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Doctors have decided how much screen time small children should be allowed

Before she had her son, Sara Yeasted did not imagine that Finding Nemo and Toy Story would be regular features in their evenings.

“When I was pregnant I was totally against television — I thought I was always going to be doing puzzles or something,” said Yeasted, of West Deer, Pennsylvania. “But there’s life that has to get done, too.”

And so her son sometimes watches a movie for an hour in the evenings while she and her husband make dinner or straighten up.

It’s a reality that the American Academy of Paediatrics — which had previously advised that children under 2 should not be exposed to any media — is now confronting, with new recommendations out Thursday on children’s media use.

The national group of paediatricians now advises that children under 18 months see screens only in the form of video chatting. Children 18 months to 2 years old should be shown media only together with an adult and children age 2 to 5 should watch one hour or less. The AAP did not specify time limits for older children, recommending instead that their media use not get in the way of adequate sleep or physical activity.

“The tone is around the idea of media not being something that’s inherently bad or good,” said Megan Moreno, a principal investigator at Seattle Children’s Research Institute and co-author of the report. “There are benefits and risks and the goal is to help parents work with their children to maximise the benefits and minimise risks.”

It’s a different take than the one the AAP took in 2011, when it emphasised that for children under two, screens have “potentially negative effects and no known positive effects.”

The change comes from the fact that screens are now practically inescapable. Fisher-Price now markets a drool-proof iPhone case (in pink or blue), some school districts issue middle schoolers a take-home tablet and 14- to 17-year-olds send an average of 100 texts per day.

“I think we should start talking to the parents about it at birth,” said Joseph Aracri, system chair of Allegheny Health Network paediatrics. “We need to embrace what’s going on right now and figure out how to work with it because bucking it is not going to work.”

The AAP notes that while children in the 1970s started watching television at age four, children today commonly start at four months. Most parents report that their children watch television for more than two hours per day, and that doesn’t count other forms of screen time. One study found that by age three, one-third of children had televisions in their bedrooms.

Given the current levels of media consumption, parents may find even the new recommendations to be unrealistic, said Brian Primack, director of the University of Pittsburgh’s Center for Research on Media, Technology and Health. He described the AAP recommendations as a valuable goal, likening them to dietary recommendations that advise eating five to nine servings of fruits and vegetables per day, even though families likely don’t get there every day.

“It’s tricky — there are so many different things that you want to potentially communicate,” he said, urging more tools and programs for parents to monitor and limit their children.

There are possible benefits to children from media, according to the AAP. Video chats (such as with an out-of-town grandparent) can promote social connection; high-quality television programmes can improve cognitive, linguistic and social outcomes for children ages 3 to 5, and media use can assist communication and engagement for older children.

But the AAP also lists numerous known risks. Excessive television viewing in early childhood can lead to language and social/emotional delays. For older children, media use brings greater risks of cyberbullying, sexting and susceptibility to marketing of inappropriate products.

Some of the most persuasive recent research concerns the effect of media on obesity and sleep, said Moreno.

The group urges against using devices within an hour of bedtime, for example, because the light emitted can disturb Circadian rhythms. It also recommends keeping screens out of children’s bedrooms while they are sleeping, including charging portable devices.

In terms of weight gain, one study found that the risks of obesity increase per every hour of media consumed, with a 10 per cent increase in risk for obesity for children and adolescents watching one hour per day and a 27 per cent increase in risk for those watching three hours.