This article contains content that is written like an advertisement .(May 2020)
|Headquarters||Itasca, Illinois, United States|
|Lee Beers, MD, FAAP|
The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C.
The Academy was founded in 1930 by 35 pediatricians to address pediatric healthcare standards.It has 67,000 members in primary care and sub-specialist areas. Qualified pediatricians can become fellows (FAAP).
The Academy runs continuing medical education (CME) programs for pediatricians and sub-specialists. The Academy is divided into 14 departments and 26 divisions that assist with carrying out its mission.
The AAP's website with child health information for families can be found at www.HealthyChildren.org.
It has the largest pediatric publishing program in the world, with more than 300 titles for consumers and over 500 titles for physicians and other healthcare professionals. These publications include electronic products, professional references/textbooks, practice management publications, patient education materials, and parenting books.
The AAP News is the academy's official news magazine,and Pediatrics is its flagship journal.
The AAP issues a weekly reporton COVID-19 cases in the United States. From when states started reporting to September 17, 2020, the AAP tracked 587,948 child COVID-19 cases, 5,016 child hospitalizations, and 109 child deaths.
In 2006, the Academy received a grant from the Flight Attendant Medical Research Institute (FAMRI) to plan and establish a Center of Excellence dedicated to the elimination of children's exposure to tobacco and secondhand smoke. The Richmond Center was established to help institutionalize pediatric tobacco control activities at AAP and was named in honor of Julius B. Richmond, MD, Chair of the FAMRI Medical Advisory Board and former Surgeon General of the United States Public Health Service. The Center provides the education, training, and tools needed to effectively intervene to protect children from the harmful effects of tobacco and secondhand smoke.
The Academy has published hundreds of policy statements ranging from advocacy issues to practice recommendations. The academy's policy website contains all current Academy policies and clinical reports.The AAP policy regarding its statements is to give each statement a five-year life, after which the statement expires unless it is reaffirmed.
The AAP has changed positions on its age limit throughout the years. In 1988, the American Academy of Pediatrics published a statement on the age limit of pediatrics that identified the upper age limit of pediatrics as age 21. The policy had a note that exceptions could always be made when the doctor and family jointly agree to an older age.
Recent studies have shown that the age of 21 years is just an arbitrary line for adolescence because brain development has not reached adult levels of functioning until their early 30s. In a 2017 policy update, AAP changed its policy to discourage age limits of pediatric providers and instead have families reach an agreement with their pediatric provider as to when to transition care.
In 2009, the national office and four of its State chapters provided training support to 49 pediatric practices to improve adherence to well-established asthma care guidelines. The percentage of patients at participating practices with well-controlled asthma (as defined by the National Heart, Lung, and Blood Institute) rose from 58 to 72 percent.
The AAP periodically issues guidance for child passenger safety, including policy recommendations for transitioning between rear-facing car seats, front-facing car seats, belt-positioning booster car seats, and vehicle safety belts.These recommendations are typically published in the peer-reviewed scientific journal Pediatrics, and tend to attract attention and controversy in popular press and social media.
Previously, the AAP recommended that children remain rear-facing until they are 2 years of age.In response to updated crash test, simulation, and field data, the AAP revised their guidance to exclude the age guideline entirely. Current AAP Child Passenger Safety recommendations (as of August 30, 2018) state that children should remain in a rear-facing car seat for as long as possible, until they meet the maximum height or weight dictated by the car seat manufacturer. The full recommendations state that:
On June 29, 2020, AAP stated that it "strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school" as remote learning makes it more difficult for education professionals to notice learning deficits, physical and sexual abuse, depression and suicidal ideation. The AAP argued that masks are probably not practical for children younger than middle school unless they can wear a mask without increased face touching. Teachers unions opposed the AAP statement, however, saying "Our educators are overwhelmingly not comfortable returning to schools...They fear for their lives, the lives of their students and the lives of their families."Two weeks later, the AAP walked back its support, under political pressure from teachers and other groups. President Donald Trump had cited AAP's original statement repeatedly, pressuring school leaders to reopen schools.
In its 2020 statement in Pediatrics, the AAP called for banning all digital advertising targeted to children under the age of 7 and urged limits to advertising aimed at people under 17.
In 1999, the academy said that the health benefits of the procedure outweigh the risks, and supports having the procedure covered by insurance.
In a 2012 position statement, the academy stated that a systematic evaluation of the medical literature shows that the "preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure" and that the health benefits "are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns," but "are not great enough to recommend routine circumcision for all male newborns". The academy takes the position that parents should make the final decision about circumcision after appropriate information is gathered about the risks and benefits of the procedure.
