Cell phones as pacifiers

It seems like a simple thing. Soothe your crying toddler by handing her a cell phone, and she’ll be occupied for hours. But too much screen time is not good for very young children, said Jill Knight, MD, a pediatrician with Baptist Primary Care. That includes cell phones, iPads and TV.

“It’s convenient, it keeps the child hypnotized,” she said. “But young children who are using screens all the time have more trouble regulating their emotions. If you try to take their cell phone away, they have a meltdown.”

Most parents realize it’s not a great idea to use a cell phone as a virtual babysitter, Dr. Knight said. Moms are often contrite when toddlers show off just how tethered they are to their phones. But getting kids away from screens is more than just a personal preference.

The World Health Organization (WHO) earlier this year came out with its first guidelines on how much screen time is OK for children under five. The limit for 2- to 4-year-olds is 1 hour per day, and less is better. Children under 2 years of age shouldn’t have any screen time at all, the organization said.

That’s a distant cry from what’s happening.

 “Kids start using the cell phone as early as they can hold the phone, and they are less than 1 year of age,” Dr. Knight said. “We find, by age 5, if we ask a child their phone number, what they actually know is the code that unlocks the phone.”

Risks of too much screen time

WHO developed play, sleep and screen guidelines at the urging of the Commission on Ending Childhood Obesity and the Global Action Plan on Physical Activity. Too much screen time contributes to obesity, Dr. Knight said, because it means kids are less active. But excess screen time can cause a range of other problems as well.

Because screens are very stimulating, if they’re used right before bed or nap time, it makes it hard for a child to unwind and get good quality sleep, Dr. Knight said. Children with too much screen time exhibit poorer social skills and delayed fine and gross motor development.

Research also shows an extreme amount of screen time can cause autism-type symptoms in very young children. Dr. Knight said she sees children who are so engaged with a phone, they don’t make eye contact and they can’t speak using two- and three-word phrases.

“It’s almost impossible to measure developmental markers because there are none. The screen is the world they interact with,” she said.  “It’s scary to see how addicted they are to the phone. That little brain is so plastic.”

 For children to develop normally, parents need to engage with them, Dr. Knight said.

WHO says young children need physical activities of varying intensity spread throughout the day. Infants who are not yet mobile need a total of 30 minutes of “tummy time” (prone on the floor) throughout the day. When young children are sedentary, reading or storytelling from a caregiver and better than screen time. 

If you have questions about ways to promote your child’s development, contact your  pediatrician. Or, visit Baptist Primary Care to find a doctor near you.

WHO Guidelines on Physical Activity, Sedentary Behavior and Sleep for Children Under 5 Years of Age 

For infants (younger than 1 year):

• No screen time at all
• A variety of physical activities several times a day, as often as possible while interacting with a caregiver. Before babies can crawl or walk, they need “tummy time” prone on the floor.
• No more than 1 hour a day restrained in a high chair, stroller, or worn on a caregiver’s back
• Sleep including naps totaling 14 to 17 hours until 3 months old; 12 to 16 hours from 4 to 11 months old.

For toddlers (1 to 2 years old):

• No sedentary screen time for 1-year-olds, an hour or less of screen time for two-year-olds
• At least 180 minutes of various physical activities, spread throughout the day
• No more than 1 hour a day restrained in a high chair, stroller or baby carrier
• Sleep, including naps, totaling 11 to 14 hours, with regular bedtimes and wakeup times

For preschoolers (3 to 4 years old):

• An hour or less of sedentary screen time
• At least 180 minutes of various physical activities, spread throughout the day, with at least 60 minutes of moderate- to vigorous-intensity exercise
• No more than 1 hour a day restrained in a high chair, stroller or baby carrier
• Sleep including naps totaling 10 to 13 hours, with regular bedtimes and wakeup times