Marcia Frellick

September 06, 2017

CHICAGO — The effect of current and proposed federal policies on the health and care of children in immigrant families will be among the hot topics here at the American Academy of Pediatrics (AAP) 2017 National Conference and Exhibition after the Trump administration's decision this week to end the Deferred Action for Childhood Arrivals (DACA) program.

Dr Jennifer Shu

"There are a lot of stressors involved with these children, particularly if they're in danger of being deported or if their parents are afraid of being deported. They may not seek care because they are afraid of repercussions," said Jennifer Shu, MD, a pediatrician in Atlanta who is chair of the conference.

A plenary on children in immigrant families and how pediatricians can support such patients will be delivered by Julie Linton, MD, assistant professor of pediatrics at the Wake Forest School of Medicine in Winston-Salem, North Carolina.

Advocacy talks will focus not only on the physical health of children who have immigrated, but also on their mental health.

The keynote address — on the way attachment and nurturance shape children in the first 3 years of life, and what physicians can do to encourage the best outcomes for families — will be delivered by Luz Towns-Miranda, PhD, a clinical psychologist from Bronx, New York, who is the mother of Hamilton creator Lin-Manuel Miranda.

During her presentation, she will also touch on her family's immigrant background and connections between medicine, psychology, art, and history.

Safe Sleeping

There will be a focus on safe sleeping at this year's conference, a topic that garnered attention recently when a study showed that fewer than half of all mothers always put their babies to sleep on their backs, despite guidelines that have recommended it for nearly 3 decades (Pediatrics. Published online August 21, 2017).

"I was alarmed to see that these numbers were so low," said Rachel Moon, MD, division head of general pediatrics at the University of Virginia in Charlottesville.

Dr Rachel Moon

During one session, she will discuss the reasons parents choose not to not follow safe sleep guidelines, such as concern about aspiration, concern that the baby does not sleep as well, and belief that sudden infant death syndrome only happens to "bad parents."

"Knowing what's behind the decisions will help providers talk with families," Dr Moon told Medscape Medical News. "We need to figure out how to create safe sleep messages that resonate with families."

A plenary will be devoted to a discussion of updated blood pressure guidelines released last month, as reported by Medscape Medical News.

It is now recommended that children and adolescents be screened for hypertension only during well-child or preventative-health visits, and not during any other visit to a healthcare setting. And instead of every hypertensive child undergoing cardiac echocardiogram, it is now advised that only those with abnormal blood pressure who are about to start medication should be tested.

Several research abstracts will evaluate which programs are working to counteract rising obesity rates.

Successful strategies from the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) will be presented by Steven Gortmaker, PhD, from Harvard T.H. Chan School of Public Health in Boston. And he will discuss how pediatricians can advocate for these strategies in their own communities.

"Teens Gone Wild"

Developmental and behavioral problems in teens are among the most common issues pediatricians encounter, but they are also areas in which they have the least training, Adiaha Spinks-Franklin, MD, a member of the AAP section on developmental and behavioral pediatrics, told AAP News during a preconference interview.

During her talk — entitled Teens Gone Wild: Advising Families on Parenting Adolescents — Dr Spinks-Franklin will explain why the part of the teenage brain responsible for decision-making and problem-solving is the last to develop, and will offer suggestions on ways pediatricians can help families navigate defiance, poor choices, experimentation with drugs and alcohol, and problems in school.

As in past conferences, debates will tackle controversial topics, such as gun safety, reasons for vaccine exemptions, whether body mass index helps or harms the measurement of obesity, and how much juice is too much, Dr Shu told Medscape Medical News.

And the debate on whether women with HIV in well-resourced countries should breast-feed will include a discussion of the evidence that HIV has been detected in human milk even in women receiving antiretroviral therapy.

The Zika virus — a continually evolving challenge for pediatricians — also returns this year.

"At first, the focus was mostly on travel and preconception," Dr Shu explained. "Now, it's focused more on pregnancy and following the child and what to look for in terms of head growth and development."

Dr Shu and Dr Moon report disclosed no relevant financial relationships.

Follow Medscape Pediatrics on Twitter @MedscapePeds and Marcia Frellick @mfrellick


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