After the release of the position statement, a debate appeared in the journal Pediatrics and the Journal of Medical Ethics .In 2013, a group of 38 Northern European pediatricians, doctors, surgeons, ethicists and lawyers co-authored a comment stating that they found the AAP's technical report and policy statement suffered from cultural bias, and reached recommendations and conclusions different from those of physicians in other parts of the world; in particular, the group advocated instead a policy of no-harm towards the infants and respect for their rights of bodily integrity and age of consent. An opinion by two authors stated that, in their view, the AAP's analysis was inaccurate, improper and incomplete. The AAP received further criticism from activist groups that oppose circumcision. The AAP responded to these criticisms in the Journal of Medical Ethics, calling for respectful and evidence-based debate.
The AAP policy regarding its statements is to give each statement a five-year life, after which the statement expires unless it is reaffirmed. [ citation needed ]The 2012 Circumcision Policy Statement has not been reaffirmed, so it expired in 2017. As of 2021, the AAP has no official circumcision policy.
Electronic nicotine delivery systems (electronic cigarettes, e-hookahs, vape pens, others) are highly addictive and often candy flavored products that are rapidly rising in popularity among middle and high school students, and appear to be serving as a gateway to other forms of tobacco, and threaten to addict a new generation to nicotine.
When they are sold, concentrated nicotine solutions such as those used in electronic nicotine delivery systems should be required to be in child-proof containers and be limited to a quantity of nicotine that would not be lethal to a young child if ingested. The US Food and Drug Administration needs to tightly regulate these products to protect youth.
In April 2010, the academy revised its policy statement on female genital cutting, with one part of the new policy proving controversial. Although condemning female genital cutting overall, this statement suggested that current federal law banning the practice had the unintended consequence of driving families to perform the procedures in other countries, where these girls faced increased risk. As a possible compromise, this policy statement suggested that physicians have the option to perform a ceremonial "nick" on girls as a last resort to prevent them from being sent overseas for full circumcision. This particular position proved controversial to advocates for a full ban on female genital cutting under any circumstancesand concern from other medical groups that even a "nick" would be condoning this widely rejected procedure. One month later, the academy retracted this policy statement.
The American Academy of Pediatrics AGCM posted guidelines in dealing with the ethical issues in pediatric genetic testing.
The American Academy of Pediatrics says that although U.S. firearms-related deaths have dropped since the 1990s, guns were responsible for over 80 percent of teen homicides in 2009 and were the most common suicide method among teens.The AAP believes pediatricians should discuss guns and gun safety with parents before babies are born and at children's annual exams. It also advocates for, among other things, more background checks, an assault weapons ban, and federal research on gun violence.
The AAP warns of possible marijuana damage to children and adolescents.In states that have already legalized marijuana, the Academy recommends that pediatricians and regulators treat it as they would with tobacco. The Academy does support "decriminalization" of marijuana—reductions in the penalties for its use and possession—in combination with an increased commitment to substance-abuse treatment. The Academy also recommends changing marijuana from a DEA Schedule 1 to a DEA Schedule 2 to facilitate research into pharmaceutical uses.
Recognizing that insufficient sleep in adolescents is an important public health issue that significantly affects the health and safety, as well as academic success, the American Academy of Pediatrics strongly supports efforts of school districts to optimize sleep in students and urges high schools and middle schools to aim for start times no earlier than 8:30 a.m. to allow students the opportunity to achieve optimal levels of sleep (8.5–9.5 hours) and to improve physical and mental health, safety, academic performance, and quality of life. Although the AAP acknowledges that numerous factors may impair the amount and/or quality of sleep in adolescents—among them, biological changes in sleep associated with puberty, lifestyle choices, and academic demands—it considers school start times before 8:30 a.m. ("earlier school start times") to be a key modifiable contributor to insufficient sleep, together with circadian rhythm disruption. It also recognizes that a substantial body of research has demonstrated that delaying the start of the school day is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to the physical and mental health, safety, and academic achievement of students—including reduced obesity risk, rates of depression, and drowsy driving crashes as well as improved academic performance and quality of life. Later start times also result in less frequent tardiness.
There is limited medical controversy surrounded the AAP regarding "Abusive head trauma".The current skepticism is not whether violent shaking, or shaking with slamming, is dangerous to infants or children, but of how the scientific information is used in the legal processes. The AAP updated its policy paper in 2020. In the updated policy paper, the APP states " The AAP continues to affirm the dangers and harms of shaking infants, continues to embrace the “shaken baby syndrome” diagnosis as a valid subset of the AHT diagnosis, and encourages pediatric practitioners to educate community stakeholders when necessary."
