Screen exposure in early childhood described by the Italian Surveillance System 0-2 years

Background

International guidelines recommend zero screen time for children younger than 2 years. Despite this, the use of digital devices among children has increased worldwide, with earlier exposure in infancy. This study describes screen exposure among Italian children aged 0-2 years evaluating its association with maternal and family socio-demographic characteristics.

Methods

The Italian Surveillance System for children aged 0-2 years is a national, cross-sectional, population-based sample survey repeated every three years, that provides prevalence estimates on health determinants in early childhood. Data are collected via a self-administered, multilingual questionnaire completed by mothers at their children’s vaccination appointments. Among the topics investigated, mothers are asked whether and how often their child is exposed to screens. Maternal and family socio-demographic characteristics are also collected. Multivariate Poisson regressions were used to evaluate social determinants of screen exposure.

Results

The 2025 data collection enrolled 64,789 mothers in all Italian regions (except Tuscany), with a response rate of 93%. Overall, 69.0% of children are not exposed to screens, with an increase compared to the previous data collection (58.2% in 2022). Nevertheless, 9.6% are exposed for at least 1 hour/day, with the highest prevalence among children aged 11-15 months (15%). Higher screen exposure was associated with maternal foreign citizenship, low or medium education, perceived economic difficulties, and with living in Central or Southern Italy. Attendance at antenatal classes was associated with lower screen exposure.

Conclusions

Although an improvement in screen guidelines adherence is observed, we are still far from the zero-exposure recommended. These findings highlight the need for early preventive strategies, starting in pregnancy, and for programs addressing social inequalities.

Key messages

• Early childhood screen exposure is a relevant and modifiable public health issue.

• Surveillance data are essential to guide equity-oriented preventive policies and programs.