American Academy of Pediatrics

Background

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 has approximately 390 employees, and it 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.

Publications

It has the largest pediatric publishing program in the world, with more than 300 titles for consumers and over 500 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.

Policy positions

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.

Asthma

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.

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. 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. 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.

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.

Ethical guidelines to pediatric genetic testing

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