutes as your heart and breathing slow. Stretch gently if you stretch. Hold a comfortable pull without bouncing or pushing into pain.

Choose safe play

Wear a helmet for biking, scootering or skateboarding. Choose shoes that fit the activity, and follow the game's rules. Bring water and take drinking breaks. Choose games everyone can join, and adapt them so friends can take part.

Hard play can leave you out of breath. But sharp pain, chest pain, dizziness, injury or trouble breathing mean stop and tell an adult right away.

Break up sitting time

Being sedentary means spending waking time sitting or lying with little movement. Homework, car rides and shows can create long sitting spells. Even after a sports practice, you still need to break up later sitting.

A break can fit between things you already do. Stand and stretch after a homework task. Walk around after a chapter of reading. Put on music and move between shows.

Cal finishes a long puzzle, then starts a movie. He has been sitting for 40 minutes already. Before the movie, he gets up to put the puzzle away and stretches. During a movie break, he walks around again. The breaks interrupt sitting; his active play later still has its own place in the day.

With an adult's permission, a short trip might become a walk or bike ride. Helping carry groceries or tidy toys adds movement too. Look for small chances to get up as well as time for harder play.

Sleep helps your body grow and repair itself. Your brain sorts and saves what you learned during the day. Sleep also helps your body fight germs.

Notice how sleep helps

After enough sleep, it is easier to listen, learn and solve problems. You may find it easier to stay calm when a game goes wrong. Sleep helps you play sports and pay attention too.

Too little sleep can show up in different ways. You might yawn in class, struggle to wake up or feel grumpy. You may have trouble following instructions or make more mistakes. Some tired children become extra wiggly instead of looking sleepy.

Leave enough hours

US sleep experts recommend 9 to 12 hours of sleep each night for ages 6 to 12. Some other countries give a range of 9 to 11 hours. About 10 hours is a useful example for planning, but work with your family to leave enough sleep for you.

To find a bedtime, start with the time you must wake up. Count back the hours you need to be asleep. Then leave extra time to fall asleep.

Work backward from morning

Amir needs to wake at 6:30 a.m. His family plans for 10 hours of sleep.

1. Count back 6 hours from 6:30 a.m. to 12:30 a.m.
2. Count back the remaining 4 hours to 8:30 p.m.
3. He needs to be asleep by 8:30 p.m. If settling usually takes 15 minutes, he gets into bed at 8:15 p.m.

Time in bed and time asleep are different. If you spend 10 hours in bed but lie awake for 30 minutes, you have not slept for all 10 hours.

You can also check a night by counting forward. From 9:15 p.m. to midnight is 2 hours 45 minutes. From midnight to 6:15 a.m. is 6 hours 15 minutes. Together that is 9 hours of sleep.

Keep a steady pattern

Sleeping very late on weekends can make Sunday bedtime harder. Protect enough sleep each night and keep waking times close to usual. Daylight, especially in the morning, and activity during the day help your body's inner clock follow day and night.

A bedtime routine is a set of calm steps you repeat each night. A familiar order helps your body and brain slow down for sleep.

Give your evening a pattern

Keep bedtime and waking time about the same each day, including weekends. Spend the last 30 to 60 minutes winding down. You could draw, read, do a quiet puzzle or talk with your family.

Switch screens off at least one hour before bed. Bright screens and exciting games can keep your brain awake. Keep devices outside your bedroom overnight so lights, messages and sounds do not disturb you.

Here is one way an evening can work. Hana gets into bed at 8:45 p.m.

• At 7:45 p.m., she puts her tablet on its kitchen charging spot.
• She showers, puts on pajamas and has a small snack if hungry.
• She brushes her teeth after the snack, then reads quietly.
• At 8:45 p.m., she turns out the light.

The routine begins before getting into bed. It does not use up the time her family has set aside for sleep.

Make your room restful

A dark, quiet, cool and comfortable room helps. A small night-light is fine. Use your bed for sleep and quiet reading. Keep busy games and homework elsewhere.

