In this issue of Pediatrics, Alruwaily et al1  provide an update on advertising to children by evaluating the presence of food product placements in user-created content on the social media platform YouTube. At a time when social media companies are creating spaces specifically for children (eg, YouTube Kids and Messenger Kids), this study offers an important start to needed research on the impacts of advertising and marketing to children by “kid influencers.” The authors define social media influencers as “‘everyday people’ whose primary tool for building fame involves creating entertaining or engaging YouTube videos or social media posts that help them attract large numbers of social media followers. Kid influencers are children whose parents film videos of the child playing with toys or engaging in family-friendly activities.”

Social media celebrity influencers are well known, have large viewing audiences, and continually generate new content that is always available. This user-generated content often includes activities such as unboxing and playing with toys, interacting with siblings, making food items, and activities that seem ordinary. In general, influencers are more diverse (eg, underrepresented minority or lesbian, gay, bisexual, transgender, or queer) than more traditional entertainers, thus increasing their relatability and appeal to diverse populations and their consumer reach.2  Digital marketing campaigns have exploited this combination of appeal and large viewership to advertise to broad audiences.3  Social media influencers are, potentially, highly effective spokespersons for product marketing.

Although, in their study, Alruwaily et al1  offer a unique research method for extracting data from a social analytics platform, the authors’ search criteria yielded only 5 kid influencer channels, and they excluded 3 channels because of having <50 videos displaying food and/or drink items in the thumbnail image displayed next to the video title. The search did not allow for the evaluation of impressions generated by microinfluencers who have from 1000 to 100 000 followers.4  These exclusions likely led to an underestimate of food and/or drink impressions. Despite the limitations, the authors found concerning results with 179 videos (1 billion views) featuring food and/or drink, with >94% of the food items being unhealthy and 93% of those items being branded.

Social media allow for direct communication with followers (such as when an influencer replies directly to comments from viewers) and relatability. The viewer may develop a one-sided or parasocial relationship (PSR) with the influencer, a term that describes an emotional connection felt by the viewer for the influencer, in which the influencer is perceived as more of a peer or friend.5  Youth who follow social media personae and have received responses from the influencer have even stronger perceived relationships with the influencer.2  Because children and parents view content on social media platforms such as YouTube, the PSR may either prevent them from recognizing the influencer as a paid promoter of products or instill trust and credibility in a product brand being displayed because of a belief that the influencer would not endorse the product if they did not truly like it.6  Among children and teenagers, perceived attractiveness and similarity with the media influencer can positively impact PSR, and that PSR can positively influence purchase intentions.7  Unfortunately, parental restriction of screen time may not affect this purchase intent.7 

The Federal Trade Commission Act “prohibits unfair or deceptive advertising in any medium. That is, advertising must tell the truth and not mislead consumers.”8  The Federal Trade Commission offers tips for social media influencers on how and when to disclose brand relationships.9  Yet guidelines fall short, given the sheer volume of views by consumers, considering that the most viewed television broadcast, the Super Bowl, had ∼100 million viewers in 202010  and the kid influencers included in this study had 48 billion views. The updated guidelines do not limit the amount of time influencers can discuss or display brand products or how they interact with brand products. These oversights can have significant ramifications. As the authors noted, food and drink impressions included the minutes (not seconds) being viewed. Brand placements in a thumbnail image and video content can be viewed repeatedly. The influence of the PSR on trust and relatability may skew the viewer from even realizing they are seeing brand endorsement, and disclosure of endorsements may be easily missed (eg, a brand disclosure briefly mentioned at the end of a video may be skipped).

The billions of views reported in this study indicate the potential for sharing healthy lifestyle and eating choices to a large population. As state health departments and pediatric institutions use social media to reach patients and families outside of the examination room,11,12  we can leverage our credibility as experts in child health and development to both generate health-promoting content and urge user-based platforms, such as YouTube, to increase regulation around the advertising of products by kid influencers to child viewers. On an individual level, health care providers can educate parents on their critical role in helping their children be conscientious consumers. Parental mediation in the form of discussion of social media content has been associated with increasing their child’s critical thinking when viewing social media.13  There is evidence that parental critical thinking about media can affect the family dietary behavior.14  The American Academy of Pediatrics has recently revised tips for encouraging digital literacy and educating parents on how to recognize product placements and potential impacts on purchasing.15  In the revised policy, it is recommended that providers recognize how advertisers target children and teenagers, encourage parents to engage in communication with their children about media, and consider using a parent or child’s digital device as a “teachable moment” in the examination room to identify advertisements or persuasive design.15  Because younger children are viewing social media, more solutions are needed to decrease exposure to advertising and mediate the effects of advertising on children and parents as consumers.

Opinions expressed in these commentaries are those of the author and not necessarily those of the American Academy of Pediatrics or its Committees.

FUNDING: No external funding.

COMPANION PAPER: A companion to this article can be found online at www.pediatrics.org/cgi/doi/10.1542/peds.2019-4057.

     
  • PSR

    parasocial relationship

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Competing Interests

POTENTIAL CONFLICT OF INTEREST: The author has indicated she has no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The author has indicated she has no financial relationships relevant to this article to disclose.