Ask the Mediatrician

How can I cut out TV time from my two-year-old's dinnertime routine?

Q: My husband and I were having difficulties preparing dinner with our two-year-old daughter in the kitchen, so we began letting her watch Curious George to keep her occupied. Initially this worked well; the show seems to have primarily positive content, and the two 15-minute segments entertained her while we cooked. We’ve been trying not to use the TV that way so much anymore, but when we leave it off, my little girl stands in front of the screen and cries, saying, “George! George!” Her crying often causes me to give in and let her watch the show, but I’m worried that this has become an unhealthy obsession…how can I effectively wean her off of the TV?
-Curious about George, in Boston, MA

A: Dear Curious,

First, don’t worry—your daughter’s behavior doesn’t mean that she is obsessed with Curious George or with TV. It just means that watching that show has become part of her transitioning-to-dinnertime routine. Having routines to help move from activity to activity can be very helpful for toddlers, who don’t have a clear sense of time and can’t quickly shift their attention, especially when they’re right in the middle of something.

This is a great opportunity to create a new pre-dinner routine that doesn’t center on TV. Try giving her books to read, or some different shapes of raw noodles to sort into bowls. Through a bit of trial and error, you can discover activities that will both allow you to cook dinner and meet your daughter’s developmental needs.

Although making this shift in her routine will be hard at first, be consistent with it, even when she cries for George. Let her know you understand that she’s upset, that that’s okay, and that we’re having reading or noodle time now. Eventually, she will settle into the new routine.

For some ideas on activities young children can do with minimal supervision, check out:

• http://www.pbs.org/parents/child-development/baby-and-toddler/

Enjoy your media and use them wisely,
The Mediatrician®

Does the sound from TV affect infants?

Q: Sometimes, we watch TV while our 7 week old is in the room. She’ll typically be in our arms or sleeping in her swing at the time. She never sees the images on TV. The shows we watch tend to be PBS shows, cooking shows, and other non-violent, non-suspenseful things. I wonder if hearing the TV is okay. Is it like hearing conversations for her, or is it an inappropriate stimulus?
-Seeking sound advice, in Austin, TX

A: Dear Seeking,

Kudos to you for being careful about the content and amount of TV your infant is exposed to! The American Academy of Pediatrics recommends no screentime for babies under 2, but if you are going to have the TV on in a room with your infant, the choices you’re making should help reduce its potential negative effects.

Even so, do the following to see how the TV is affecting her and to make sure it’s not taking away from the things she needs:

1. Interact with her a lot while she’s awake. Research shows that screens can distract parents from paying attention to their children. Make sure to turn off the TV and give her some direct attention.
2. Talk to her. Unlike television voices, real-life voices respond to the baby, which is important for language development. Recorded voices can’t replace human interaction.
3. Watch her play. Babies and toddlers learn through creative, problem-solving play (like stacking blocks) and exploring their environment (like petting a dog). Studies show that background TV distracts children from those things. If you notice that she’s looking at the TV, turn it off.
4. Pay attention to how she acts, and choose content that helps keep her stress level low. Babies hear emotional tone, so watch her even during shows that seem benign to you. She might start squirming when she hears Emeril say “BAM!” but seem content during Martha Stewart’s monotone how-to’s. Notice that and change your viewing choices accordingly.
5. Notice to how she reacts to commercials. They may sound very different from the shows they surround, so consider muting them.

Enjoy your media and use them wisely,
The Mediatrician®

What could possibly make my two year old so scared of an eyeglass commercial?

Q: When a certain commercial for eyeglasses comes on TV, my two year old practically jumps in my arms and holds on for dear life! In it, one pair of eyeglasses makes a karate noise and splits into two pairs. I’m pretty sure it’s the karate sound that scares her, since her brother wears glasses and she’s not afraid of those. She gets so scared I don’t even watch channels that show that commercial. What should I do?
-Confused mom, Fresno, CA

A: Dear Confused,

You’re already doing the right thing—you see that she is terrified of this commercial, so you’re avoiding it.