Avoid caffeine, which makes you feel more awake. It is found in coffee, tea, many colas and chocolate. Children should not drink energy drinks. A big meal just before bed can be uncomfortable. If you are hungry, a small healthy snack is fine; brush afterward.

If sleep takes a while

Keep the lights low and try a calm activity in your mind. Picture a peaceful place or relax your body from your toes upward. You can breathe slowly and comfortably. Picking up a screen adds light and excitement again.

Talk about worries with an adult earlier in the evening. Writing a worry down can also help you leave it until tomorrow. If you often cannot fall asleep, wake many times or feel tired every day, tell a parent or caregiver. They can help you get support.

Some tiny things called germs can make you sick. They are too small to see with your eyes. Germs include bacteria and viruses. Bacteria are tiny living cells. Viruses make copies of themselves inside living cells. Many bacteria do not harm you.

Follow the journey

Hands can pick up germs from shared surfaces, such as door handles and toys. Those germs can reach your body when your fingers touch your eyes, nose or mouth. Hands can also move germs onto food.

For example, a child blows their nose and then picks up a shared game piece. Another player touches that piece and later rubs their nose. Germs can travel along that route even though the piece looks clean.

Coughs and sneezes send tiny drops and particles into the air. Some smaller particles can stay in the air. Germs can also pass through shared cups, bottles, utensils and toothbrushes.

Cover a cough or sneeze

Use a tissue to catch a cough or sneeze. Put the tissue in the trash right away, then wash your hands. Without a tissue, use your bent elbow. Coughing into your hands puts germs on the hands you use to touch things.

Use your own bottle, cup, utensils and toothbrush. Sharing a drink can pass germs from one mouth to another. Friends can share a game without sharing mouth items.

When you are sick, rest and follow your family's and school's rules about staying home. Time away from others helps reduce the spread of illness.

Clean-looking is not germ-free

You cannot check for germs just by looking. Wash at the important times even if your hands look clean. Keep your fingers away from your eyes, nose and mouth.

Learning to wash well helps communities stay healthier. Studies compared groups with and without handwashing education. For every 100 people who would have had diarrhea, about 23 to 40 fewer became sick. For every 100 who would have had a cold or similar illness, about 16 to 21 fewer became sick.

Wash your hands before eating and before helping prepare food. Wash after the bathroom, nose-blowing, coughing, sneezing, touching animals or their food, handling garbage and outdoor play. Wash whenever your hands look dirty too.

Five steps for a good wash

1. Wet your hands with clean running water. Warm or cold water works. Turn off the faucet and add soap.
2. Lather by rubbing your hands together with soap.
3. Scrub for at least 20 seconds. Rub your palms, backs, between fingers, thumbs, fingertips and under nails.
4. Rinse well under clean running water.
5. Dry with a clean towel or an air dryer.

The 20 seconds are for scrubbing. A quick splash at the beginning does not count as the scrub. You can hum "Happy Birthday" twice to help time it.

Soap loosens dirt, grease and germs so water can carry them away. Water alone removes fewer germs. Remember your thumbs and fingertips: it is easy to rub your palms and miss those spots.

Drying matters because wet hands pass germs along more easily. Wiping on a dirty shirt can put dirt back on your clean hands.

Try the whole sequence

Nora has been helping feed a pet and wants to make a sandwich. She washes first, even though her hands look clean. She wets them, adds soap and lathers. During her scrub, she rubs each thumb and her fingertips too. After at least 20 seconds, she rinses and uses a clean towel. Now she is ready to handle food.

When there is no sink

An adult may give you hand sanitizer with at least 60% alcohol when soap and water are unavailable. Follow the amount on the label. Rub it over all parts of both hands until dry, about 20 seconds. Keep sanitizer out of your mouth and away from your eyes.

