Fussy infants and toddlers watch more TV, study says

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ATLANTA (CNN) — Does your baby have difficulty calm him or herself? Falling and staying asleep? It can be stressful, especially for new parents. But once again, researchers are recommending that parents avoid plopping them down in front of the television.

According to a new study published Monday in the journal Pediatrics, fussy babies and toddlers tend to watch more TV and videos than infants with no issues or mild issues. And that can lead to problems down the road.

"We found that babies and toddlers whose mothers rated them as having self-regulation problems - meaning, problems with calming down, soothing themselves, settling down to sleep, or waiting for food or toys - watched more TV and videos when they were age 2," said study author Dr. Jenny Radskey, who works in the division of developmental and behavioral pediatrics at Boston Medical Center.

"Infants with self-regulation problems watched, on average, about 9 minutes more media per day than other infants. This may seem small, but screen-time habits are established in these early years."

"Television and other entertainment media should be avoided for infants and children under age 2," says the American Academy of Pediatrics because they say "a child's brain develops rapidly during these first years, and young children learn best by interacting with people, not screens."

We found that babies and toddlers whose mothers rated them as having self-regulation problems — meaning, problems with calming down, soothing themselves, settling down to sleep, or waiting for food or toys — watched more TV and videos when they were age 2.

–Dr. Jenny Radskey, study author

Radskey says the infants and toddlers who had the fussiest behavior were 40 percent more likely to exceed those AAP guidelines. This study also found that 42 percent of 2-year-olds exceeded those guidelines.

What's not clear, according to Radskey, is whether they watched more TV because they were fussy and their parents put them in front of the TV as a distraction, or if the heavy TV use contributed to their self-regulation problems. But Radskey says one thing is clear: "Several studies show that too much screen time before age 2 or 3 is associated with language and learning delays, ADHD, and difficulties in school - probably because the screen time replaced early learning activities. And also probably because early media habits predict later media habits."

Infants get very little from watching TV, Radskey says, and it could be overstimulating them, so viewing time should be minimal.

"A little bit of calm, educational and age-appropriate media is probably fine in this age group, and is probably beneficial if it leads to less-stressed parents who can get some things done in the meantime," she said. "But the primary way that infants and toddlers learn is through play with their caregivers and exploring environment, not looking at 2-dimensional images."

The researchers looked at data from nearly 7,500 children born in 2001 who participated in the Early Childhood Longitudinal Study. At 9 months and again at 2 years old, parents filled out the Infant Toddler Symptom Checklist, a scale that looks at self-regulation. The checklist identifies infants and toddlers who are fussy, and have problems with sleep, eating and regulating mood and behavior. They found that at age 2, these children watched about 2.3 hours of TV or video a day.

Dr. Penny Glass, director of child development programs at Children's National Health System in Washington, believes at this age watching TV and videos contributes to behavior problems.

"There's no practice of conversational skills when a child is watching a program aimed at and designed to capture their attention in a hypnotic kind of way," she said. "It's scary to think that you have to present preschoolers information in the form of video in order for them to be interested enough to learn from it. They should be interacting with each other, developing social relationships.


"You do not develop socially if your primary interest is watching TV. It's a skill developed with practice."

Glass has this advice for parents with a toddler who has problems self-regulating: "Get help early on. Because using TV as an answer is not going to solve the problem; they are more likely to end up with a bigger problem."

Dr. Mary Pipan, a behavioral pediatrician at the Children's Hospital of Philadelphia (CHOP) who specializes in child development, has a more moderate approach.

"TV that is watched with a parent that is developmentally appropriate for a child can be a positive experience for both the parent and the child," Pipan said. "It's a content question and an amount question. And the bottom line is it's not so much what appropriate TV does to children, it's what it takes them away from: socializing and physically active play."

Radesky suggests staying away from loud, jarring and overstimulating shows, and sticking to age appropriate content for just a brief period each day. And if it helps decrease parental stress levels along the way....

"The most important thing is for parents to take care of themselves," she said. "So if a little bit of calm, age-appropriate screen time helps parents stay sane, and the screen time is balanced with lots of other activities, I think that is OK. But it's also important to learn how to read our fussy kids, and not just opt for an easy way to make the fussing stop."

She says responding to a fussy child depends on their age, stage of development, and why they are fussing. "Do they just need some hugs and feel like they're your center of attention? Do they want to play or dance or read together? Do they want to be involved in what you're doing? Are they frustrated with something they need your help with? Some of these fussing moments are actually good teaching moments."

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