American Academy of Pediatrics
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.
|Motto||Dedicated to the health of all children|
|Headquarters||Itasca, Illinois, United States|
|Colleen A. Kraft, MD, MBA, FAAP (2018–2019)|
The academy was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It has 64,000 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.
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 health-care 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 newsmagazine, and Pediatrics is its flagship journal.
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.
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.
Car safety seats
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:
- Infants, toddlers and children should remain rear-facing as long as possible. Currently available car seats provide weight and height limits that allow children to be rear-facing beyond their second birthday.
- Once children are transitioned to forward-facing, they should use a car safety seat equipped with a 5-point harness for as long as the manufacturer recommends (i.e., until they reach the manufacturer's weight or height limit). Currently available convertible car seats and combination car seats support the use of a 5-point harness until a child is 65 pounds or more.
- Once children are transitioned to a belt-positioning booster car seat, they should continue to use the booster until the vehicle's lap and shoulder belt fit properly, which typically occurs when a child is over 4-feet 8-inches tall, and approximately 8–12 years of age.
- Once children are transitioned to the vehicle's lap and shoulder seat belt, they should always use the vehicle's seat belt to maximize protection in the event of an accident.
- Children under 13 years of age should be seated in the rear passenger seat (not the front seat) to maximize protection in the event of an accident.
Elective infant circumcision
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. The 2012 statement is a shift in the academy's position from its 1999 statement in that the academy says the health benefits of the procedure outweigh the risks, and supports having the procedure covered by insurance.
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. The 2012 Circumcision Policy Statement has not been reaffirmed, so it expired in 2017. As of 2019, the AAP has no official circumcision policy.
Female genital cutting
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 circumstances and 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.
Gun violence prevention
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.
School start times for adolescents
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.
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.
Ethical guidelines to pediatric genetic testing
The American Academy of Pediatrics AGCM posted guidelines in dealing with the ethical issues in pediatric genetic testing.
- American College of Pediatricians
- American Pediatric Society
- Academic Pediatric Association
- Society for Pediatric Research
- Sheppard–Towner Act – opposition by the AMA to this federal act (providing for maternity and infant care nationwide) caused the dissenting AMA Pediatrics Section to establish the AAP.
- "Contacting the American Academy of Pediatrics". American Academy of Pediatrics. May 25, 2004. Retrieved March 30, 2013.
- "Pediatric History Center". American Academy of Pediatrics. Retrieved March 30, 2013.
- "AAP Facts: Membership". American Academy of Pediatrics. Retrieved May 10, 2016.
- "FAAP Certification". American Academy of Pediatrics. Retrieved April 12, 2016.
- "Departments & Divisions". American Academy of Pediatrics. Archived from the original on April 1, 2013. Retrieved March 30, 2013.
- "AAP Facts: Publications". American Academy of Pediatrics. Retrieved March 30, 2013.
- "AAP News". American Academy of Pediatrics. Archived from the original on July 27, 2013. Retrieved March 30, 2013.
- "AAP Journals: Pediatrics – The Flagship Journal of the AAP". American Academy of Pediatrics. Archived from the original on May 1, 2013. Retrieved March 30, 2013.
- "Advocacy & Policy". American Academy of Pediatrics. Retrieved March 30, 2013.
- "National Academy and Affiliated State Chapters Support Pediatricians in Improving Asthma Care, Leading to Better Guideline Adherence and Disease Control, Fewer Acute Episodes". Agency for Healthcare Research and Quality. June 5, 2013. Retrieved June 6, 2013.
- "AAP Updates Recommendations on Car Seats for Children". American Academy of Pediatrics. August 30, 2018. Retrieved August 31, 2018.
- Committee on Injury, Violence, and Poison Prevention (2011). "Child Passenger Safety". Pediatrics. 127 (4): 788–793. doi:10.1542/peds.2011-0213. Retrieved August 31, 2018.
- Dennis R. Durbin, MD (2018). "Child Passenger Safety" (PDF). Pediatrics. 142 (4): e20182461. doi:10.1542/peds.2018-2461. Retrieved August 31, 2018.
- "Pediatricians drop age limit for rear-facing car seats". CNN. August 30, 2018. Retrieved August 30, 2018.
- "New car seat guidelines for rear-facing seats are designed to save lives". All the Moms – A USA Today Publication. August 31, 2018. Retrieved August 31, 2018.
- "AAP Updates Recommendation on Car Seats for Children". American Academy of Pediatrics. August 30, 2018. Retrieved August 30, 2018.
- Dennis R. Durbin, MD (2018). "Child Passenger Safety" (PDF). Pediatrics. 142 (4): e20182461. doi:10.1542/peds.2018-2461. Retrieved August 31, 2018.
- "Circumcision Policy Statement". Pediatrics. 130 (3): 585–586. August 27, 2012. doi:10.1542/peds.2012-1989. PMID 22926180.
