Pediatric Annals

Editorial Free

Screen Time and 30 Million Words

Joseph R. Hageman, MD

The World Health Organization (WHO) recommends no screen time for infants younger than age 1 year and limiting screen time to 1 hour per day for toddlers.1 How am I going to explain this that to my daughter when she hands the mobile device to my toddler-aged granddaughter who gets fussy in a restaurant? I admit, I have donated my mobile device to my grandchildren in those situations, and it does work to stop a toddler from being fussy. As the article states, infants and toddlers become engrossed or mesmerized with the cartoon characters on the screen. My children, who are all parents of children ranging in age from 12 years to 4 months, do limit screen time for their children. However, I do understand the reasoning behind such a time-restricted stance by the WHO.

Dr. Dana Suskind, a pediatric otolaryngologist at The University of Chicago, has written a book entitled Thirty Million Words: Building A Child's Brain in which she discusses the importance of talking with your infant during the first 3 years of his or her life to help them develop expressive language, school readiness, and to “build their brain.”2 The importance of parents reading and talking with their children in an active way and not putting them in front of a television, computer, or mobile device, which is more of a passive activity, is emphasized in the literature.2–4 The American Academy of Pediatrics also presents some recommendations and guidelines in reference to screen time for infants, toddlers, and young children, which are summarized below:4

  • For children younger than age 18 months, screen time is discouraged;
  • Parents of children age 18 to 24 months should choose high-quality programming and/or apps that are specific to learning; parents should use the media with their children; unattended media use should be avoided;
  • For children older than age 2 years, screen time should be 1 hour or less per day;
  • For teenagers, designate media-free times (eg, family dinner) and media-free zones (eg, bedrooms).

All of the recommendations presented are helpful guidelines for clinicians when counseling families about age-appropriate screen time limitations.


  1. Timberg C, Siegel R. World health officials take a hard line on screen time for kids. Will busy parents comply? Accessed August 13, 2019.
  2. Suskind D. Thirty Million Words: Building A Child's Brain. New York, NY: Dutton; 2015.
  3. Anderson DR, Subrahmanyam KCognitive Impacts of Digital Media Workgroup. Digital screen media and cognitive development. Pediatrics. 2017;140(suppl):S57–S61. doi:. doi:10.1542/peds.2016-1758C [CrossRef]29093033
  4. Healthy Children. Where we stand: screen time. Accessed August 13, 2019.

Joseph R. Hageman, MD

Pediatric Annals Editor-in-Chief Joseph R. Hageman, MD, is the Director of Quality Improvement, Section of Neonatology, Comer Children's Hospital; a Senior Clinician Educator, The University of Chicago Pritzker School of Medicine; and an Emeritus Attending Pediatrician, NorthShore University HealthSystem.

Address correspondence to Joseph R. Hageman, MD, via email:


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