AAP and the American Heart Association recommended statins for children as young as 8 years with high lipid concentrations and for children as young as 2 years with major cardiovascular risk factors. The AAP was criticized for "fear that it will open the way for drug companies to bombard anxious parents with ads promoting these and other products and increase the number of parents insisting on prescriptions for their children. The ease of popping pills should not distract parents, health professionals, or policy makers from the more arduous tasks of cutting back on junk foods, promoting healthy diets, and putting physical education back into the schools.”
AAP recommends that tobacco control programs should change the image of tobacco by telling the truth about the substance. This includes prohibiting tobacco advertising and promotion that is accessible to children, as well as point of sale advertising, product placements in movies and other entertainment media, and promotion in print or internet based media accessible to youth. Advertising and promotion has been shown to be a cause of tobacco use initiation in adolescents.
AAP supports a minimum purchasing age of 21 years for tobacco products. Increasing age of purchase has been shown to decrease youth smoking rates. Younger age of starting tobacco use leads to lower the rates of ever stopping tobacco use.
In addition to comprehensive smoking bans in workplaces and public areas, smoking in multi-unit housing should be prohibited
In 2018, the AAP issued a policy statement putting forward a model of "gender affirmative care".Gender affirmative care are based in the idea that "transgender identities and diverse gender expressions do not constitute a mental disorder", that "variations in gender identity and expression are normal aspects of human diversity, and binary definitions of gender do not always reflect emerging gender identities", that "gender identity evolves as an interplay of biology, development, socialization, and culture" and that "if a mental health issue exists, it most often stems from stigma and negative experiences rather than being intrinsic to the child". The AAP also describe in this policy "conversion" or "reparative" therapy as "unsuccessful", "deleterious" and "outside the mainstream of traditional medical practice". Finally, the AAP recommends that youth identifying as transgender have access to comprehensive and development-appropriate healthcare provided in safe and inclusive clinics but also that family based therapy be available. The AAP also recommend that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for transgender youth.
Paediatrics is the branch of medicine that involves the medical care of infants, children, and adolescents. The American Academy of Pediatrics recommends people seek pediatric care through the age of 21. In the United Kingdom, paediatrics covers patients until age 18. Worldwide age limits of pediatrics have been trending up year over year. A medical doctor who specializes in this area is known as a pediatrician, or paediatrician. The word pediatrics and its cognates mean "healer of children"; they derive from two Greek words: παῖς and ἰατρός. Pediatricians work in hospitals and children's hospitals particularly those working in its subspecialties, and as outpatient primary care physicians.
Spanking is a common form of corporal punishment involving the act of striking, with either the palm of the hand or an implement, the buttocks of a person to cause them physical pain. Although the term spanking broadly encompasses the use of either the hand or implement, the use of implements can also refer to the administration of more specific types of corporal punishment such as caning, paddling and slippering.
Male circumcision is the surgical removal of the foreskin (prepuce) from the human penis. The ethics of circumcision in neonates and children is a source of much controversy.
The Denver Developmental Screening Test (DDST) was introduced in 1967 to identify young children, up to age six, with developmental problems. A revised version, Denver II, was released in 1992 to provide needed improvements. These screening tests provide information about a range of ages during which normally developing children acquire certain abilities and skills. By comparing a child’s development to the developmental age ranges in this tool, it allows providers to identify young children with developmental problems so that they can be referred for help.
The red reflex refers to the reddish-orange reflection of light from the back of the eye, or fundus, observed when using an ophthalmoscope or retinoscope. The reflex relies on the transparency of optical media and reflects off the fundus back through media into the aperture of the ophthalmoscope. The red reflex is considered abnormal if there is any asymmetry between the eyes, dark spots, or white reflex (Leukocoria).
Third-hand smoke is contamination by tobacco smoke that lingers following the extinguishing of a cigarette, cigar, or other combustible tobacco product.
Reach Out and Read, Inc. is a US, nonprofit organization that promotes reading. Reach Out and Read envisions a world where every child is read to every day; where parents have daily, meaningful, language-rich interactions with their children.
