The objectives of this study were to describe media access and use among US children aged 0 to 6, to assess how many young children fall within the American Academy of Pediatrics media-use guidelines, to identify demographic and family factors predicting American Academy of Pediatrics media-use guideline adherence, and to assess the relation of guideline adherence to reading and playing outdoors. Data from a representative sample of parents of children aged 0 to 6 (N = 1051) in 2005 were used. Descriptive analyses, logistic regression, and multivariate analyses of covariance were used as appropriate. On a typical day, 75% of children watched television and 32% watched videos/DVDs, for approximately 1 hour and 20 minutes, on average. New media are also making inroads with young children: 27% of 5- to 6-year-olds used a computer (for 50 minutes on average) on a typical day. Many young children (one fifth of 0- to 2-year-olds and more than one third of 3- to 6-year-olds) also have a television in their bedroom. The most common reason given was that it frees up other televisions in the house so that other family members can watch their own shows (54%). The majority of children aged 3 to 6 fell within the American Academy of Pediatrics guidelines, but 70% of 0- to 2-year-olds did not. This study is the first to provide comprehensive information regarding the extent of media use among young children in the United States. These children are growing up in a media-saturated environment with almost universal access to television, and a striking number have a television in their bedroom. Media and technology are here to stay and are virtually guaranteed to play an ever-increasing role in daily life, even among the very young. Additional research on their developmental impact is crucial to public health.