I was getting ready for the day, my 2 1/2 year old was watching Sesame Street. In the show, the segments change every few minutes or so and seem to weave old-school 1970′s content (familiar to me) with newly created vignettes that have a modern feel and construction. I like it nearly as much as the boys. One of the stories this morning was about tooth fairies. An animated group of fairies were detailing how they got to the tooth under a child’s pillow (lifting up the child) to replace it with a golden coin. Mind you, I was coming and going from the room and didn’t view the whole story. However at one point, the fairies accidentally turn on the child’s TV and worry it might wake the child, ultimately uncovering their work and secret magic.

A TV in the child’s bedroom? No way, Sesame.

If it were my child, I’d never allow a TV in a child’s bedroom. Plain and simple, I know it’s not good for them and ultimately will only detract from their life. When I talk to families in my practice, I say that TV in the bedroom is just never going to make their life better. It won’t enhance. Unfortunately, what I hear is that it might make a parent’s life better. Some families really do come to rely on it as did I this AM while I was getting ready. But we need to figure out ways to use it better. When I talk with families about reducing media time, I talk about media use and the substantial effect junk food advertising has on children actually asking for and eating junk food, how distracted eating (eating in front of a screen) may contribute to obesity, how TV contributes to disrupted and poor quality of sleep, and the studies that find early TV exposure increases the risk for attention challenges. TV doesn’t help language development either, I say that too.

TV can be a great way for children to learn cooperation and model friendship or empathy if shown educational programming geared for their age. In balance, TV isn’t all-bad. Of course we make screen time decisions in the context of life. But I must say, I really don’t think TV will make your child smarter.

The timing of this Sesame episode this morning was uncanny. Today, the AAP published a policy statement from The Council on Communications and Media (full disclosure: I sit on this council) entitled, “Children, Adolescents, Obesity and the Media” detailing effects of screen time/media and junk-food advertising on children in relation to obesity. The authors state, “Sufficient evidence exists to warrant a ban on junk-food or fast-food advertising in children’s TV programming.” and they point out that, “Pediatricians need to ask 2 questions about media use at every well-child or well-adolescent visit”

1. How much screen time is being spent per day?
2. Is there a TV set or Internet connection in the child’s bedroom?

I also tell families that TV watching is not as cognitively sedating as our instincts may suggest. TV viewing in the 1-2 hours before bed seems to rev kids up, not wind them down. Today, more data to support this. Dr. Michelle Garrison, Kimberly Liekweg, and Dr Dimitri Christakis from Seattle Children’s, published a study in Pediatrics describing violent-TV’s effect on preschoolers. They studied over 600 children between 3 and 5 years of age and reviewed their TV/media diaries.

• Dr. Garrison et al found that preschoolers watched on average over an hour of TV daily (72.9 min) with the minority being at bedtime (14 min after 7pm).
• They also found that children with a bedroom TV watched 40 more minutes of TV than those without one. Not surprisingly, children with a bedroom TV watched more TV after 7pm as well.
• Violent TV viewing in the daytime and TV after 7pm disrupted sleep for the preschoolers.
• Children with a bedroom TV were more likely to have parent-reported daytime tiredness (8% vs 1% without bedroom TV).
• Children were more likely to have trouble falling asleep, have more nightmares, and more awakenings if in the 1 hour prior to going to bed, they watched TV, violent or not.
• Fortunately, nonviolent daytime TV didn’t seem to change or impair preschoolers’ sleep.
• It didn’t make a difference on sleep if parents watched TV alongside their children.

A TV (or iPad, computer, or smartphone) in the bedroom makes pre-bedtime viewing that much more common. Once a screen is in a child’s room, it will be difficult to get it out. Most estimates find that about 1/3 of every preschooler in America has a TV in their bedroom (some studies as high as 40%). So something about this is very appealing to many families.

What’s your take? Do you follow the AAP’s guidelines for no TV prior to age 2 and then after age 2, only 2 hours maximum screen time daily? Do you think it’s crazy to recommend no TV for an hour or two prior to bed?  Do you share my frustration with Sesame Street over the vignette they presented with a TV in the bedroom?

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc.

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