Screens before age two: what the guidance says, and what it means for a baby's eyes
WHO and the AAP advise little or no screen time before two. What they actually say, what is known and unknown about a baby's eyes, and the eye signs that need a check whatever the screen habits.
- WHO (2019): screen time is not recommended for infants under one year, sedentary screen time is not recommended at age one, and age two should have no more than an hour.
- The AAP (2016) says to discourage screen media under 18 months other than video-chatting. The video-call exception is the AAP's, not WHO's.
- No published evidence shows that screens damage a baby's eyes. The AAP statement does not discuss eyes, and the myopia studies are mostly in older children and show association, not proof of cause.
- Outdoor time has the stronger trial evidence for children's eyes: an extra 40 minutes a day at school cut new myopia in six-year-olds from 39.5% to 30.4% over three years.
- Not looking at faces, an eye turning most of the time, or a white pupil in photos need a check whatever the screen habits.
The guidance is firm for babies and softer for toddlers. WHO (2019) says screen time is not recommended for infants under one year, and not recommended as sedentary screen time for one-year-olds. The American Academy of Pediatrics (AAP) says to discourage screen media under 18 months other than video-chatting. Neither says a screen damages a baby's eyes. The worry about eyes is real, but the evidence for it comes from older children, and this page sets out where the line between known and unknown sits.
Parents ask this in plain words: is it bad for my baby's eyes if the phone keeps him quiet at dinner, and does a video call with grandma count. The answers draw on WHO, the AAP policy statement, a 2021 meta-analysis of smart devices and myopia, and a school outdoor-time trial. Where the guidance and the eye evidence differ, the page says so.
What does WHO say about screens for babies and toddlers?
WHO's 2019 guidelines for children under five say that for infants under one year "screen time is not recommended". For one-year-olds, "sedentary screen time (such as watching TV or videos, playing computer games) is not recommended". For two-year-olds it should be no more than one hour, and "less is better".
The reasons WHO gives are about movement, sleep and being with people, not about the eyes. Infants should be active several times a day, including at least 30 minutes of tummy time spread through the day for babies who are not yet mobile, and should not be strapped in a pram or high chair for more than an hour at a time.
When sitting still, "reading and storytelling with a caregiver is encouraged". One correction to a common summary: the WHO page does not carve out video calls. That exception is in the AAP guidance below. The practical step: treat the first birthday as the point where the screen question starts, and the first two years as the time to use screens little.
What does the AAP say, and do video calls count?
The AAP policy statement Media and Young Minds (2016) says: "For children younger than 18 months, discourage use of screen media other than video-chatting." For children aged 18 to 24 months whose parents want to introduce digital media, it advises "high-quality programming/apps" used together with the child, and says letting children use media by themselves should be avoided.
Video calls count differently because they are interactive: the baby sees a relative who sees the baby and responds. The statement names Skype and FaceTime as examples. A call with a grandparent in another town is a conversation held through a screen, which is what the exception recognises.
A video playing in the background is different, because nobody answers the baby. The action: say yes to the call, and treat the cartoon as the thing to hold back. For the older child, screen rules that survive grandma's house shows how to keep one set of rules across homes.
Do screens harm a baby's eye development?
There is no published evidence that screens damage the eyes of babies. A baby's eyes are still learning to see: what a baby can see at 1, 3, 6 and 12 months shows how focus, following and depth develop over the first year, mostly by looking at faces, hands and the room.
The AAP statement does not discuss eyes or myopia at all. The American Academy of Ophthalmology states that it "does not have specific recommendations for amount of screen time for children", and that the effects of digital eye strain are "temporary and no permanent damage is being done to the eyes".
The honest summary is that the guidance for under-twos is driven by sleep, language, movement and the loss of face-to-face play, and the eye question is open for this age group. Not knowing is not the same as safe, and not the same as harmful. It means the evidence is missing.
What do we know about screens and short-sightedness?