- Rabin, Roni (August 27, 2012). "Benefits of Circumcision Are Said to Outweigh Risks". The New York Times. Retrieved March 30, 2013.
- Brown, Eryn (August 26, 2012). "Pediatricians' Group Shifts in Favor of Circumcision". Los Angeles Times. Retrieved March 30, 2013.
- Tanner, Lindsey (August 27, 2012). "Circumcision Benefits Outweigh Risks and Insurers Should Pay; Pediatricians Revise Stance". Associated Press (via National Post). Retrieved March 30, 2013.
- Aigrain, Yves; Barauskas, Vidmantas; Bjarnason, Ragnar; Boddy, Su-Anna; Czauderna, Piotr; de Gier, Robert P.E.; de Jong, Tom P.V.M.; Fasching, Günter; Fetter, Willem; Gahr, Manfred; Graugaard, Christian; Greisen, Gorm; Gunnarsdottir, Anna; Hartmann, Wolfram; Havranek, Petr; Hitchcock, Rowena; Huddart, Simon; Janson, Staffan; Jaszczak, Poul; Kupferschmid, Christoph; Lahdes-Vasama, Tuija; Lindahl, Harry; MacDonald, Noni; Markestad, Trond; Märtson, Matis; Nordhov, Solveig Marianne; Pälve, Heikki; Petersons, Aigars; Quinn, Feargal; Qvist, Niels; Rosmundsson, Thrainn; Saxen, Harri; Söder, Olle; Stehr, Maximilian; von Loewenich, Volker C.H.; Wallander, Johan; Wijnen, Rene (April 2013). Frisch, Morten (ed.). "Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision" (PDF). Pediatrics. American Academy of Pediatrics. 131 (4). doi:10.1542/peds.2012-2896. PMID 23509170. Retrieved January 23, 2019.
- Svoboda, J. Steven; Van Howe, Robert S. (March 18, 2013). "Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision". Journal of Medical Ethics. 39: 434–441. doi:10.1136/medethics-2013-101346. PMID 23508208. Retrieved January 22, 2019.
- Stehr, Maximilian; Winters, Anna (September 2013). "Preventive circumcision: European doctors doubt AAP report". Aktuelle Urologie (in German). Thieme Medical Publishers. 44 (5): 337–338. doi:10.1055/s-0033-1356849. PMID 24043524. Retrieved January 22, 2019.
- Emmons, Sasha (August 27, 2012). "AAP: Health benefits of circumcision outweigh the risks". CNN. Retrieved September 22, 2014.
- Rochman, Bonnie (August 27, 2012). "Circumcision: Pediatricians Say Benefits Trump Risks". Time. Retrieved September 22, 2014.
- "The AAP Task Force on Neonatal Circumcision: a call for respectful dialogue". Journal of Medical Ethics. 39: 442–443. March 18, 2013. doi:10.1136/medethics-2013-101456. Retrieved March 30, 2013.
- Belluck, Pam (May 6, 2010). "Group Backs Ritual 'Nick' as Female Circumcision Option". The New York Times. Retrieved March 30, 2013.
- "Joint RCOG/RCPCH statement on the AAP policy statement on FGM". Royal College of Obstetricians and Gynaecologists. May 12, 2010. Retrieved March 30, 2013.
- "American Academy of Pediatrics withdraws policy statement on female genital cutting". American Academy of Pediatrics. May 27, 2010. Archived from the original on October 13, 2013. Retrieved March 30, 2013.
- Belluck, Pam (May 26, 2010). "Doctors Reverse Stand on Circumcision". The New York Times. Retrieved March 30, 2013.
- Pittman, Genevra (October 18, 2012). "Pediatricians call for strict gun laws to protect kids". Reuters. Retrieved October 21, 2013.
- Rho, Helena (February 1, 2013). "The Pediatricians vs. the NRA: How the gun lobby is trying to gag doctors from talking about kids and guns". Slate. Retrieved October 21, 2013.
- Viebeck, Elise (April 29, 2013). "Pediatricians to push for gun control on Capitol Hill". The Hill. Retrieved October 21, 2013.
- "American Academy of Pediatrics Gun Violence Policy Recommendations" (PDF). January 2013. Retrieved October 21, 2013.
- "School Start Times for Adolescents". Pediatrics. 134 (3): 642–9. 2014. doi:10.1542/peds.2014-1697. PMID 25156998.
- Committee on Substance Abuse, Committee on Adolescence (2015). "The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update" (PDF). Pediatrics. 135 (3): 584–7. doi:10.1542/peds.2014-4146. Retrieved April 25, 2018.
- "American Academy of Pediatrics Reaffirms Opposition to Legalizing Marijuana for Recreational or Medical Use". American Academy of Pediatrics. January 26, 2015. Retrieved April 24, 2018.
- "AAP Issues New Guidance on Genetic Testing of Children". American Academy of Pediatrics. February 21, 2013. Retrieved October 21, 2017.