As a developmental and behavioral pediatrician, I get asked a wide range of questions about what’s “right” for kids at this age or that age. One of the most common topics is about toddlers and screen time. It can be hard for parents to know what’s a healthy screen time balance.

The truth is, as a mom, I also know we need to be realistic. I don’t want us passing judgment on each other for handing a toddler our cell phone at times. Tablets, cell phones, television, and computers have become ubiquitous in our lives.

But we must understand the effects of recreational screen use on the development and wellbeing of young children. I will share healthy screen time recommendations by age and some strategies for avoiding too much screen time for kids—especially for young children.

Why We Turn to Screen Time for Young Kids

As the mother of a toddler, I’ll tell you, I’ve seen how toddlers and young kids are drawn to screens like little moths to flames. It’s exciting—the lights, the sounds, the movement! Young children find screen time entertaining, “grown-up,” and fun.

During child development, kids model the behavior of their parents and other adults. Kids want to use those screens because they see us using them a lot.

Screens give kids exposure to the world outside their homes. We may think it can help them develop skills and learn. However, I don’t recommend using “online classes” for your young child. Simple, imaginative playtime is much better for their development. As we’ll explore here, there are many hazards of screen time for kids, and young kids can’t learn well from screen-based media.

Another reason that parents may think screen time necessary is that it gives parents a break. When we’re busy, stressed, and trying to balance life, it’s very tempting to hand your toddler the iPad and let them play.  Even before phones and tablets were pervasive, parents used TV as an occasional babysitter. Those who grew up in the 70s, 80s, and 90s probably remember spending quite a few hours “parked” in front of the TV watching cartoons.

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Again, as a mom, I understand. It’s not about judging what’s “right” as a parent. But there are pediatrician recommendations for screen time by age and by situation with strong research and rationale behind them. Most pediatricians, including myself, encourage moderation when it comes to toddlers and screen time.

How Much is Too Much Screen Time for Kids?

Screen time has increased dramatically over the last several years. A study from Kaiser found that older children were spending over 7 hours a day on screens. Even younger children were spending increasing amounts of time in front of screens (many even hitting that 7-hour mark). Parents reported that kids as young as two years old were spending 2 hours a day or even more playing screen-based games.

For older children, grades declined based on increases in screen time. Incidents of obesity and the effects of a sedentary lifestyle also trended upward when too much screen time was present. Unfortunately, these health effects can carry on into adulthood, setting kids up for less success and wellness later in life.

On-screen gaming employs operant conditioning elements—a system of rewarding our brain with feel-good chemicals when we successfully complete a task. Conditioning works on everyone, adults and children alike. When we get a rush from winning at a level or unlocking a new item, it’s very similar to the rush we get from gambling. It becomes addicting, especially for young children, leading them to follow certain risky behaviors as they get older. Too much screen time lowers impulse control in kids.

parents and kids all using their own gadgets
Too much screen time can result in gadget addiction – not to mention poor communication within the family.

Even during their younger years, repetitive use of video games resulted in addictive disorders. Kids who played video games frequently displayed a preoccupation with gaming, withdrawal symptoms, and increased tolerance (meaning they needed to play MORE games to get their “fix”).

Is Screen Time Really a Big Deal for Toddler Brains?

If your child isn’t spending THAT much time on a screen, you may wonder if it’s a lot of fuss about nothing. Maybe you’re pretty balanced with the amount of screen time you allow, and your child seems to enjoy drawing on the tablet or watching a few YouTube videos during downtime. Is there harm in letting your child use your phone or computer?

Researchers have shown that kids may actually lose brain cells and harm neural connections from too much screen time. Exposure to screens can reduce creativity and disrupt sleep patterns. While we can’t see it happening, we can see the effects in behaviors like shortened attention spans and increased tantrums.

brain cells and their connections
A lot is going on in young kids’ brains. They are making lots of connections. Too much screen time can harm these brain cells and connections.