To understand what’s going on, think about this from the perspective of a two year old: She probably has no idea what that loud, scary sound means to adults. To her, it’s an unfamiliar noise that makes one thing split into two things—and for a young child, changes like that can be very, very frightening.

Use this as an opportunity to limit the TV she sees that isn’t designed for young children. This commercial is aimed at adults (since they’re the ones buying glasses) and will air with TV shows that are also for adults. These shows are likely confusing, distracting, and anxiety provoking for her anyway, so I recommend waiting to watch adult TV until she’s asleep or out of the house.

For ideas on how to occupy your child while you’re getting things done—like cooking dinner or doing laundry—take a look at this post: How do I stop myself from parenting with television?

Enjoy your media and use them wisely,
The Mediatrician®

Am I being paranoid if I don't want to post pictures of my baby on Facebook?

Q: I am a new mom, and I’m not sure how I feel about posting pictures of my baby on Facebook. Nearly all of my friends do it. I can understand the need to remain connected to family and friends and to show off your beautiful child, but this makes me uneasy. As we know, once something is posted, Facebook owns that content, even after we delete it or cancel our account. Plus, anyone can copy it and use it however they want. None of my peers seem worried about this—am I being paranoid? What impact will having one’s entire life documented online have on these children as they reach adolescence and adulthood?
—New Mom in Medford, MA

A: Dear New Mom,

You’re right—when you post information online, it can spread rapidly and never really goes away, and you give up control over how it’s used. That’s true of all kinds of images, from the mildly embarrassing (a five-year-old naked in a tub) to the overtly incriminating (a teenager holding a beer at a party). Because the technologies are so new, we don’t know what effect these postings will have on kids as they grow up (other than what we can guess from how they respond to snapshots of their 5-year-old selves in the tub)—either emotionally, professionally, or legally.

So when deciding how to manage sites like Facebook, think about what you do know—remember that pictures of your child will end up not only on your friends’ pages, but can be reposted on their friends pages, and their friends’ pages, and on and on. If you want to show off your beautiful baby to lots of people you don’t know, then posting on a social media site like Facebook is fine. But if what you’d really like to do is share images of your baby with specific people whom you love and trust, then I would suggest setting up a personal photo account and sending links to that instead. 

In the end, go with your gut. If you don’t feel comfortable posting your baby’s picture on Facebook, don’t. You can always share pictures in other ways. Or choose carefully which to post for the public to see and which are really just for friends and family, and share them accordingly. 

Enjoy your media and use them wisely,
The Mediatrician®

Are static images on TV harmful to toddlers?

Q: When our 14-month-old son was born, his pediatrician told us to avoid screen time, so we do not allow him to watch TV and we rarely have it on while he is awake. But, we subscribe to a music service that streams through the TV. When the songs play, the album covers are shown on the TV screen. A friend told me that seeing the album covers has the same neurological effects as if he were watching a TV show. Another friend says that because the album covers are static images, there are no detrimental affects. Can you please clear this confusion up for us?
-Music Mystified, in Los Angeles, CA

A: Dear Mystified,

Your second friend—the one who says that the effects are reduced because the album covers are static images—is closer to right. Our brains are wired to pay attention to things that change in our environments. That’s why we turn to look when someone walks into the room or when the image on a TV shifts.

It’s also why screens can draw the attention of even young children who can’t yet understand what they’re seeing. The static image of an album cover almost certainly won’t hold your child’s attention in that way. However, he may turn to look each time the image changes, which could interrupt his play.

I would recommend watching your son while the music service is on. Does he turn away from what he’s doing to look at the screen? Does he pause in his play?

If so, a simple fix would be to see if your TV has a brightness control and, if so, to turn it all the way down. If it doesn’t, hang a sheet over the screen when your son is in the room. That should help reduce any distraction and allow him to focus on free play, which is one of the things he most needs.

