NEW YORK, Jan 20: Children’s screen time alone is no longer enough to protect their health, the American Academy of Pediatrics (AAP) said in new guidance highlighting the growing impact of digital media on sleep, learning, and mental well-being.

The guidance, based on a review of hundreds of studies on digital media and health over the past 20 years, emphasizes that device limits must be paired with broader strategies to address how platforms are designed and how children interact with them. It provides recommendations for families, healthcare providers, technology companies, and policymakers to create safer online experiences for children.

“Over the last decade, the science of media has evolved, and simply taking devices away or enforcing rigid rules can backfire for parents,” said Dr. Tiffany Munzer, pediatric behavioral specialist at the University of Michigan Hospital. “We now understand there are specific design features of digital media — some that promote positive benefits, and others that are highly engagement-based that can overtake healthier activity.”

The AAP noted that while concerns about heavy screen use remain valid, enforcing strict time limits alone does not address platforms’ powerful engagement-driven designs. “Screen time alone doesn’t tell the whole story anymore,” said Dr. Hansa Bhargava, pediatrician and AAP spokesperson on social media use. “Today’s digital world isn’t just TV — it’s an immersive ecosystem designed to keep kids engaged as long as possible.”

This ecosystem includes social media, video games, apps, and algorithm-driven feeds built around autoplay, notifications, and targeted content, Bhargava added. Low-quality digital use, such as mindless scrolling, autoplay videos, frequent notifications, and algorithm-driven extreme content, can overstimulate children and lead to poor sleep, attention difficulties, academic challenges, and emotional regulation problems.

Conversely, high-quality digital content — including educational, creative, and social platforms — can benefit developing minds when it avoids manipulative designs and prioritizes privacy, the report said.

The guidance offers parents strategies for managing digital use, including being selective about sites and engaging in shared media experiences with their children. “Watching a movie together and then talking about what you’re seeing, I don’t really think of as screen time — it’s together time,” Bhargava said.

The report also emphasized that responsibility cannot rest solely with families. “There are powerful systemic factors shaping children’s digital experiences — and that’s exactly why the responsibility has to be shared,” Munzer said. The guidance recommends that technology companies and policymakers take concrete steps, including limiting targeted advertising to minors, strengthening privacy protections, improving age verification, and increasing transparency around algorithms.

Munzer highlighted the need for safety standards for digital platforms similar to those applied to playgrounds, toys, cars, and food. “We created safety rules for playgrounds once we realized kids were getting hurt. In the digital world, we have yet to build the same safety standards,” she said.

The report also urged greater investment in public resources to provide offline alternatives to screens, such as libraries, parks, after-school programs, childcare, and community spaces. “When kids have safe places to play, learn, and connect offline, screens stop filling that gap,” Bhargava said. “We need to make sure kids are getting the fundamentals — sleep, nutrition, exercise, and communication with their parents. If those pieces are in place, screens don’t have the same power.”