Intact America is a registered non-governmental Intactivist organization created in 2008 to advance the view that the circumcision of non-consenting minors is unethical and medically unnecessary, and therefore should be abandoned. They also claim that circumcision reduces sexual sensation in males and that it is a violation of modern bio-ethical standards to forcibly remove erogenous tissue from children. The activist organization uses traditional media, social-networking, demonstrating, and other methods to encourage social change. The group has been mentioned in the Chicago Tribune, New York Times, MSNBC, and Huffington Post.
The American College of Pediatricians (ACPeds) is a socially conservative advocacy group of pediatricians and other healthcare professionals in the United States. The group was founded in 2002. In 2005, it reportedly had between 150 and 200 members and one employee; in 2016 it reportedly had 500 physician members. The group's primary focus is advocating against abortion and the adoption of children by gay or lesbian people. It also advocates conversion therapy.
Calvin C.J. Sia was a primary care pediatrician from Hawaii who developed innovative programs to improve the quality of medical care for children in the United States and Asia. Two particular programs have been implemented throughout America: the Medical Home concept for primary care that has been promoted by the American Academy of Pediatrics and the federal Emergency Medical Services for Children program administered by the U.S. Department of Health and Human Services’ Health Resources and Services Administration, Maternal and Child Health Bureau. His Medical Home model for pediatric care and early childhood development began to take root in several Asian countries in 2003.
Children with Special Healthcare Needs (CSHCN) are defined by the Maternal and Child Health Bureau as:
The scientific community in United States and Europe are primarily concerned with the possible effect of electronic cigarette use on public health. There is concern among public health experts that e-cigarettes could renormalize smoking, weaken measures to control tobacco, and serve as a gateway for smoking among youth. The public health community is divided over whether to support e-cigarettes, because their safety and efficacy for quitting smoking is unclear. Many in the public health community acknowledge the potential for their quitting smoking and decreasing harm benefits, but there remains a concern over their long-term safety and potential for a new era of users to get addicted to nicotine and then tobacco. There is concern among tobacco control academics and advocates that prevalent universal vaping "will bring its own distinct but as yet unknown health risks in the same way tobacco smoking did, as a result of chronic exposure", among other things.
An alternative vaccination schedule is a vaccination schedule differing from the schedule endorsed by the Advisory Committee on Immunization Practices (ACIP). These schedules may be either written or ad hoc, and have not been tested for their safety or efficacy. Proponents of such schedules aim to reduce the risk of adverse effects they believe to be caused by vaccine components, such as "immune system overload" that is argued to be caused by exposure to multiple antigens. Parents who adopt these schedules tend to do so because they are concerned about the potential risks of vaccination, rather than because they are unaware of the significance of vaccination's benefits.
Michael Weitzman is an American pediatrician specializing in public health and policy. He is known for his research focusing on the social and environmental determinants of child health. He has published over 150 articles in medical and scientific journals on the damaging effects of second-hand smoke, lead exposure, and countless other determinants of children's health and behavior. From 1999-2005 he served as the executive director of the Center for Child Health Research, a national research institute created by the American Academy of Pediatrics.
Brief resolved unexplained event (BRUE), previously apparent life-threatening event (ALTE), is a medical term in pediatrics that describes an event that occurs during infancy. The event is noted by an observer, typically the infant's caregiver. It is characterized by one or more concerning symptoms such as change in skin color, lack of breathing, weakness, or poor responsiveness. By definition, by the time they are assessed in a healthcare environment they must be back to normal without obvious explanation after the clinician takes the appropriate clinical history and physical examination.
Dimitri Alexander Christakis is an American pediatrician, researcher, and author from Seattle, Washington.
Rhea W. Boyd is an American pediatrician and child and community health advocate. Boyd is a popular science communicator, making use of social media to amplify a diverse range of voices in an effort to improve the heath of communities of colour.
Timothy Brei is a Professor of Neurodevelopmental Pediatrics at the University of Washington and a developmental pediatrician at Seattle Children's Hospital. He is also the medical director of the Spina Bifida Association of America. Brei's research has focused on healthcare outcomes for children with spina bifida and as an adult with spina bifida who is an uncommon leader, he has also served as an advocate.
Suzinne Pak-Gorstein is an attending pediatrician at Harborview Medical Center, an Associate Professor in the Pediatrics Department, and an Adjunct Associate Professor in the Global Health Department at the University of Washington in Seattle. She serves on numerous committees and focuses her career on helping immigrant and refugee children and families. Pak-Gorstein focuses her work on Child Health Equity which includes Global Health Nutrition. More specifically; refugee health, global health, and global public health education. Pak-Gorstein is a contributor to many publications on global health, pediatrics, and nutrition.
All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.