Sanitizer works less well on visibly dirty or greasy hands. After muddy play, use soap and water. Sanitizer also does not kill every kind of germ. Choose a proper handwash whenever you can.

Washing removes dirt, sweat and germs from your skin and hair. It helps you feel comfortable and fresh. Clean clothes matter too, especially after sweaty or messy play.

Wash after a busy day

Take baths or showers regularly as part of your family's routine. Wash after getting very dirty or sweaty, and after swimming in a pool or lake. Use soap to clean your skin, including underarms, feet and between toes. Wash your face and private parts gently too.

Sweat itself has almost no smell. Body odor happens when germs on your skin break down sweat. Soap and clean clothes help remove the smell. Spraying a scent onto dirty skin does not wash dirt away.

Care for hair and nails

Wash your hair often enough to keep it clean. Comb or brush it each day, using your own comb or brush.

Keep fingernails short and clean. Dirt and germs can collect underneath. Clean under nails while washing your hands; a nail brush can help. Biting nails moves germs toward your mouth.

Change and put away

Put on clean underwear and socks every day. After PE or sports, take off sweaty clothes and put them in the laundry. Choose clean clothes that fit the weather.

After muddy gardening, Eli puts his dirty clothes in the laundry. He washes his body and hair as needed, cleans under his nails and puts on fresh clothes. Putting the muddy shirt back on would bring dirt against his clean skin again.

Give used things a clean place too. Put dirty dishes away and wash your water bottle often. Empty old food and sweaty clothes from a sports bag. That makes the next day's clean clothes and equipment easier to find.

A sticky layer called plaque builds up on teeth each day. Germs in plaque use sugar to make acid. The acid can damage teeth and cause holes called cavities. Plaque near your gums can make them sore too.

Twice a day, two minutes each time

Brush in the morning and before bed. After your bedtime brush, drink only water. Use a soft toothbrush and a pea-sized amount of fluoride toothpaste. Fluoride strengthens the outside of teeth and helps protect against cavities.

Spend 2 minutes on each brush. You can split your mouth into top right, top left, bottom right and bottom left. Spend about 30 seconds on each part. Four lots of 30 seconds make 120 seconds, or 2 minutes.

Reach every surface

Tilt the brush toward your gums. Move it gently back and forth with short strokes about one tooth wide. Clean:

• the outside surfaces, facing your cheeks and lips;
• the inside surfaces, facing your tongue;
• the chewing tops of your back teeth.

For the insides of front teeth, hold your brush upright and move it up and down. You can gently brush your tongue too. Spit out extra toothpaste instead of swallowing it. Avoid rinsing with lots of water straight afterward so fluoride stays on your teeth.

Brushing hard does not replace careful coverage. It can hurt your gums. A soft brush used gently can reach the places you need to clean.

Floss the spaces

Your brush cannot reach all the way between neighboring teeth. Clean between teeth once a day with floss or floss picks. Ask an adult to show you or help. Slide floss gently into a space. Curve it into a C-shape against one tooth and move up and down, then clean the side of the next tooth. Avoid snapping it down into your gums.

Look after your brush and teeth

Replace a toothbrush every 3 to 4 months, or sooner if the bristles are bent or frayed. Use your own toothbrush.

Adult teeth start arriving at about age 6. They need to last throughout your life. Baby teeth need care too: they help you chew and speak and hold space for adult teeth.

Your daily choices affect how often teeth face sugar and acid. The amount of sugar matters, and so does how often you eat or drink it.

Give teeth breaks from sugar

Each sugary snack or sip gives plaque germs another chance to make acid. Think about a small sweet drink. Finishing it with lunch is one drinking occasion. Taking tiny sips throughout the afternoon keeps bringing sugar to your teeth again and again.

Sticky sweets, such as gummies and caramel, cling to teeth. If you have a sweet treat, have it with a meal, then drink water. Choose snacks such as fresh fruit, crunchy vegetables, cheese or plain yogurt. Nuts can be a choice if you are not allergic.

