Baby unplugged: a novel, market-based approach to reducing screen time and promoting healthy alternatives

The issue of electronic media use by young children is increasingly important in pediatrics, a major risk factor for numerous chronic conditions. Despite guidelines in place since 1999, screen time is on the rise, aided by new formats removing practically all barriers of use. Key drivers are technological allure, confusion about developmental readiness, and perception of educational value, fueled by potent marketing. This article describes the development of Baby Unplugged, a series of children's board books celebrating "old-school," screen-free childhood. Written by a pediatrician who also owns a children's bookstore, the books were inspired and informed by advocacy projects in the areas of media use and early literacy as a pediatric resident. They reinforce AAP Electronic Media Guidelines, notably discouraging screen-based media under 2 years old, largely by encouraging healthy, fun alternatives. Examples include Pets, Book, and Yard. Multi-sensorial exploration and parent-child engagement are emphasized in a non-prescriptive way, featuring gender and ethnic diversity and activities that are accessible and inexpensive. The author describes challenges faced by pediatricians providing anticipatory guidance for media use, given limited time and resources and the perception that we are out of touch. This is heightened by oft-deceptive marketing of screen-based products more likely to be perceived as "cool." Reach Out and Read is cited as an example of a successful, "cool" intervention, though limited to select populations. Baby Unplugged takes advocacy to the marketplace, where the screen time battle is being lost.