Smartphones and internet-enabled mobile devices have become common in households and have substantially changed children's access to digital media. Portable devices differ from traditional television because they can be used anywhere, are highly interactive, and provide instant access to videos, games, social media, and educational content [1,2].

Although digital media may provide educational and communication benefits, excessive or unsupervised use has been associated with increased sedentary behavior, sleep disturbance, unhealthy lifestyle patterns, and psychosocial concerns in children and adolescents [4-10]. Pediatric guidance therefore emphasizes age-appropriate limits, parental supervision, and avoidance of using screens as a routine calming strategy [1,15].

In India, increasing smartphone availability has resulted in early exposure of children to mobile devices. However, local data regarding the exact pattern of mobile phone use, duration of exposure, and reasons for providing devices remain limited. Understanding these determinants is essential for developing practical counseling strategies for parents. The present study was conducted to evaluate patterns and determinants of mobile phone use among children aged 1-15 years attending a tertiary-care pediatric center in North India.

Study design and setting: This was a hospital-based prospective cohort study conducted in the Department of Pediatrics and Neonatology, Asian Institute of Medical Sciences, Faridabad, Haryana, India. Study duration: The study was carried out from October 2020 to March 2021. Study population: Children aged 1-15 years attending the outpatient and inpatient services of the Department of Pediatrics who were using mobile phones for any reason were eligible for inclusion. Sample size: A total of 500 children were enrolled. The sample size was calculated using an expected proportion of mobile phone non-users from previous literature, with a 5% level of significance and 2.5% margin of error. Inclusion criteria: Children aged 1-15 years who used mobile phones for any purpose and whose parents/guardians provided informed consent were included. Exclusion criteria: Children who were mentally challenged, unable to participate, or whose parents/guardians refused consent were excluded. Data collection: After written informed consent, a detailed history was taken using a pre-tested questionnaire. Information regarding age, sex, residence, type of family, parental education, socioeconomic status, parental mobile phone use, duration of child mobile phone use, purpose of use, and reasons for providing mobile phones was collected. Statistical analysis: Data were entered in Microsoft Excel and analyzed using Statistical Package for Social Sciences (SPSS) version 25.0. Categorical variables were expressed as frequencies and percentages.

A total of 500 children aged 1-15 years were enrolled. The largest age group was 7-9 years, comprising 211 (42.2%) children. Male children constituted 377 (75.4%) participants. Urban residence was reported in 331 (66.2%) children. Most children belonged to nuclear families (63.0%).

Table 1. Sociodemographic characteristics of children

Among parents, 359 (71.8%) mothers and all fathers had mobile phones. A total of 454 (90.8%) parents had smartphones and 449 (89.8%) had internet access on mobile phones. Parental use of mobile phones for 1-3 hours daily was reported in 241 (48.2%) families.

Table 2. Parental mobile phone use

All enrolled children used mobile phones. The mother's phone was used by 265 (53.0%) children and the father's phone by 235 (47.0%). Daily mobile use of 1-3 hours was reported in 302 (60.4%) children and more than 3 hours in 79 (15.8%) children. The commonest activity was watching YouTube/app-based series (31.6%), followed by playing games (25.0%) and internet surfing (22.4%).

Table 3. Pattern of mobile phone use among children

The present study demonstrated widespread mobile phone exposure among children across all age groups. Most children used mobile phones for 1-3 hours daily, which is consistent with previous studies reporting increasing screen exposure among children worldwide and rapid penetration of smartphones into family environments [2,11]. Earlier work has shown that digital media use begins early in life and continues to rise with age, particularly in urban populations [3,4]. Parental influence emerged as a major determinant of mobile phone exposure. More than 90% of parents possessed smartphones and internet-enabled devices, and children primarily accessed phones owned by their parents. Similar findings have been reported by Rideout and Kabali et al., who observed that parental ownership and accessibility strongly influence children's media habits and screen-time behaviors [2,11]. Video streaming and gaming were the predominant activities among children in the present study. This observation is in agreement with studies demonstrating that entertainment-based screen exposure has largely replaced traditional television viewing among children and adolescents [6-8]. Increased engagement with digital entertainment platforms may contribute to sedentary behavior and reduced physical activity levels [4,5]. A noteworthy finding was the frequent use of mobile phones to calm children or manage behavior. Previous investigations have similarly reported that parents increasingly use smartphones as behavioral regulation tools during feeding, public outings, or periods of distress [12,13]. Although such practices may provide short-term benefits, excessive dependence on digital devices may adversely affect emotional self-regulation and social development [10,12]. The observation that a sizeable proportion of children used mobile phones for more than 3 hours daily is clinically important. Prolonged screen exposure has been linked with adverse health indicators, including obesity, sleep disturbances, poor academic outcomes, psychological distress, and reduced quality of life [4,5,8-10]. These associations reinforce the need for early anticipatory guidance in pediatric practice. The present study also found that academic use accounted for a smaller proportion of mobile phone exposure than entertainment or behavioral-management reasons. This is important because parents may perceive mobile devices as educational tools, but actual use frequently shifts toward video viewing, games, and recreational content [1,2,11]. Active parental supervision and co-viewing are therefore essential components of healthy digital media use [1,13]. Findings from the present study are comparable to previous Indian work by Bansal and Mahajan, who also reported substantial mobile phone use among children and emphasized the need for parental awareness regarding excessive exposure [14]. In the Indian context, rapid smartphone availability, online education, and social acceptance of handheld devices may further increase exposure unless clear family-level rules are established. The public health implications of these findings are substantial. International recommendations emphasize age-appropriate screen exposure limits, adequate sleep, physical activity, and reduced sedentary behavior among children [1,15]. Pediatricians should integrate screen-time counseling into routine outpatient visits and encourage parents to replace passive screen exposure with interactive play, reading, outdoor activity, and structured family time [1,12,15]. The strengths of the present study include its prospective design, relatively large sample size, and detailed assessment of usage patterns and reasons for mobile phone exposure. However, the findings should be interpreted in light of certain limitations including the single-center design, reliance on parent-reported information, and lack of objective screen-time monitoring. Similar methodological limitations have been acknowledged in previous pediatric screen-time studies [3,4,11]. Overall, the findings support the growing body of evidence suggesting that parental practices play a crucial role in determining children's mobile phone exposure. Family-centered educational interventions, routine pediatric counseling, and adherence to established screen-time recommendations may help promote healthier digital habits among children [1,12,14,15]. Strengths The study included a relatively large sample size and assessed multiple dimensions of mobile phone use, including parental device ownership, duration of use, purpose of use, and reasons for providing phones. Limitations This was a single-center study conducted in a hospital setting and may not be fully generalizable to the community. Mobile phone use was assessed through parent-reported information rather than objective digital tracking. The study was descriptive; therefore, causal relationships cannot be inferred.

Mobile phone use among children aged 1-15 years is highly prevalent and largely mediated through parental devices. Video streaming, gaming, and internet surfing are the commonest activities, while calming the child and behavioral/social reasons are major drivers of exposure. Parent-centered interventions, supervised use, and adherence to age-appropriate screen-time guidance may help promote healthier digital habits among children.

Ethical Approval

The study was conducted after approval from the Institutional Ethics Committee of Asian Institute of Medical Sciences, Faridabad, India. Written informed consent was obtained from parents/guardians before enrollment. The study site and ethics approval belong to the institution where the research was originally conducted.

Funding

Nil.

Conflict of Interest

The author declares no conflict of interest.

Acknowledgement

The author acknowledges the Department of Pediatrics, Asian Institute of Medical Sciences, Faridabad, and the participating children and parents.

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