Enjoy your media and use them wisely,
The Mediatrician®

The Top 10 Mediatrician Q&A's of 2011

Each week this year, you asked our Mediatrician, Dr. Michael Rich, your most pressing questions about the effects of media on kids, and he answered! 

Here are the top 10 most-viewed Ask the Mediatrician Q&As from 2011:

1. When should I talk to my girls about media and body image?

2. Are 3D video games safe for kids’ vision?

3. Video games seem bad for my son, but he doesn't agree...what do I do?

4. Is it OK that my toddler doesn’t like TV?

5. How can I limit my teen’s internet time without distracting him from homework or invading his privacy?

6. Can I protect my kids’ media use at school? On the bus?

7. Will media affect my 4 year old’s ability to pay attention?

8. Can TV help my infant sleep while keeping me awake?

9. How do I ensure that my wired kids are being responsible citizens offline?

10. My teen daughter’s addiction to technology is ruining our family life--what do I do?

Do YOU have a question about children and media? Submit your question by sending an email to cmch@childrens.harvard.edu

Do you have any last-minute tips for holiday shopping?

Q: I'm doing last-minute holiday shopping, and I still don't know what to give! How do I know what to choose for the children in my life? The choices are overwhelming!
-Holiday harried, in Medford, MA

A: Dear Holiday harried,

Never fear! Even as time grows short, you still have time to take a breath and think about what to give the children on your list this holiday season--whether you're giving media or non-media gifts. No matter what you choose, remember to keep the CHILD first:

• Creativity: Think creatively about who the child is & customize your gift.
• Homework: Do your homework to make sure the gift matches the child.
• Imagination: Stimulate their imagination with gifts they can use creatively.
• Learning: Encourage learning with gifts that peak their curiosity.
• Donate: Teach about giving by helping a child make a donation.

Take a look at our media shopping gift guide if you're considering giving media gifts. If you're looking for non-media gifts, check out our non-media gift ideas. And remember, some of the most meaningful gifts are free.

Enjoy your media and use them wisely,
The Mediatrician® 

How can I get my 2½ year old's dad to stop showing her movies that scare her?

Q: I am a single mom of a fun-loving 2½ year old who watches about one hour of TV per day. She spends Saturdays with her dad, and she comes home telling me about Scooby Doo, Sponge Bob Square Pants, Happy Feet, Dumbo, and Finding Nemo. I am concerned about the age appropriateness of these selections. She has had nightmares after watching  Dumbo, and I have watched Finding Nemo and Happy Feet with her and seen her cower behind her hands in certain places. I’ve spoken to her father, and he sees no issue with her watching such TV and will not accommodate my wishes for the TV to be more educational than entertainment. Do you have any data or advice on the damage these media may have on my child?
-Concerned, in Chicago

A: Dear Concerned,

Scary media content can certainly have immediate and lasting effects on kids. Think about how clearly you remember the movies that scared you as a child. For me, the flying monkeys in Wizard of Oz sent me cowering behind the couch, and some college students report that after seeing Jaws as children, they stopped swimming entirely, even in lakes. Long-lived fear reactions like these can happen after just one viewing.

How you address your daughter’s fear reactions should depend on her age. Until she is 7 or 8, her brain won’t really understand the difference between fantasy and reality, so explaining that something isn’t real won’t help her feel better. Therefore, when you see her cowering behind her hands, turn it off, comfort her, and switch activities. If she wants to discuss it, emphasize that she is safe, and that the things she saw won’t happen to her (or to you—many animated films involve parents dying or being separated from their children).

When it comes to discussing this issue with the child’s father, of course, matters can become more complicated. He may see your request as a criticism of his parenting. To sidestep that issue, approach this as a conversation about your mutual efforts to ensure your daughter’s health and well-being, not about whether his media choices are educational.

For example, you can say, “Is she having nightmares at your house? She wakes up crying at mine, and I’m really worried. I think she’s afraid of things she sees on TV and in movies.” Talk with him about what he thinks scares her and how you might work together to create a safer-feeling environment for her. And don’t forget to share what makes her happy in everything she does, including TV and movies. 

