As a pediatrician who’s practiced medicine in the Twin Cities area for almost 30 years, I’ve cared for generations of local kids. During that time I’ve been encouraged to see significant progress in pediatric care — new therapies, more inclusive research. Over the past decade as a pediatrician, I’ve been alarmed to see a trend starting to threaten that progress.
Kids are being sucked into a digital vortex that’s driving declining school performance and a rise in mental health issues unlike anything I’ve seen in my career. Social media is consumed by nearly every kid, even the littlest ones. Young patients blithely show me usage statistics on their phones that reveal a mind-boggling number of hours spent on digital platforms like YouTube and TikTok. What my patients don’t realize is the enormous impact all this screen time can have on their developing minds, their self-esteem — even their sleep patterns.
Parents may not fully realize the dangers, either. Many parents lack the tech savvy to help their children meaningfully navigate the online world. Many of my families speak Spanish as the primary language in the home. As a result, their families face additional challenges in this digital era where platforms are often geared toward English-speaking users. And with all the addictive features baked into the technology and platforms kids are using, the reality is that just saying “put down the phone” is no longer enough.
As pediatricians, it’s part of our job to educate kids and parents about healthier screen use and avoiding danger and exploitation online — but given the scope of these problems, the responsibility can’t fall solely on this side of the technology. We need education and legislation to safeguard kids online.
That’s why our state’s pediatric community is proud to support the Minnesota Kids Code, legislation that would improve young people’s experiences online by requiring tech companies to implement privacy-by-default and safety-by-design protections. This legislation takes a smart approach by addressing these problems at their root and making youth privacy and child development a central consideration in developing any technology (and addressing design flaws in existing ones) that kids will interact with.
We know that platforms like YouTube and TikTok can comply because other countries, including the U.K. and Ireland, already have passed laws implementing an Age Appropriate Design Code. In practice, these provisions are helping make technology look more like what the American Academy of Pediatrics officially recommends for kids: “interfaces that are appropriate to child developmental abilities, that are not distracting, and that promote shared parent-child media use and application of skills to the real world” (ideas that AAP’s Family Media Plan can helps parents and kids put into action).
The Kids Code’s safety-by-design framework is paired with solid privacy rules that protect young people and their data from exploitation. Enhancing privacy is critical given the dangers we now know children are being exposed to on the most popular social media platforms. New revelations from an ongoing lawsuit by more than 40 state attorneys general against the parent company of Instagram and Facebook show that Meta knows adult predators use features like “People You May Know” to target kids — but refuses to stop them.
Malicious contact like this can wreak devastation in a child’s life. I’ve even had a patient attempt self-harm after sharing inappropriate personal photos.
That’s just one example of the harm social media facilitates. Other patients struggle with body image, a crisis fueled by design features that glorify or normalize extreme weight loss techniques and ever-shrinking physiques. During adolescence, it’s common for teens of all genders to have increased concerns about body image and appearance. My own clinical experience reflects the national statistic that health visits related to eating disorders more than doubled among kids 16 and younger between 2018 and 2022. These days, youth are reporting profoundly distorted views of themselves — wanting to look like they do through beauty filters, comparing themselves to AI-generated influencers.
It’s no coincidence that the number of kids with mental health issues is at the highest I’ve ever seen. We are seeing skyrocketing levels of mental and behavioral problems linked to social media in pediatric clinics all across Minnesota. This has prompted a tremendous change in how pediatricians practice medicine, as we’ve had to step into the roles of psychologists and psychiatric prescribers.
We must tackle this public health threat head-on and safeguard Minnesota’s kids. That’s why, as pediatricians, we call on legislators to take action and pass the Minnesota Kids Code into law.
Eileen Crespo, MD, FAAP, is the president of the Minnesota Chapter of the American Academy of Pediatrics. Dr. Crespo practices at Hennepin Healthcare and is the vice president of medical services at Delta Dental.
