A systematic review by doctors in Bahrain has raised concerns about the age at which children are first exposed to smartphones and tablets, as well as the amount of time they spend using them, with some introduced to the devices before their first birthday.
The review found that some young people spend more than eight hours a day online, prompting researchers to urge schools and healthcare professionals to address excessive screen use. They warned that prolonged screen time can disrupt sleep and reduce participation in healthy activities.
The review, entitled ‘Smartphone Use Health Outcomes in Children and Adolescents: A Systematic Review of Behavioural, Developmental and Environmental Risk Pathways’, was recently published in the World Journal of Clinical Cases. It was conducted by doctors in Bahrain from the University Hospital, Arabian Gulf University, Royal College of Surgeons in Ireland – Bahrain, along with several doctors in Egypt.
Researchers examined 97 studies involving children and adolescents below 18, looking at the potential effects of smartphone use on their health and development.
“Strong and consistent evidence linked smartphone use to disrupted sleep, with several studies finding that greater screen exposure, particularly before bedtime, was associated with shorter sleep, taking longer to fall asleep and poorer sleep quality,” the review said.
The findings revealed widespread smartphone exposure from an early age, with around 91 per cent of children aged four and under already using or being exposed to the gadgets.
“These early years are an important period for brain development, meaning excessive smartphone use during this stage could have a greater impact on children’s development and ability to learn,” the review said.
Prolonged smartphone use was also linked to neck, shoulder and upper-back pain, particularly when children spent long periods looking down at their screens.
“These problems were more commonly reported among those using smartphones for more than three to five hours a day,” the review added.
Dr Elbeltagi
For Professor of Paediatrics and Senior Consultant at University Hospital, Arabian Gulf University Mohammed Elbeltagi, and one of the study’s authors, years of treating children in Bahrain have heightened his concerns about prolonged and poorly regulated smartphone use.
“Prolonged close-up smartphone use even has an effect on children’s eyes,” he told the GDN.
“Children may blink less frequently and may not take enough visual breaks, leading to eye fatigue, dryness or burning, blurred vision, headaches, difficulty focusing and a feeling of heaviness or discomfort around the eyes.”
Prof Elbeltagi also cited research showing that children spend a significant amount of time on screens, with average daily usage exceeding seven hours on weekdays and eight hours on weekends.
He noted that excessive screen use was prevalent among children of both working mothers and homemakers, indicating that the issue cannot be solely attributed to whether parents are at home.
“This suggests that the issue is influenced by several factors, including family routines, easy access to devices, parental monitoring and the growing role of digital media in everyday life,” he said, adding that tackling this should not fall solely on parents as schools and healthcare professionals should also play a role in helping children develop healthier habits.
Dr Tomar
King’s College Hospital London, Dubai (Bahrain Clinic) consultant paediatrician and paediatric hepatologist Dr Rajeev Tomar said the concern is not only the amount of time children spend on screens, but also whether screen use is replacing essential elements of a healthy daily routine.
He warned that excessive screen time can become harmful when it reduces opportunities for physical activity, adequate sleep and healthy eating habits. This, in turn, may contribute to unhealthy weight gain and increase the risk of conditions such as insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD).
MASLD is an increasingly important health concern and is emerging as a leading cause of chronic liver disease and liver transplantation in adults.
“Parents should focus on creating a healthy balance rather than removing screens completely, recommending clear boundaries such as keeping devices out of bedrooms at night, having screen-free mealtimes, encouraging regular breaks and making time for daily physical activity and outdoor play,” said Dr Tomar, who is also the director of the Paediatric Liver Transplant Centre.
“Parents do not need to think of screens as something that must be completely removed from their children’s lives,” he added.
“The important question is whether screen use is crowding out the things children need for healthy development.”
For younger children, he also noted that excessive screen time has been associated with delayed speech and language development, particularly when it replaces face-to-face interaction, play and communication with parents and caregivers.
* Health groups such as the American Academy of Paediatrics recommend limiting non-school screen time to no more than two hours a day for those aged five to 17.
* For younger children, the recommended limit is one hour or less for ages two to five, while children under 18 months should generally avoid screen use, apart from video calls.
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