The myopia evidence is mostly in older children, and it is about association, not proof of cause. A 2021 systematic review and meta-analysis in The Lancet Digital Health covered 33 studies of people aged 3 months to 33 years.
Smart device screen time on its own was associated with myopia with an odds ratio of 1.26 (95% confidence interval 1.00 to 1.60), and 1.77 when combined with computer use. All the studies measured screen exposure by questionnaire, and the authors concluded that device exposure "might be associated" with higher risk, and that better, objective measures are needed.
That does not show a screen shortens a baby's eye. Near work, time indoors and family history are mixed up with screens in the figures. What does have stronger trial evidence is the other side: in a school trial in Guangzhou, 1,903 six-year-olds who spent an extra 40 minutes outdoors every school day had less new myopia over three years (30.4% against 39.5%).
So the habit with the firmer trial evidence for a young child's eyes is daylight outdoors. Does screen time cause short-sightedness goes through the studies for school-age children.
What can I do instead of a screen for a baby or toddler?
Choose things that give the eyes real depth, faces and distance to look at. The AAP and WHO lists agree on the same shape of day: floor play, tummy time, reading aloud, singing, outdoor time, and a sleep routine. A board book held at the baby's eye level, a mirror, a walk outside in the shade, a toy that rolls across the room and invites following, and simple games of peekaboo all give a baby's eyes something real to follow and focus on.
Some practical steps from the AAP statement: keep mealtimes, bedrooms and parent-child playtime screen free, avoid screens for the hour before bed, and turn off the television when nobody is watching it. "Even infants exposed to screen media in the evening hours show significantly shorter night-time sleep duration", it notes. If a screen is used at 18 to 24 months, watch with the child and talk about it. Does screen size matter and why does my child sit so close to the screen are for when the child is older.
Which eye signs need a check, whatever the screen habits?
A baby's eyes need to be looked at by a doctor if the baby does not seem to look at faces or follow a light or a toy, if an eye turns in or out most of the time, or if a pupil looks white or yellow in a flash photo. These signs matter on their own, with or without screens, and none of them is caused by a phone.
Three pages cover them. My baby does not look at me yet is about eye contact and following. The white glow in a photo is about a pupil that reflects white instead of red; a white glow is a reason to see a doctor promptly. Crossed eyes in newborns explains what is normal in the first months.
The AAO notes that fixation and following are checked at well-child visits, and that instrument-based screening can be done from 12 months to 3 years and should be attempted by age 2 where available; the baby's first eye check describes what to expect. A screen habit is not the reason to book a visit. A worrying sign is.
- The baby does not seem to look at faces or follow a light or toy.
- An eye turns in or out most of the time.
- A pupil looks white or yellow in a flash photo.
- The eyes shake or wobble, or one eye looks different in size.
- A child rubs or covers one eye, or seems not to see on one side.
Common questions
Is any screen time okay for a baby under 1?
Does WHO say video calls are fine for babies?
How much screen time is okay for a 2-year-old?
Can screens cause short-sightedness in babies and toddlers?
Can phone or tablet light damage a baby's eyes?
What should I do instead of using a screen?
When should I take my baby to an eye doctor?
- World Health Organization · To grow up healthy, children need to sit less and play more (2019) · www.who.int
- American Academy of Pediatrics · Media and Young Minds, policy statement (Pediatrics, 2016) · publications.aap.org
- The Lancet Digital Health · Association between digital smart device use and myopia: a systematic review and meta-analysis (Foreman et al., 2021) · pubmed.ncbi.nlm.nih.gov
- JAMA · Effect of time spent outdoors at school on the development of myopia among children in China (He et al., 2015) · pubmed.ncbi.nlm.nih.gov
- American Academy of Ophthalmology · Screen use and kids · www.aao.org
- American Academy of Ophthalmology · Vision screening for infants and children, clinical statement · www.aao.org