Unfortunately, we don’t actually have MRI machines in our homes. We can’t see our child’s brain shrinking the longer they use a screen. I think though, if we did, we’d be much more careful about screen time. Researchers have used MRI studies to show that screen time is associated with ACTUAL physical brain damage to the gray matter (brain cells) and white matter (neural connections) in preschool children.

Many parts of the brain can be damaged the more screen time children have. The pathways for sensory processing, executive function, empathy and emotions, and movement control can all be affected by longer screen times. In young children who are starting to develop all of these essential functions, too much screen time is dangerous.

In a study of 47 pre-K children,  kids who spent higher amounts of time on screens showed lower microstructural organization and myelination of the brain parts required for language and literacy. The kids in the screen time study had lower scores in language processing, vocabulary, and literacy tests.

Now it’s easy to dismiss these small studies of children and screen time as “only a handful of kids”. However, we should remember that in the 1950s, the first studies emerged correlating cigarettes to cancer. It took a lot of time before people started believing these studies. Today it’s an established fact—smoking causes cancer. With children and screen time, when it comes to our kids, I don’t think we should wait for more studies before we act.

We’ll probably never be able to get anything more than correlation studies about screen time anyway. Why? Because to get anything better than a correlation study, you’d need to do an experiment. You’d need to randomly assign kids to different groups, and force each group of kids to watch screen time at different amounts for months or even years on end and track them. This is extremely unethical, not to mention impossible to control!

So the best evidence we can get for things like screen time (just like with cigarette smoking) are really correlation studies. So based on the best available evidence we can possibly get, limiting screen time for our kids is necessary.

Physical Health and Screen Time for Kids

The effects of screen time aren’t limited to cognitive health and brain development, either. In a study of 390,000 adults, every two hours of increased screen time correlated with an increase in heart disease, cancer, and mortality rates. This effect was especially pronounced in adults with lower overall fitness scores. Risk factors for type 2 diabetes also increased. The media habits we set in childhood can carry us down the road into healthy or unhealthy adulthood.

Other studies have found connections to increased blood pressure rates between children and screen time. TV viewing and computer gaming have also been associated with back pain and headaches in kids and teens. Some ophthalmologists have expressed concern that screen time can also lead to myopia or near-sightedness.

So yes, there are certainly some health effects associated with all this screen time for kids. When kids are sitting in front of screens, they’re simply moving less. I know that there are times when it feels calming to have your children sit still and stay quiet for a few moments. It’s hard to resist the impulse to hand over the screens or turn on the TV.

But giving kids an outlet for their energy by encouraging them to move and play will help them sleep better, feel more alert, and discover a healthier lifestyle. When young children start developing social skills, they must have interactions with other kids their age. Playing games, trying sports, and pretending can help them build cognitive, emotional, social, and language skills. They learn how to resolve conflict and how to express their wants. They become stronger communicators.

If we rely on screens instead of movement and activity, many of those skills are deterred—not to mention the fine and gross motor skills that preschoolers and toddlers need to work on during those critical years. When we opt for screen time, we’re not encouraging physical health, and our kids aren’t getting a chance to stretch toward those developmental milestones.

Screen Time and Mental Health

In a study of 40,000 children between the ages of 2 and 17, researchers discovered some concerning findings on the mental health effects of screen time and children. Kids who spent more than ONE hour a day in front of a screen were less curious. They were less eager to learn about new concepts and less likely to finish a task.

Additionally, the kids who consumed more screen time had a hard time staying calm when challenged or confronted. They were more likely to argue with their caregivers and displayed lower psychological wellbeing overall. The caregivers of the group of 2-5-year-olds reported that the children were more easily distracted, more likely to lose their temper, couldn’t calm down, and struggled with self-control. These kids had a harder time sitting still, completing simple tasks, avoiding distractions, and displaying perseverance.

Researchers have yet to discover whether these issues were a cause of the screen time or an effect. There seems to be an interplay between genetics and the environment. It’s certainly possible that the impact of screen time on children’s mental wellbeing goes both ways.

