By Rachel Harvey
Teaching children to make healthy choices is one of the most critical jobs a parent has – and it can be one of the most difficult. With increasing access to mobile devices and tablets, parents today are facing an increasingly important issue, and decision: when it comes to screen time, how much is too much?
There is no doubt that screen time is on the rise for Generation Alpha, children born from 2010 to 2025. In 2014, children under the age of two averaged 3.05 hours of daily screen time, compared to 1.32 hours per day in 1997, according to a recent report published in the Journal of the American Medical Association. As the first generation entirely born within the 21st century, children of Gen Alpha are coming into a world dominated by smart phones, and with artificial intelligence tools like Siri and Alexa in their homes.
As children continue to be exposed to screens at increasingly younger ages, questions around how to best support children’s health and development in our digital world are becoming more common, and understanding the issues is more crucial than ever. It is no surprise that parents today find themselves grappling with uncertainties about how technology should play a role in their children’s lives.
“Screens are no longer simple devices, but often mobile computers. Parents now have to manage not just the quantity of time, but the content,” said Bert Mandelbaum, MD, chair of the department of Pediatrics at Penn Medicine Princeton Health. "As screens become a bigger party of our daily lives, managing a child’s time spent on these devices requires comprehensive strategies. Parents have to consider the age of the child and the content, and try to balance – or even prioritize – other activities such as education, free play, exercise and family time.
Mandelbaum says there are some basic rules that are almost always applicable, such as limiting the amount of time in any given session and having screen free areas, such as the kitchen and the bedroom.
“Other rules are harder, but clearly worth it,” he says, noting that there are lots of benefits that our children get from technology, but also a lot of pitfalls. “Parents have to be actively engaged in the conversation around screen time to help decide what is best for their families."
Sedentary screen time – defined as time spent passively watching screen-based entertainment such as a TV, computer, or mobile device – has been associated with physical inactivity, identified by the World Health Organization (WHO) as a leading risk factor for global mortality and a contributor to the rise in obesity.
In their newly released guidelines on physical activity, sedentary behavior and sleep for children under 5 years of age, the United Nations health agency has included specific recommendations for children’s screen time.
The new guidelines state that children under two years old should have no screen time, and children aged two to five should have no more than one hour a day of sedentary screen time – and even less is better.
Developed by a WHO panel of experts, the guidelines focus on the importance of physical activity, quality sleep, and limiting the amount of time spent passively watching screens and being restrained in strollers or chairs.
The WHO’s recommendations are somewhat similar to those released by the American Academy of Pediatrics (AAP) in 2016, advising that children under 18 months avoid the use of screens with the exception of video-chatting. The AAP also notes that parents of children 18 to 24 months of age should choose high-quality programming and watch it with their children to help them understand what they're seeing.
“When determining what type of digital content is appropriate for children, parents should choose advertising-free content when possible,” Mandelbaum said. In light of a recent study published in the Journal of the American Academy of Pediatrics, Mandelbaum, who was not involved in the report, explained that there is now evidence that advertising works even on young children.
Based on a behavioral experiment, the study involved preschool-age children watching an episode of Sesame Street embedded with commercials. The children were given a healthy snack prior to viewing the show so that they would not be hungry. They were then divided into groups, viewing the show with embedded commercials for either food or department stores. While watching, they were given access to two snack foods, one of which was the food advertised in the commercials.
The results? Children exposed to food advertisements consumed more calories and ate more of the specific food advertised.
“First and foremost, we should advocate for less screen time for our children and monitor what they watch,” Mandelbaum said. “Though this addresses the quantity of media use and the content of the programming, it obviously doesn't address the marketing aspects of commercials. There is no quick fix for this.”
When it comes to screen time, maintaining a balance with physical activity and adequate sleep is key. Playing on the playground or hiking through the woods are good ways to get children moving. Many communities also have wellness programming for children, like Penn Medicine Princeton Health’s Healthy Eating, Active Living for Kids. Community activities can play a valuable role in encouraging physical activity, social interaction, and fun and educational activity choices for children.
Parents can help make physical activity fun by making it a family affair. A weekend camping trip or simply going for a walk around the neighborhood as a family after dinner are great opportunities to spend time together and model healthy behaviors.
How parents interact with their children not only has a significant impact on their emotional well-being but can also have a positive influence on their physical development and help prevent obesity and illness later in life.