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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.[1]

American Academy of Pediatrics
2LineAAPLogoPos.png
Motto Dedicated to the health of all children
Formation 1930; 88 years ago (1930)
Type Professional association
Headquarters Itasca, Illinois, United States
Coordinates 42°02′12″N 87°58′58″W / 42.0366°N 87.9827°W / 42.0366; -87.9827Coordinates: 42°02′12″N 87°58′58″W / 42.0366°N 87.9827°W / 42.0366; -87.9827
Membership
64,000
Official language
English
AAP President
Colleen A. Kraft, MD, MBA, FAAP (2018–2019)
Staff
390
Website aap.org

Contents

BackgroundEdit

The academy was founded in 1930 by 35 pediatricians to address pediatric healthcare standards.[2] It has 64,000 members in primary care and sub-specialist areas.[3] Qualified pediatricians can become fellows (FAAP).[4]

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.[5]

PublicationsEdit

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.[6]

The AAP News is the academy's official newsmagazine,[7] and Pediatrics is its flagship journal.[8]

Policy positionsEdit

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.[9]

AsthmaEdit

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.[10]

Car safety seatsEdit

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.[11] These recommendations are typically published in the peer-reviewed scientific journal Pediatrics[12][13], and tend to attract attention and controversy in popular press and social media.[14][15][16]

Previously, the AAP recommended that children remain rear-facing until they are 2 years of age.[17] In response to updated crash test, simulation, and field data, the AAP revised their guidance to exclude the age guideline entirely.[18] 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.[19] The full recommendations state that:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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 circumcisionEdit

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.[20] 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.[21][22][23]

After the release of the position statement, a debate appeared in the journal Pediatrics and the Journal of Medical Ethics. A group of 38 Northern European doctors, 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.[24] An opinion by two authors stated that, in their view, the AAP's analysis was inaccurate, improper and incomplete.[25] The AAP received further criticism from activist groups that oppose circumcision.[26][27] The AAP responded to these criticisms in the Journal of Medical Ethics, calling for respectful and evidence-based debate.[28]

Female genital cuttingEdit

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[29] and concern from other medical groups[30] that even a "nick" would be condoning this widely rejected procedure. One month later, the academy retracted this policy statement.[31][32]

Gun violence preventionEdit

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.[33] The AAP believes pediatricians should discuss guns and gun safety with parents before babies are born and at children's annual exams.[34] It also advocates for, among other things, more background checks, an assault weapons ban, and federal research on gun violence.[35][36]

School start times for adolescentsEdit

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 [37] 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.[38]

MarijuanaEdit

The AAP opposes legalization of marijuana, citing potential harms to children and adolescents. The Academy also opposes medical marijuana "outside the regulatory process of the US Food and Drug Administration."[39] In states that have already legalized marijuana, the Academy recommends that pediatricians and regulators treat it as they would 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.[40]

Ethical guidelines to pediatric genetic testingEdit

The American Academy of Pediatrics AGCM posted guidelines in dealing with the ethical issues in pediatric genetic testing.[41]

See alsoEdit

  • 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.

