The American Academy of Pediatrics has discouraged media use in young children since 1999. The initial recommendation was based on limited data, but we believed that there were more potential negatives of media than positives in this age group. Since then, the policy has taken flak from parents, industry and even some pediatricians. Many ask what the harm is in a baby being entertained by a video so a parent can make dinner or take a shower.

But the concerns raised are even more relevant today. Screens are everywhere and 90 percent of kids two-years and younger spend an average of an hour a day watching TV or videos. So we decided to take a fresh look at the scientific evidence and see if our concerns were still valid.

Here are the key questions and answers we found:

Do infant/toddler programs have any educational value for kids under the age of two?

Nope. There is a digital developmental divide. Video gets “lost in translation” for children under one and a half to two and a half-years-old. They can’t figure out the content or context to actually learn from televised programs. While a few 18-month-olds might “get it,” the majority of kids don’t have that skill until they are at least two-years-old. Entertaining? Yes. Educational? No. Young children learn best from real people and playing with real objects. Kids over age two can learn language and social skills from high-quality shows.

Is there any harm in children under the age of two watching televised programs?

There are three concerns here.

1) Short-term language delays. Young children who watch televised programs may have delayed language skills. Why? We don’t know. One concern is that parents talk less to their kids when the TV is on, and that “talk time” is critical for young children to learn language. We don’t have any long-term studies to see how this plays out, but the short-term effects are concerning.

2) Less quality and quantity of sleep. Nearly 30 percent of American kids aged two to three have a TV in their bedroom and 30 percent of parents admit to using TV as a sleep aid for their child. However, this backfires as kids go to bed later and have more disrupted sleep when they go to bed with the tube on.

3) Time well spent? We know you can’t play with your child 24/7, but letting your child have unplugged, unstructured, independent playtime while you cook dinner is really valuable! It fosters your child’s problem solving skills and her imagination - important life tools. That is time better spent than being entertained by a program. (Check out the tips below for what your little one can be doing while you’re busy doing something else.)

Does secondhand TV (programs intended for adults that are on when a child is in the room) affect young children?

Yes. It is distracting for parents, who are talking less to their child when their shows are on. And it is distracting for the child. Even if the show is over a child’s head, he will be less focused on his activity if he is playing nearby with the TV on. And many parents say their TV is always or often on, even when no one is watching it (which begs the question, WHY?). Our advice: turn the TV off if you aren’t watching anyway, and watch your own shows later.

We know you can’t keep your child away from screens 100 percent of the time, and we know you can’t play with your child 24/7, but this updated statement is meant to make parents more aware of the impact of media on young children so that they will thoughtfully consider the whole family’s media use and make a plan how to manage it!

Here are some ideas for simple, inexpensive activities that your infant or young child can do without your participation. Remember that as your baby starts to crawl, use a portable playpen or safety gates to keep your child in a safe area if your eyes are distracted. And make sure all toys are too large and impossible to swallow or chew.

Sensory Activities

• For young infants, offer interesting items like colorful or high-contrast toys or mobiles to look or follow with their eyes.
• Let your baby listen to music. Let your older baby or young child play with rattles or child-friendly music boxes.
• Offer safe objects or toys that are touchable with different textures.
• Offer large plastic toys, wood or plush toys without small removable pieces to grab, manipulate and mouth.

Cognitive/Language

• Let your baby explore hard cardboard books that are bite and rip-proof.
• Offer “cause and effect” toys. Let your baby figure out how to make an object light up or make noise or move.
• Toys that can be filled and dumped are also popular with young children.

Social

• Let your baby play with a plastic mirror to look at herself.
• Offer pretend play props to children over age one (pretend food, picnicware, teacups, a grocery cart, baby doll or baby carriage).
• Let your child participate in activities of daily living. While you are cooking, let your baby “cook” his own meal on the floor with pots and pans. While you are cleaning up, let him “clean up” with his own towel.

Large and Small Muscles

• Infants as young as three months can play with an activity gym to bat/grab objects.
• Offer old measuring cups, plastic food containers, pots, pans, wooden spatulas to explore.
• Let your older baby play with a big ball to roll, kick or throw.
• Stacking cups or “nesting cups” are good for using small muscles and figuring out how to stack. Shape sorters (cylinders with plastic shapes and matching holes in the top) are another classic toy for toddlers to encourage eye-hand coordination.

Dr. Ari Brown is a pediatrician in Austin, Tex. and is the lead author of the American Academy of Pediatrics report "Media Use by Children Younger Than Two Years."

All statements and opinions expressed on this blog are those of the individual contributors, and not of the Bill & Melinda Gates Foundation or NBC News.