Choose your drink

Water is the best everyday drink for teeth. Milk is a good choice too. Soda, sweet tea, sports drinks and fruit punch contain sugar. Juice contains natural sugar, so it is not the same as water for teeth.

Many sodas and sports drinks also contain acid, including some sugar-free ones. Removing sugar does not remove every way a drink can harm teeth. Safe tap water is useful, and in many places it contains added fluoride that helps protect teeth.

What happens at a checkup?

Visit the dentist as often as they recommend. For many children, this is about every six months. A dentist checks for cavities, and a dentist or hygienist removes hardened plaque that your brush cannot remove. They may take X-rays to see places hidden from view.

A dentist may apply fluoride varnish for extra protection. They may also place sealants, thin coatings over deep grooves in back teeth. Food and germs can collect in those grooves.

Keep checkups even when teeth feel fine. Early problems may not hurt yet. Tell an adult if a tooth hurts, you notice a dark spot or hole, or your gums often bleed. You do not need to wait for the next planned visit.

For sports where a hit to the mouth is possible, wear a mouthguard. If an adult tooth is knocked out, tell an adult immediately; it needs emergency help.

Sunshine helps make outdoor play enjoyable, but it also carries ultraviolet rays, called UV rays. You cannot see or feel UV. Too much can damage your skin and eyes.

Skin damage can appear later

Sunburn is damage caused by UV. Skin can become red or darker, hot and sore. It may peel or blister. The change can take hours to show, so waiting until you notice a burn leaves protection too late.

A tan also shows UV damage. Skin darkens as it tries to protect itself. A tan from the sun is not a healthy goal. UV can harm people with every skin color. Darker skin has more natural protection and burns less easily, but it can still burn and be damaged.

Sun damage adds up over your life. Childhood sunburns increase the chance of skin cancer later. Protecting your skin now helps care for your future skin too.

Use helpful clues

The UV Index in a weather report tells you how strong UV is. Its scale starts at 0. At 3 or higher, protect your skin and eyes.

Look at your shadow as another clue. A shadow shorter than your height means strong UV: find shade and use protection. UV is usually strongest around the middle of the day. In the continental United States during daylight saving time, take extra care around 10 a.m. to 4 p.m.

Clouds do not block all UV

A cool breeze can feel pleasant while UV remains strong. Clouds let some UV through too. Water, sand, snow and concrete reflect UV, so protection matters beside a pool and in snow as well as at the beach.

For example, Mae is going skating outdoors on a chilly day. The UV Index is 4. She still needs sun protection even though she is wearing a jacket. Her face and eyes can be exposed to UV, and snow can reflect it.

Protect your eyes as well as your skin. Never look directly at the sun, even through sunglasses.

Five actions help protect you outdoors: shirt, sunscreen, hat, shade and sunglasses. The rhyme "slip, slop, slap, seek, slide" can help you remember them.

Cover and shade

Slip on a shirt with sleeves. Longer shorts or pants cover more skin. Tightly woven fabric blocks more UV than thin, see-through fabric. Ordinary clothing may protect less when wet.

Slap on a wide-brimmed hat. Its brim shades your face, ears and neck. A baseball cap leaves your ears and neck exposed, so those parts need protection too.

Seek shade under trees, umbrellas or covered areas, especially near midday. Reflected UV can still reach you in shade. Keep your other protection on.

Slide on sunglasses labeled UV400, 100% UV protection, or protection against both UVA and UVB. Dark lenses alone do not show UV protection. Wraparound glasses also block light from the sides.

Read the sunscreen label

US skin doctors recommend SPF 30 or higher, broad-spectrum and water-resistant sunscreen. Broad-spectrum means protection against both UVA and UVB. SPF means sun protection factor; a higher number gives more protection against sunburn.

Check the expiration date. Ask an adult to help read the label. Put plenty on dry skin about 15 minutes before going outside. Cover all uncovered skin, including ears, neck, arms, legs and tops of feet.

