American Academy of Pediatrics releases two updated guidelines
- Paula Mydlenski MS, RDN, CDN
- Monday, October 31st, 2016
You may have recently seen that the American Academy of Pediatrics (AAP) announced updated versions of two guidelines.
The first, released October 21, is regarding screen time guidelines for children. It appears that these guidelines acknowledge:
- How integral digital communication has become in our everyday lives;
- The quality difference of various screen communications (e.g. online games such as "Grand Theft Auto" or "drill and grill numbers" versus video chatting with a deployed parent or quality, age-appropriate PBS/Sesame Street programming);
- And the importance of parent or adult presence and interaction with the child as she/he interacts with the screen.
They have scrapped "no screen time before age 2 years" and replaced it with “the only acceptable form of screen time for children under 18 months is video-chatting”.
Some of the AAP's main recommendations are:
- For children younger than 18 months, avoid use of screen media other than video-chatting. Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they are seeing.
- For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
- For children ages 6 and older, place consistent limits on the time spent using media and the types of media; and make sure media does not take the place of adequate sleep, physical activity, and other behaviors essential to health.
- Designate media-free times together, such as dinner or driving, as well as media-free locations at home, such as bedrooms.
- Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.
The full AAP news release can be found at http://tinyurl.com/hn2ouyq. A shorter article from Time.com is at http://time.com/4541118/screen-time-guidelines-kids-parenting/.
The other new guideline, released October 24, discusses infant sleeping guidelines updated to prevent sudden infant death syndrome (SIDS) and other sleep-related conditions. The last guidelines were issued over a decade ago.
A few "big news" aspects -- The policy statement recommends that babies sleep in the parents' room, but not in the same bed, for at least the first six months of life and preferably for the first year. AAP indicates that room sharing, like breastfeeding, has been shown to reduce SIDS by as much as 50%. In the full statement, AAP acknowledges that parents get tired and sometimes fall asleep while feeding their baby, which may occur on a couch, armchair or adult bed with soft bedding, pillows, etc. So, the guidelines recommend that parents should plan for this.
Here is a quick list of AAP's 2016 safe sleep recommendations:
- Place infants on their back to sleep (supine) for every sleep period until they are 1 year old. This position does not increase the risk of choking and aspiration.
- Use a firm sleep surface.
- Breastfeeding is recommended.
- Infants should sleep in the parents’ room, close to the parents’ bed but on a separate surface designed for infants, ideally for the first year, but at least for the first six months.
- Keep soft objects and loose bedding out of the infant’s sleep area.
- Consider offering a pacifier at naptime and bedtime.
- Avoid smoke exposure during pregnancy and after birth.
- Avoid alcohol and illicit drug use during pregnancy and after birth.
- Avoid overheating and head covering in infants.
- Pregnant women should obtain regular prenatal care.
- Infants should be immunized according to the recommended schedule.
- Avoid using commercial devices that are inconsistent with safe sleep recommendations, such as wedges and positioners.
- Do not use home cardiorespiratory monitors as a strategy to reduce SIDS risk.
- Supervised tummy time while the infant is awake can help development and minimize positional plagiocephaly.
- There is no evidence to recommend swaddling to reduce the risk of SIDS.
- Health care professionals and staff in newborn nurseries and neonatal intensive care units as well as child care providers should endorse and model recommendations to reduce SIDS risk.
- Media and manufacturers should follow safe sleep guidelines in messaging and advertising.
- Continue the Safe to Sleep campaign, focusing on ways to further reduce sleep-related deaths.
- Research and surveillance should continue on all risk factors.
For the complete AAP press release on screen time, go to http://tinyurl.com/j5ag342.
For an additional article, view this CNN story at http://www.cnn.com/2016/10/24/health/sids-sleep-in-same-room/.