This article first appeared in www.todayonline.com on 29 October 2016
As I write this, my youngest lay sleeping peacefully next to the window, exhausted by 12 hours of non-stop vomiting. The gastric flu bug hit her with a vengeance, but thankfully, her five-year-old arms and legs are still chubby.
Under the sunlight, her skin is plump and glistens copper. For the past two days, she had been spending her time next to the window, whether awake or asleep.
With what I know now about myopia and daylight, I took comfort that she was getting some sun exposure despite being ill.
You see, I already have two “Si Yan Tian Ji” (or Four Eyed Frogs) in the family. The son started wearing spectacles when he was in Primary Two, and it was Daddy, similarly myopic, who spotted the problem from the start.
Getting the boy’s prescription glasses was an indictment of sorts for me. Why had I allowed him to read all the time, even in the car? Why did I not see him squinting? And the vision screening the Health Promotion Board does for preschoolers? I must have chucked it aside without so much as a glance.
The experts now know that if you spend more time outdoors as a child, you can delay or even prevent myopia. This is because natural light can trigger the release of a chemical called retinal dopamine, which stops myopia from developing.
Sounds easy — and sunlight is free!
So how much time do our kids need to spend outdoors to delay or prevent myopia?
Two to three hours a day, according to Professor Saw Seang Mei, head of myopia research at the Singapore Eye Research Institute.
Holy spectacles! This works out to at least 14 hours of outdoor time a week.
With our lifestyles here in Singapore, our kids can never spend 14 hours a week outdoors. Or can they?
SO HOW TO FULFILL THE DAILY QUOTA?
With an umbrella in one hand, I pushed my girls on the swing with the other.
“Mommy, you look so funny,” giggled Number Two.
I smelt even funnier.
After the sunscreen, I sprayed on mosquito repellent to protect against Zika and Dengue. Thirty minutes prior to sun exposure, I had also popped an oral supplement that purportedly protects against UV rays. Then there was my Japanese-made umbrella that costs a fortune.
Sunlight may be free, but it does come with attendant costs.
In our climate, spending time outdoors is a gargantuan undertaking. I wonder if this litany of sun and mozzie protection measures deterred any of the parents in a study conducted by Prof Saw and her colleagues.
Back in 2014, they studied a group of 285 children over a period of nine months. The aim was to teach parents about the importance of outdoor time in order to prevent myopia. They provided step-counters, organised outdoor weekend activities for families and even offered incentives — cash prizes! — for cooperation.
Guess what?
The study found no difference in outdoor time spent at the end of the nine-month period.
If cash incentives could not get us out in the sun, what can? First, I wanted to know if I can, well, cheat.
What is the definition of “time spent outdoors”? Does commuting time count if I make sure my kids look out of the window? I asked the experts hopefully.
“Distance vision — not focusing on near objects such as the iPad or story book — whilst in the car commuting is useful,” says Dr E-Shawn Goh, director of Oculoplastics, Orbit and Lacrimal Services at Eagle Eye Centre. “However, the recommendation of two hours was in a defined outdoor activity.”
Prof Saw, who is also Professor of Epidemiology at the National University of Singapore, added: “Common outdoor activities Singapore preschool children engage in include playing in the playground, park, open area, or playing sports such as ball games or swimming. Children may spend time outdoors talking to one another, or just relaxing.
“Some buildings are constructed with skylights and open windows that allow sunlight to stream in, or children could spend time in the patio or courtyard.”
The Early Childhood Development Agency (ECDA) requires centres that take on full-day programs to include at least 30 minutes of gross motor activities a day. For half-day programs, the requirement is at least 30 minutes a day, three times a week, says its spokesperson.
At St James’ Church Kindergarten, three-year-olds spend 30 minutes in outdoor free play almost everyday, says its vice-principal Joanna Koh. At Little Village, another preschool, children spend at least one hour outdoors each day.
My kids in primary school spend an average of two to two-and-a-half hours a week in physical education classes. Unless parents are clocking in the extra hours, we are way off the 14 hours a week ideal.
Full time working mother of three kids, Julia Tan, says she finds it “challenging” to meet the 14 hours a week minimum. “Unless they go to sleep at 11pm, they still have to cope with some basic schoolwork and then there’s family time,” she said.
It is no wonder that 80 per cent of 18-year-olds are short-sighted in Singapore, compared to around 30 per cent in Australia. Australian kids spend at least three hours a day in outdoor activity.
AN AIR-CONDITIONED GLASS HOUSE PERHAPS?
It is clear that while parents can and should try our best to incorporate more outdoor time, schools should do the same. Studies in China and Taiwan found decreased levels of myopia when outdoor time was boosted, for example by ensuring students stayed outdoors during recess.
The good news is, ECDA is currently reviewing the requirements for gross motor activity and outdoor play, “with a view of requiring pre-schools to provide more such opportunities under a new regulatory framework”. For example, pre-schools without easy access to outdoor play space may soon have to plan for outdoor activities for their children at least once a week.
“Outdoor play is not a good-to-have — it is a must-have if we want to ensure healthy development of our children’s minds, bodies and spirits,” says Sheena Ang, Little Village’s principal.
Being the air-conditioned nation that we are, perhaps the future is classrooms that are air-conditioned glass houses? These will allow the daylight to pass through, while the kids remain in their comfort zone.
Also, parents will not be so “heart pain” that our kids are being overheated.
But until that happens, I need to be creative about outdoor time. So I am sending Number One to the MRT station for an errand. The 20-minute walk will do him good for sure.
And oh, I am looking at my house with new eyes. Where can the kids hang out that will benefit their eyes?
It has got to be the window where my baby is sleeping peacefully.