Know when to reapply

Put on more sunscreen at least every 2 hours outdoors. Reapply sooner after swimming or sweating for the label's 40 or 80 minutes, and right after towel drying. No sunscreen is waterproof.

Sofia plans to swim at 11:30 a.m. She applies sunscreen at 11:15 a.m. The label says water-resistant for 40 minutes.

1. She counts 40 minutes from 11:30 a.m. to 12:10 p.m.
2. She needs a break to reapply by 12:10 p.m. if still swimming.
3. If she leaves sooner and towels dry, she reapplies right then.

A two-hour reminder does not replace the swimming or towel rule. Sunscreen also does not replace clothing, shade, a hat or sunglasses.

On hot days, drink water often and rest in shade. Tell an adult if the heat makes you dizzy, sick to your stomach or very tired.

Screens can help you learn, create, talk with family and have fun. Homework, drawing on a tablet, video calls and watching shows are different uses. Think about what you are doing on a screen as well as how long it lasts.

Notice what gets pushed aside

A day has 24 hours. Extra game time has to take time from something else. When fun screen time crowds out sleep, movement, homework or people, your day is out of balance. Most screen use also involves sitting.

You might notice that you keep skipping outdoor play, lose track of time or feel upset whenever you need to stop. Tired, dry eyes or late nights on a device can be clues too.

Make a family media plan

A family media plan is an agreement about how and when your family uses screens. US guidance does not set one number of hours for every child. Families make limits that protect sleep, activity, schoolwork and time together. Some countries advise no more than 2 hours daily of screen time for fun.

Plan screen-free meals, the hour before bed and bedrooms overnight. Put devices away during homework unless the homework needs them.

Choose what you will play or watch before you start. Set a timer or choose a stopping point, such as the end of an episode. Turn off autoplay, which starts another video by itself. During longer use, take breaks to move and look far away.

Plan both the start and stop

Tess wants to watch a 25-minute nature show after homework. Her family agrees she will turn the TV off when it ends. She switches autoplay off before starting and sets out her drawing supplies for afterward. A clear next activity helps her follow the stopping point.

A dance game can get you moving, but it still counts as screen time. It can be part of a plan alongside play outdoors, daylight and time with friends. A moving game does not make screen-free time disappear from your day.

A habit is something you repeat until it becomes familiar. A routine puts actions in a regular order, such as washing, getting dressed and brushing teeth each morning.

Look at your whole day

Sleep, movement and sitting all take time. Keep enough hours for sleep and at least 60 minutes for active play. Break up long sitting spells. Washing, brushing, sun protection and screen limits fit around meals, school and play.

Here is one way to divide a 24-hour school day: 10 hours asleep; 7 hours at school, including recess and PE; 2 hours for meals and getting ready; 1 hour of active play after school; 1 hour of homework and reading; 2 hours of family time, chores and hobbies; and 1 hour of fun screens. These parts add to 24 hours. Movement during school belongs inside the school block; do not count its time twice.

Choose a clear action

"I'll be healthier" does not tell you what to do next. A clearer plan is, "After school on Tuesday and Thursday, I'll dance for 20 minutes." It says what you will do, when and how much. It is one step toward the whole day's activity.

Start small. Link the action to something you already do: "After I hang up my backpack, I wash my hands." Hanging up the backpack becomes a reminder. Ask your family to help make needed things easy to reach.

Use a chart to learn

A checklist can show what you did and when you forgot. Priya plans to brush morning and night for five days. That makes 2 × 5 = 10 brushing times. Her chart shows 9 checks, with one evening missed.

She looks at the empty box. She forgot while packing for a trip. Next time, she packs her toothbrush in a place she can reach that evening. The chart helps her choose a change; it is not a reason to give up.

If you miss an action, start again at the next chance. On trips and weekends, keep sleep times close to usual and adapt the rest of the routine. You can work with family or classmates too: compare favorite active games and try one together.