ReferencesEdit

  1. ^ "Contacting the American Academy of Pediatrics". American Academy of Pediatrics. 2004-05-25. Retrieved 2013-03-30. 
  2. ^ "Pediatric History Center". American Academy of Pediatrics. Retrieved 2013-03-30. 
  3. ^ "AAP Facts: Membership". American Academy of Pediatrics. Retrieved 2016-05-10. 
  4. ^ "FAAP Certification". American Academy of Pediatrics. Retrieved 2016-04-12. 
  5. ^ "Departments & Divisions". American Academy of Pediatrics. Retrieved 2013-03-30. 
  6. ^ "AAP Facts: Publications". American Academy of Pediatrics. Retrieved 2013-03-30. 
  7. ^ "AAP News". American Academy of Pediatrics. Archived from the original on July 27, 2013. Retrieved 2013-03-30. 
  8. ^ "AAP Journals: Pediatrics - The Flagship Journal of the AAP". American Academy of Pediatrics. Retrieved 2013-03-30. 
  9. ^ "Advocacy & Policy". American Academy of Pediatrics. Retrieved 2013-03-30. 
  10. ^ "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. 2013-06-05. Retrieved 2013-06-06. 
  11. ^ "AAP Updates Recommendations on Car Seats for Children". American Academy of Pediatrics. 30 August 2018. Retrieved 2018-08-31. 
  12. ^ Committee on Injury, Violence, and Poison Prevention (2011). "Child Passenger Safety". Pediatrics. 127 (4): 788–793. doi:10.1542/peds.2011-0213. Retrieved 2018-08-31. 
  13. ^ Dennis R. Durbin, MD (2018). "Child Passenger Safety" (PDF). Pediatrics. 142 (4): e20182461. doi:10.1542/peds.2018-2461. Retrieved 2018-08-31. 
  14. ^ "Pediatricians drop age limit for rear-facing car seats". CNN. 30 August 2018. Retrieved 2018-08-30. 
  15. ^ "New Recommendations for Rear-Facing Car Seats". Mommyhood101 Your Source for Everything Baby. 31 August 2018. Retrieved 2018-08-31. 
  16. ^ "New car seat guidelines for rear-facing seats are designed to save lives". All the Moms - A USA Today Publication. 31 August 2018. Retrieved 2018-08-31. 
  17. ^ Committee on Injury, Violence, and Poison Prevention (2011). "Child Passenger Safety". Pediatrics. 127 (4): 788–793. doi:10.1542/peds.2011-0213. Retrieved 2018-08-31. 
  18. ^ "AAP Updates Recommendation on Car Seats for Children". American Academy of Pediatrics. 30 August 2018. Retrieved 2018-08-30. 
  19. ^ Dennis R. Durbin, MD (2018). "Child Passenger Safety" (PDF). Pediatrics. 142 (4): e20182461. doi:10.1542/peds.2018-2461. Retrieved 2018-08-31. 
  20. ^ "Circumcision Policy Statement". Pediatrics. 130 (3): 585–586. 2012-08-27. doi:10.1542/peds.2012-1989. PMID 22926180. 
  21. ^ Rabin, Roni (2012-08-27). "Benefits of Circumcision Are Said to Outweigh Risks". The New York Times. Retrieved 2013-03-30. 
  22. ^ Brown, Eryn (2012-08-26). "Pediatricians' Group Shifts in Favor of Circumcision". Los Angeles Times. Retrieved 2013-03-30. 
  23. ^ Tanner, Lindsey (2012-08-27). "Circumcision Benefits Outweigh Risks and Insurers Should Pay; Pediatricians Revise Stance". Associated Press (via National Post). Retrieved 2013-03-30. 
  24. ^ "Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision". American Academy of Pediatrics. Retrieved 2013-03-30. 
  25. ^ Svoboda, J Steven; Van Howe, Robert S (2013-03-18). "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 2013-03-30. 
  26. ^ Emmons, Sasha (2012-08-27). "AAP: Health benefits of circumcision outweigh the risks". CNN. Retrieved 22 September 2014. 
  27. ^ Rochman, Bonnie (2012-08-27). "Circumcision: Pediatricians Say Benefits Trump Risks". Time. Retrieved 22 September 2014. 
  28. ^ "The AAP Task Force on Neonatal Circumcision: a call for respectful dialogue". Journal of Medical Ethics. 39: 442–443. 2013-03-18. doi:10.1136/medethics-2013-101456. Retrieved 2013-03-30. 
  29. ^ Belluck, Pam (2010-05-06). "Group Backs Ritual 'Nick' as Female Circumcision Option". The New York Times. Retrieved 2013-03-30. 
  30. ^ "Joint RCOG/RCPCH statement on the AAP policy statement on FGM". Royal College of Obstetricians and Gynaecologists. 2010-05-12. Retrieved 2013-03-30. 
  31. ^ "American Academy of Pediatrics withdraws policy statement on female genital cutting". American Academy of Pediatrics. 2010-05-27. Retrieved 2013-03-30. 
  32. ^ Belluck, Pam (2010-05-26). "Doctors Reverse Stand on Circumcision". The New York Times. Retrieved 2013-03-30. 
  33. ^ Pittman, Genevra (2012-10-18). "Pediatricians call for strict gun laws to protect kids". Reuters. Retrieved 2013-10-21. 
  34. ^ Rho, Helena (2013-02-01). "The Pediatricians vs. the NRA: How the gun lobby is trying to gag doctors from talking about kids and guns". Slate. Retrieved 2013-10-21. 
  35. ^ Viebeck, Elise (2013-04-29). "Pediatricians to push for gun control on Capitol Hill". The Hill. Retrieved 2013-10-21. 
  36. ^ "American Academy of Pediatrics Gun Violence Policy Recommendations" (PDF). January 2013. Retrieved 2013-10-21. 
  37. ^ AAP
  38. ^ "School Start Times for Adolescents". Pediatrics. 134 (3): 642–9. 2014. doi:10.1542/peds.2014-1697. PMID 25156998. 
  39. ^ 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 2018-04-25. 
  40. ^ "American Academy of Pediatrics Reaffirms Opposition to Legalizing Marijuana for Recreational or Medical Use". American Academy of Pediatrics. 26 January 2015. Retrieved 2018-04-24. 
  41. ^ "AAP Issues New Guidance on Genetic Testing of Children". American Academy of Pediatrics. February 21, 2013. Retrieved 21 October 2017. 

External linksEdit