The first 1001 days of life, beginning from conception and continuing until a child's second birthday, represent one of the most critical periods of human development. During this time, the brain undergoes rapid structural and functional changes, making infants particularly sensitive to environmental influences. Healthy caregiver interaction, responsive communication, play, nutrition, and adequate sleep are essential for optimal neurodevelopment.1,2 With digital devices becoming increasingly integrated into daily life, concerns have grown regarding the impact of screen exposure during this vulnerable developmental period.
A recent systematic review commissioned by the 1001 Critical Days Foundation and conducted by researchers from the University of Leeds, Leeds Trinity University, Aston University, and Loughborough University evaluated global evidence regarding screen exposure in children younger than two years.3 The review concluded that intentional and regular screen use during infancy offers limited developmental benefits while being associated with several adverse health and developmental outcomes. Consequently, the authors recommend that children younger than two years should avoid routine intentional screen exposure and suggest reconsidering recommendations or commercial claims that describe digital media as suitable for infants of "all ages".3
These findings are consistent with current international recommendations. The World Health Organization advises that children younger than two years should not be exposed to sedentary screen time, while the American Academy of Pediatrics recommends avoiding digital media in children younger than 18–24 months except for supervised video communication with family members.1,4 Despite these recommendations, studies indicate that screen exposure among infants continues to increase worldwide.3
One of the major concerns highlighted by the review is the effect of excessive screen exposure on caregiver–child interaction. Infants acquire language, emotional regulation, and social skills primarily through direct, responsive interactions with caregivers. Increased screen use may reduce opportunities for these essential face-to-face exchanges, thereby affecting language acquisition and social development.5,6
Sleep is another area that may be negatively influenced by early digital media exposure. Several studies have demonstrated an association between screen use in infancy and shorter sleep duration, delayed sleep onset, and poorer sleep quality, possibly due to overstimulation and disruption of circadian rhythms.7 Since adequate sleep is fundamental for brain maturation and cognitive development, maintaining healthy sleep habits during infancy remains an important public health priority.
The review also identified associations between prolonged screen exposure and reduced physical activity, fewer opportunities for imaginative play, impaired peer interaction, increased sedentary behaviour, greater risk of childhood obesity, and possible adverse effects on visual health.3,8 Furthermore, frequent reliance on digital devices to calm distressed children may interfere with the development of healthy emotional self-regulation.3 However, the authors emphasize that current evidence demonstrates associations rather than direct causal relationships with specific developmental disorders.
An important observation from the review was that parental screen use strongly correlates with children's screen exposure. Rather than assigning blame to caregivers, the researchers acknowledge that digital technology has become deeply embedded in everyday life through work, education, healthcare, shopping, and communication. Consequently, parents often receive limited guidance while navigating increasingly digital environments.
Parents participating in the review reported uncertainty regarding appropriate screen use for young children and expressed a desire for clearer advice from healthcare professionals.3 In response, the researchers propose incorporating infant screen-time risk assessments into routine healthcare visits. Such assessments could help identify children at risk of excessive screen exposure, facilitate timely counselling, and encourage healthier developmental practices.
Although further research is required to determine the most effective interventions, several practical strategies have demonstrated potential benefits. Encouraging outdoor activities promotes physical development while reducing opportunities for screen use and supporting eye health.1,8 Avoiding digital devices during mealtimes may improve eating behaviours and increase family interaction. Providing non-digital toys encourages active exploration, cognitive development, and fine motor skills. Likewise, regular face-to-face interaction with caregivers, siblings, and peers remains essential for language development, emotional wellbeing, and social competence 3,5
The review concludes that addressing excessive infant screen exposure requires a coordinated societal approach rather than focusing solely on individual parenting practices. Researchers advocate for stronger public health policies, improved caregiver education, consistent guidance from healthcare professionals, and responsible marketing by technology companies. Supporting families with evidence-based recommendations and practical resources may help optimize developmental outcomes during the first 1001 days of life, laying the foundation for healthier childhood development and long-term wellbeing.
References:
1. World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. Geneva: World Health Organization; 2019.
2. Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet. 2017;389(10064):77–90.
3. University of Leeds, Leeds Trinity University, Aston University, Loughborough University. Digital screen use during the first 1001 days: A systematic review commissioned by the 1001 Critical Days Foundation. Leeds (UK): University of Leeds; 2026.
4. American Academy of Pediatrics. Beyond screen time: quality family media use in early childhood. Pediatrics. 2024;154(5):e2024066840.
5. Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA. Associations between screen use and child language skills: a systematic review and meta-analysis. JAMA Pediatr. 2020;174(7):665–75.
6. Domingues-Montanari S. Clinical and psychological effects of excessive screen time on children. J Paediatr Child Health. 2017;53(4):333–8.
7. Cheung CHM, Bedford R, De Urabain IRS, Karmiloff-Smith A, Smith TJ. Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep onset. Sci Rep. 2017;7:46104.
8. Oswald TK, Rumbold AR, Kedzior SGE, Moore VM. Psychological impacts of screen time and green time for children and adolescents: a systematic scoping review. PLoS One. 2020;15(9):e0237725.
Read more...