In older children, the mental health effects of screen time were also pronounced. If they reported over seven hours of screen time per day (which is around the current average), they were twice as likely to be diagnosed with depression or anxiety. They were also more likely to need medication for a psychological or behavioral disorder.

As you look at your toddler or preschooler, it’s essential to set them up with the right skills to stay healthy throughout their teenage years and into adulthood. Good mental health practices like focusing, perseverance, and healthy self-esteem begin in these early years of childhood development.

Kids’ Screen Time Recommendations by Age

Based on the AAP and other research recommendations, we can reach a few conclusions about healthy screen time for kids. In our world today, NO screen time is probably not a realistic goal, but setting age-appropriate limits on screen time is important. Here are the screen time recommendations by age.

Screen Time for 18-Months and Younger

For babies as young as 18 months, the best recommendation is NO screen time at all. Babies are often fascinated by light and movement, so they may catch glimpses of the television while family members are watching, but try to keep screen viewing at a minimum. FaceTime and live video chat with family members and friends are still okay too! What’s better than a call to grandma or FaceTime with an aunt who lives out of town?

Video chat is a great and acceptable way to use screen time!

Screen Time for 18-Months to 2 Years

For young toddlers, continue to limit screen time as much as possible and avoid solo use of media. Babies are building those critical motor skills and busy discovering and interacting with their world. If your very young child watches any TV, choose HIGH-QUALITY educational programming and watch with them to help them understand (and develop those communication and language skills).

Screen Time for 2 through 5 Years

From 2 to 5 years, screen time can be an occasional treat, but try to limit your child to an hour or less per day. As much as possible, watch together with your child to ensure that they understand what they’re viewing. While you are watching, discuss what they see on the screen and help them apply it to the outside world.

Choosing the Appropriate Type of Screen Time for Young Kids

It’s essential to choose developmentally appropriate types of screen time and media for your child too. Not all screen time is created equal. Seek out “passive” media, like short films and high-quality children’s programming on television. These media are better teaching tools and less addictive than more interactive media like games.

If your child is already used to fast-paced videos, he will likely protest at first, but kids will quickly adjust to calmer screen time. An excellent way to determine if a show is appropriate for kids is to look for videos that seem to run at the same pace as everyday life—fast animation conditions the brain to expect that same high level of stimulation all the time. The less frenetic pace will help set them up for success when they get to school. Exercise and activity videos should be appropriately paced for young children to follow along.

Screen time with loved ones is also a great option. Of course, you should ALWAYS know who your child is chatting with. Screen time and videos of people singing or reading stories to children can be a fun way to interact with family from afar.

Media that appeals to the other senses can be healthy as well. Music playlists, podcasts, and audiobooks are enjoyable for kids and can be helpful during car trips. Ebooks are also okay, but it’s important to remember that physical books provide a better sensory experience AND cause less eye strain than reading on a screen.

Finally, keep the TV off when you’re at home and no one is watching. If you’re a family who likes “background noise,” keep in mind that for every hour a television is on, studies show that adults speak 500-1000 fewer words. This can affect kids’ language skills. Read this post about why it’s important that young kids hear more words spoken to them, by an actual person (not just a video!) to stimulate language development.

What We Can Learn from Children and Screen Time

As adults, it doesn’t harm us to have less screen time, either! As you’ve read these tips, you’ve probably considered your own ties to media and your electronic devices. Remember that kids learn best from how the people around them behave. They watch what we do and try to follow our cues.

If you show less interest in your screen, your child will also find screens less interesting. At the end of the day, what kids want most is our attention and interaction. We can all learn to put down our phones a little more often and enjoy some scree-free activities together.

Above all, be kind to yourself. If there are days that you end up giving more screen time than you’d like, don’t give up. Don’t conclude that you’ve failed. Tomorrow is another day to work towards striking a healthy screen time balance.

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About the author: Dr. Victoria Nolasco is a developmental and behavioral pediatrician, clinical associate professor of pediatrics, and mom of a toddler. Through her blog effectivemommy.com, she helps toddler moms understand development and behavior, and raise happy and successful kids.