Enjoy your media and use them wisely,
The Mediatrician®

What does the new AAP policy say about screentime for babies?

On Monday, the American Academy of Pediatrics came out with a revised policy on media for kids two and younger. The recommendations for this age group are much the same as they were in 1999—that it is best for their developing brains and bodies to avoid both screen use (such as placing a toddler in front of a TV or video) and background media (such as leaving the TV on in the same room where a baby is playing)—but there is new scientific evidence to support these recommendations.

We already knew that newborn brains develop in response to whatever is in their environment. New research from the past 12 years suggests that interacting with people, exploring the physical world (like stacking blocks or “reading” board books), and playing in open-ended ways are great for that development. And no matter how “educational” their content, screen media can’t provide that kind of environment.

That said, screen media aren’t toxic for babies—they’re just not really what they need. And other kinds of media, like music and books, can be great for kids of this age group. The updated AAP policy statement also recognizes that there are good screen media options for preschoolers, whose brains have developed to the point where they can learn from electronic screens.

The reality, of course, is that sometimes you just need get the laundry done or get dinner on the table, so you need a way to occupy your baby or toddler. While you’re taking care of the business of life, try some of these non-screen activities that can occupy and optimize their brain development.

Enjoy your media and use them wisely,
The Mediatrician®

Can TV help my infant sleep while keeping me awake?

Q: My boyfriend and I just had a beautiful baby boy. He is a month old. I like to leave the TV on even if he is sleeping so that I can stay awake. I was hoping that the noise would be good for him and that it would keep me awake while he sleeps. Is that okay for him?
-TV for sleep?, in Washington

A: Dear TV for sleep?,

You are right that TV can help you stay awake—because humans are animals that evolved to be awake in the daytime and asleep at night, we are aroused and activated by light. Television provides that light, as well as moving, changing images and sounds that grab our attention. The same elements that keep you awake will also keep your baby awake and, thus, can interfere with healthy sleep.

The difference between “calming” and “quieting”
You may notice that older children, even very active ones, will sit quietly in front of the tube even when they won’t settle down for much else. That might make it seem like watching TV calms them down. But what’s actually happening is that the bright light and constantly changing image are capturing and holding their attention—which arouses and alerts their brains. They are being constantly stimulated, and their still-developing brains won’t really let them turn away.

So if TV arouses kids, why do they so often fall asleep in front of the TV? Because, ultimately, all of that stimulation wears them down until they simply can’t stay awake anymore. When in front of the TV, they enter sleep by way of exhaustion rather than by calming themselves to sleep.

But once exhaustion has overwhelmed stimulation and he is asleep, he may become dependent on the TV, music, or other accompaniment when he is falling to sleep, not because it is calming, but because it is what he is used to. Then he may find it difficult, perhaps impossible to get to sleep without it—and may wake up the moment it is turned off. Babies have a self-protective reflex to go on alert when there is a change in their environment. If the noise and light of the TV are the environment in which he drifts off, there is a dramatic environmental change when the TV is turned off and he will go on alert.

The importance of self-calming
Children need to learn to calm themselves and get to sleep without the aid of external technology. This will allow them to cope with stressful situations, manage their emotions and impulses, and get to sleep. Not only will he be able to soothe himself and get to sleep in a variety of situations (a real help to you as a busy parent), but he will be calmer when he is awake. The ability to calm himself learned as an infant will serve your son well as an adult.

You may want to consider taking those precious moments when he is asleep to get some rest yourself. But if you are using TV to keep yourself awake, let your baby put himself to sleep in a quiet, dark space and watch TV in another room. Not only are you helping him to self-calm and preparing him for a lifetime of restful, healthy sleep habits, but you are keeping TV out of his bedroom, which will lower his risk of poor sleep, school problems, aggression, and obesity as he grows up. 

Enjoy your media and use them wisely,
The Mediatrician®