Why Investing In Mothers Will Help Solve the Childhood Physical Inactivity Epidemic

This morning I watched a video of Serena Williams training in the lead up to the Australian Open with her daughter hitting balls alongside her. Aside from being super cute, it got me reflecting on a question I was asked in an interview earlier this week: “what would be the single most important step we could take towards solving the problem of childhood inactivity?”

Physical activity in children helps with concentration, learning, emotional regulation, sleep quality, bone and muscular health, cardiovascular health and more. Yet in my home state of NSW, 3 in every 4 children don’t meet the minimum daily recommended activity levels of one hour per day. Unsurprisingly, 44% of kids spend more than 2 hours a day in sedentary leisure time on top of school and seated travel time. 22% of kids aged 5-16 are overweight or obese.

Childhood physical inactivity is a big picture health issue and a public health ticking time bomb. We know movement is important for all of us, and especially so for kids, yet our kids are becoming less active, instead of more.

In recent decades, preventative health policy has focused on things like making our built environment more accessible for active living by adding things like footpaths and playgrounds in an attempt to get kids outside and moving. Other state-based strategies involve giving families with school-aged children two $100 rebate vouchers per year to use on organised sport. Having spent much of my professional life working in childhood obesity health programs, I can tell you that these strategies are not working.

“Make sure your kids are active every day”, parents are told. The majority of school pick ups are done by mothers, and the majority of fathers work full time, arriving home in time for baths and bed. Reading between the lines, this means that, like just about everything else related to child health and wellbeing, mothers are tasked with ensuring children are to be physically active each day, while being given none of the support or free time to make it happen. 

How is one meant to singlehandedly fit in transport to and from extracurricular activities and sports (which we now must do to use those blasted $100 vouchers to avoid feeling like awful parents), management of siblings during sessions, and getting dinner on the table before the little one cracks it in the 3 short hours between daycare, pre-school and school pick up and 6pm? Even if we reject adding extra-curricular activities to our week, stranger danger and smaller backyards mean we need to be with our kids for outdoor activities more than generations past, but no-one else seems to be magically appearing to chop our vegetables or bring in the laundry before dark.

So how are we going to fix the childhood inactivity epidemic? Rather than throwing money at the built environment or putting “make the kids exercise” on mothers’ to-do lists, my suggestion is simple: support mums properly from the start.

Here is my eight step plan:

1. Support during pregnancy. During pregnancy, mums would receive physical activity support from qualified health professionals. Mothers who are active during pregnancy and babies with greater heart rate variability (an indicator of heart health and fitness) and better motor coordination, so these babies might be more drawn to being active from the start. It would also help in reducing risk of gestational diabetes, which affects the baby’s likelihood of struggling with their weight in future.
   
   
2. Reduced birth interventions. Birthing people would be encouraged to use whatever active labour positions they wanted to reduce need for interventions, rather than tethering them to a powerpoint or making them lie in bed. This helps to reduce need for interventions and the birth injuries that go along with them. When we can move and crawl and play with our babies without pain, we start the ball rolling towards an active childhood during infancy.
   
   
3. Make pelvic floor follow up standard practice. After birth, proper follow up and pelvic floor retraining (where needed) would be made standard practice. Unlike in some European countries, subsidised pelvic floor rehabilitation after baby is essentially non-existent in Australia. The official stat is that "1 in 3 women who have ever had a baby wet themselves", yet it is probably higher than this because so many women don’t risk exerting themselves enough to find out if they're leaky or not. The idea that we can we fix the public health problem of childhood inactivity while ignoring the public health problem of maternal incontinence is ludicrous.
   
   
4. Six weeks of paid partner parental leave. There is a risk of the uterus prolapsing from women doing more than what they should be (read: almost nothing but resting and feeding the baby) particularly in the first six weeks post-birth. It’s pretty hard to get psyched about getting active with your kids if you feel like your womb is falling out of your vagina. All partners or primary support people should have six weeks paid leave from the time of birth (the time it takes from the uterus to shrink from weighing 1kg to 50-100g, breastfeeding to become established, and women's hormones to start to stabilise) regardless of method of delivery as a safeguard to the mother's future health and therefore the child’s future activity levels. I do not believe it's a coincidence that countries with the most parental leave for men and women (like Finland, where parents each get 7 months leave at full pay) have much higher rates of adult and childhood physical activity, despite a much less favourable climate for outdoor activities than ours.
   
   
5. Quit selling perfection. Mothers who aspire to the “supermum" ideal are often exhausted and depleted. Who wants to swing on the monkey bars or go chasing after a soccer ball feeling like that? Supporting families to be active means helping mothers get the rest they need by reducing the social expectation to “do it all”, and by other community members stepping up to fill the void. It also means helping mums accept their body as it is, instead of selling them slimming tights and cellulite creams to supposedly make them feel confident to play in public with their children.
   
   
6. Getting mothers off the sidelines and into side-by-side activities. Most parents I speak with want to move more but can’t find the time. On the other hand, every kids’ sport I go to has a wall of parents sitting watching, juggling babies or scrolling social media. What if basketball centres made an effort to run an adults social comp (complete with creche) taking place while the kids all trained? What if your council-operated pools had a scheme where parents could swim laps for free while their children do their swim lessons? There is much scope for creative thinking.
   
   
7. Backing up her efforts. If mum is doing all this work on the home front, schools need to step up too. Schools have to include a certain amount of activity time in the curriculum, but by the time kids get ready (change shoes, uniform, toilet break, whatever), get equipment, choose teams and do some skills activities, much of the time is used up. Schools can quit cutting into kids’ play times by making them sit down to eat after sitting in the classroom all morning. They can disallow devices during school hours to encourage active or imaginative play. Ensuring all girls’ uniforms as conducive to sports and energetic play as the boys ones are, rather than giving an ugly “unisex option” as an afterthought would also be a welcome step in the right direction.
   
   
8. Valuing the work mothers do. Serena Williams would probably not have been hitting tennis balls with her kid if she wasn’t being valued for spending time doing that thing. She is paid to be active, which makes her kid more likely to be active with her. An hour a day of being physically active with our kids equates to enormous long-term public health saving, but in our current economic model, sitting our kids in front of the TV while we work on our computers is what pays the bills. Financially recognising the work that primary carers do, rather than giving them pitifully low support payments and forcing them into paid work or poverty, would ensure there is time for parents to get outside and play with their kids like they are being asked to do.

To support mothers to be active is to support children to be active.

I’m no economist, but it’s not hard to see how small investments now make for big benefits long-term.

It’s time for the big systems to fund maternal health as well as footpaths, for the good of ourselves and our kids.

[If you’re a mum, or a professional who works with parents in the first six months post-birth, you might like to join my “Moving Well After Baby” workshop. The live sessions are on 17th Feb (Mums session) and 18th Feb (professionals session) and will be recorded if you can’t join at the time. It’s $25AUD and you’ll get resources to keep included + a certificate for CPD if you want one. Clickhere for more info]