Screen time: the good, the bad and the ugly

Investigating the original literature that informed a recent American Academy of Pediatrics (AAP) recommendation regarding screen time for infants and children opened a Pandora’s box of studies from multiple countries looking at cognitive, motor, executive function, gender, emotional effects, behavioral changes and more. Earlier, before all this research, it was felt that the downside of screen time for young children was that it simply displaced time that the child would be using to engage with the world, exploring and relating. It did not seem that the screen experience itself was harmful but that it took away from activities that would promote normal development.

Not any more. These studies indicate otherwise. Although researchers have not pinpointed the exact mechanisms by which children’s brains are altered, screen time itself, is associated with some worrisome effects. There have been studies in older children that have shown that screens can be helpful tools in education and we certainly see them everywhere in schools now. But even in these school-age children, caution should be taken as we implement this modality so universally, with minimal information on its short and long-term effects.

Focusing on the young child, it seems very clear that exposure to screens can be deleterious to development. Each hour of television viewed by two-year-olds resulted in a 6% unit decrease in fourth grade math performance. Two hours or more of daily screen time resulted in behavioral problems and poorer vocabulary. Between 6 and 18 months, it led to emotional reactivity and aggression. This is just a sampling of the many studies found at the National Institute of Health’s website: ncbi.nim.nih.gov/pmc/articles/PMC103539471.

The AAP recommends zero screen time for babies 18 to 24 months old, with the exception of video chatting. (So important for keeping connection with family who live far away.) Children who had had daily screen time were more likely to struggle with language and problem solving skills. Those with more than four hours of daily exposure were almost five times as likely to have communication delays.

Babies learn language through interactions with adults. The key component of those interactions seems to be reciprocity in the conversation. Hold baby in your lap, facing each other. Making sensitive eye contact, mimic baby’s sounds and facial expressions. Give her time to respond. Often, when we learn that babies enjoy us, need faces and interaction to thrive, we might be tempted to keep a constant monologue going. This can easily overwhelm a baby and result in baby shutting down. Watch her closely for cues of needing a break in this compelling play.

OK, bring on peek-a-boo, pat-a-cake, eensy weensy spider and where is Thumbkin!! 

November is Healthy Skin Month

A few suggestions for caring for your baby’s skin:

**Avoid using products that contain propylene glycol. This common additive to cosmetics is neurotoxic and has caused a seizure in a baby whose diaper rash was treated with an ointment that contained it.
*Bathe baby only two or three times each week
*Use a product identified as “cleanser” as it will have a more neutral pH
*Use products that are free of fragrances
*Moisturize/massage baby with oils that are food-grade. Avoid nut oils which may cause an allergic reaction.

Premies get a warm snuggle

In the October 2010 issue of Oprah, a product designed by Jane Chen is a nifty solution to keeping premature babies warm without the use of an expensive incubator. In some developing countries, the absence of incubators poses a challenge to the health care providers attempting to care for premature and term babies who require specialized care. This little bunting has a hood but most importantly, a heat source that tucks into a pocket of the little sleep sack. The waxlike substance can be melted in hot water and then placed in the pocket to maintain a temperature of 98.6 degrees. Every 4 to 6 hours, the packet can be re-warmed and replaced. The cost is under $100. Apparently families can use these at home. The product will be introduced to India and then China and Africa. Chen hopes it saves the lives of 100,000 babies. It sounds wonderful to me. My only caveat is that the mother is a great heat source, maintaining the perfect skin temperature without any cost or need to renew every few hours. Skin to skin holding also offers many benefits beyond temperature control. The mother should be encouraged to hold her baby on her chest as a first choice of intervention. Maintaining a baby’s normal temperature is one of the MOST important therapies for newborns right up there with recognizing the role of the parent and providing the information for her to do the best for her baby.