How physicians can help families curb smartphone use in young children

The smartphone is ubiquitous, and that includes smartphone use by children. It is worth considering the potential harm to our youngest patients. This article looks at the risks of smartphone use in young children and at what physicians can do to help families manage those risks.

Smartphone use has penetrated the child demographic to an impressive degree, even among children younger than 10. The 2025 Common Sense Census found that nearly 1 in 4 children have their own cellphone by age 8, and that 40% of children have a tablet by age 2.

What the research shows

Research has tied early smartphone ownership to worse health outcomes. A study of more than 10,500 children in the Adolescent Brain Cognitive Development study, published in Pediatrics, found that owning a smartphone at age 12 was associated with higher rates of depression, obesity and insufficient sleep, and that a younger age of acquisition was linked to additional risk of obesity and insufficient sleep.

A separate German cohort study published in Pediatric Research found that symptoms of problematic smartphone use and daily use of more than three hours have both become more common since 2018, with the sharpest increases among girls and younger children.

Clinicians have connected heavy early use to a longer list of concerns, including:

• Interference with the development of empathy and social skills, both with peers and within the family.
• Interference with vital hands-on play and learning.
• Development of addictive behavior patterns.
• Interference with sleep.
• Anti-social online behavior such as cyberbullying.
• Damage to children's vision.
• Depression and alienation.

What can parents do?

A few suggestions for parents include:

• Do not buy young children a smartphone before you sense they are ready to use it responsibly. A reasonable guideline is to wait until the mid-teen years.
• Join forces with other parents. Schools may get involved if parents take a stand.
• Know what your child is doing, online and offline, and steer them firmly away from harmful uses. Monitoring and time-limiting applications are readily available, including Apple Screen Time, Google Family Link, Bark and Qustodio.
• Set limits on screen time and on when smartphone use is allowed.
• Do not permit smartphone use at dinner or at bedtime.
• Do not permit screen time before homework is finished.
• Educate the child about the device, the internet and cyberbullying. Parents tell children not to talk to strangers, and the same rule applies to communicating with strangers on a smartphone.

Seven steps for physicians

Physicians can play a key role in guiding families to limit and manage smartphone use in young children by pairing evidence-based recommendations with the strategies parents are already using.

1. Follow AAP and Surgeon General guidance. The American Academy of Pediatrics advises against screen time for children younger than 18 months, limits children ages 2 to 5 to one hour of high-quality programming a day and stresses the quality of interactions over strict time limits. The HHS Office of the Surgeon General's May 2026 advisory on the harms of screen use urges children to be in the moment, encouraging outdoor play, face-to-face socializing and unstructured play away from screens.

2. Encourage co-viewing. Counsel families to prioritize co-viewing and co-playing with parents or older siblings rather than passive screen time. It helps children learn, develop social skills and build emotional guard rails.

3. Set balanced, contextual rules. Instead of rigid time limits, recommend household rules such as device-free times at meals and bedtime, co-viewing to monitor content and reinforce learning, and offline activities like reading, sports and creative play.

4. Monitor and manage content. Advise parents on using parental controls to block inappropriate or violent content, previewing apps and videos before use, and choosing interactive, educational media over passive scrolling.

5. Recognize warning signs of problematic use. Educate families about the signs of digital addiction, including losing track of usage, compulsive checking, withdrawal from real-life activities and negative effects on sleep, mood or relationships. Early recognition leads to timely intervention.

6. Address developmental risks. Explain to parents that early and excessive smartphone use can affect neuroplasticity and social-emotional development, especially during sensitive developmental periods. Encourage delaying the first smartphone until the child shows maturity, and limiting its use to education and communication.

7. Collaborate with schools and the community. Work with pediatricians, school nurses and community health programs to promote healthy screen habits, especially in school settings, where device use is common.

Bottom Line: Physicians can help curb smartphone use in young children by applying AAP and Surgeon General guidance, focusing on quality over quantity, setting balanced rules, monitoring content, recognizing problematic use and encouraging the offline activities that support healthy development.

Neil Baum, M.D., a professor of clinical urology at Tulane University in New Orleans, Louisiana. Dr. Baum is the author of several books, including the best-selling book Marketing Your Medical Practice: Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.