title: Prevalence of infant television viewing and maternal depression symptoms.
abstract: BACKGROUND
  Early television (TV) viewing has been linked with maternal depression and has adverse health effects in children. However, it is not known how early TV viewing occurs. This study evaluated the prevalence at which parents report TV viewing for their children if asked in the first 2 years of life and whether TV viewing is associated with maternal depression symptoms.
  
  
  METHODS
  Using a cross-sectional design, TV viewing was evaluated in children 0 to 2 years of age in 4 pediatric clinics in Indianapolis, IN, between January 2011 and April 2012. Families were screened for any parental report of depression symptoms (0-15 months) and for parental report of TV viewing (before 2 years of age) using a computerized clinical decision support system linked to the patient's electronic health record.
  
  
  RESULTS
  There were 3254 children in the study. By parent report, 50% of children view TV by 2 months of age, 75% by 4 months of age, and 90% by 2 years of age. Complete data for both TV viewing and maternal depression symptoms were available for 2397 (74%) of children. In regression models, the odds of parental report of TV viewing increased by 27% for each additional month of child's age (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.25-1.30; p < .001). The odds of TV viewing increased by almost half with parental report of depression symptoms (OR, 1.47; CI, 1.07-2.00, p = .016). Publicly insured children had 3 times the odds of TV viewing compared to children with private insurance (OR, 3.00; CI, 1.60-5.63; p = .001). Black children had almost 4 times the odds (OR, 3.75; CI, 2.70-5.21; p < .001), and white children had one-and-a-half times the odds (OR, 1.55; CI, 1.04-2.30; p = .032) of TV viewing when compared to Latino children.
  
  
  CONCLUSIONS
  By parental report, TV viewing occurs at a very young age in infancy, usually between 0 and 3 months and varies by insurance and race/ethnicity. Children whose parents report depression symptoms are especially at risk for early TV viewing. Like maternal depression, TV viewing poses added risks for reduced interpersonal interactions to stimulate infant development. This work suggests the need to develop early targeted developmental interventions. Children as young as 0 to 3 months are viewing TV on most days. In the study sample of 0 to 2 year olds, the odds of TV viewing increased by more than a quarter for each additional month of child's age and by as much as half when the mother screened positive for depression symptoms.
authors.affiliation: *Pediatric Institute, Cleveland Clinic, Cleveland, OH; †Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN; and ‡The Regenstrief Institute for Health Care, Indianapolis, IN.
authors.forename: Vibha
authors.initials: V
authors.lastname: Anand
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Downs
authors.forename: Nerissa S
authors.initials: NS
authors.lastname: Bauer
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Carroll
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000523:psychology; D008297:Male; D009035:Mothers / Q000523:psychology*; D015995:Prevalence; D013690:Television / Q000706:statistics & numerical data*