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Anaphylaxis Definition, Clinical Support Tool
Pediatrics ·Volume 156·Number 2
August 1, 2025
The American Academy of Pediatrics has endorsed 3 items in the following publication: Dribin TE, Muraro A, Camargo CA, Zuberbier T, Sampson HA; GA2LEN Anaphylaxis Study Team. Anaphylaxis definition, overview, and clinical support tool: 2024 consensus report-a GA2LEN project. J Allergy Clin Immunol. Published online January 27, 2025. https://www.jacionline.org/article/S0091-6749(25)00072-7/fulltext. Note: The American Academy of Pediatrics endorsed the following 3 items: (1) the anaphylaxis definition; (2) clinical support tool; and (3) the clinical supp...
Policy
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-072390/202643/Anaphylaxis-Definition-Clinical-Support-Tool
Medical Vs Nonmedical Immunization Exemptions For Child Care And School Attendance: Policy Statement
Pediatrics ·Volume 156·Number 2
August 1, 2025
Routine childhood immunizations against infectious diseases are an integral part of our public health infrastructure. They provide direct protection to the immunized individual and indirect protection to children and adults unable to be immunized by reducing spread of vaccine-preventable diseases in the community. All 50 states, the District of Columbia, and Puerto Rico have regulations requiring proof of immunization as a condition for child care and school attendance as a public health strategy to protect children in these settings and to secondarily serve as a mechanism to promote timely immunization of children by their caregivers. Although all states and the District of Columbia have mechanisms to exempt school attendees from specific immunizations for medical reasons, the majority also have a heterogeneous collection of regulations and laws that allow nonmedical reasons for exemption. The American Academy of Pediatrics (AAP) supports certification of immunization to attend child care and school as a sound means of providing a safe environment for attendees and employees of these settings. The AAP also supports medically indicated exemptions to specific immunizations as determined for each individual child. The...
PolicyAmbulatory Care ServicesImmunizationChild CareCommunityPublic Health MedicineVaccination
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-072714/202656/Medical-vs-Nonmedical-Immunization-Exemptions-for
Increasing Access To Antiretroviral Therapy For The Prevention And Treatment Of HIV In Infants, Children, And Youth In The United States: Policy Statement
Pediatrics ·Volume ·Number
July 21, 2025
Although significant progress has been made in prevention and treatment of HIV in the United States, nationally and globally, infants and children younger than 13 years have less access to optimal antiretroviral therapy compared with youth (13-24 years) and adults, which can negatively affect health outcomes for those with HIV. Despite youth having nearly as many antiretroviral options for HIV management as adults, optimal HIV management in youth is challenged by psychosocial and structural barriers that result in poor access to HIV prevention and care. Significant barriers remain in providing equitable access to optimal HIV treatment and prevention service...
Policy
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-072718/202660/Increasing-Access-to-Antiretroviral-Therapy-for
Health Supervision For Children With 22Q11.2 Deletion Syndrome: Clinical Report
Pediatrics ·Volume ·Number
July 21, 2025
22q11.2 deletion syndrome is the most frequent chromosomal microdeletion syndrome, with an estimated frequency of about 1/4000 in children younger than 1 year. Associated features in neonates and infants are conotruncal heart defects, interrupted aortic arch type B, cleft palate, hypocalcemia (which can present as seizures), feeding problems, developmental delay, and immune system abnormalities. Older children, adolescents, and adults may have neurocognitive impairments and/or speech disorders. Psychiatric diagnoses are more common than in the general population. Newborn infants may have a positive newborn screening for severe combined immunodeficiency (SCID). Genetic diagnosis is confirmed by chromosome microarray. This document is intended to provide guidance for health care providers to help identify individual patients at high risk of developing serious se...
Policy
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-072717/202658/Health-Supervision-for-Children-With-22q11-2
Guidance For Caring For Infants And Children With Trisomy 13 And Trisomy 18: Clinical Report
Pediatrics ·Volume ·Number
July 21, 2025
Over the last several decades, there has been a steady increase in medical and surgical interventions provided for infants and children with trisomy 13 or trisomy 18 (chromosomal syndromes associated with a range of congenital anomalies and universally severe neurodevelopmental impairment). Despite previous characterizations of these disorders as being uniformly lethal, multiple studies have demonstrated improved morbidity and mortality when indicated interventions, such as cardiac surgery, are performed, and these interventions and their potential risks and benefits can be carefully explored with parents who may wish to pursue them. Although the presence of trisomy 13 or trisomy 18 impacts prognosis for survival and long-term outcomes and cannot be disregarded in complex decision making, there are no ethical justifications for universal, principle-based differential treatment based solely on these genetic diagnoses. Thus, which medical and surgical interventions are offered, denied, or required for patients should be based on the best available evidence and appropriately tailored to the individual's clinical context, should respect the same moral principles as are applied to other children, and should not vary widely between institutions. Pediatric and obstetric clinicians participating in the care of these patients should maintain current knowledge of the literature to provide adequate counseling through a shared decision-making process and offer the...
Policy
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-072719/202649/Guidance-for-Caring-for-Infants-and-Children-With
Contraceptive Counseling And Methods For Adolescents: Clinical Report
Pediatrics ·Volume 156·Number 1
July 1, 2025
To provide contraceptive care to adolescents, pediatricians need a working knowledge about counseling basics as well as a full range of contraceptive methods. Pediatricians may provide contraception for pregnancy prevention or for menstrual suppression and other medical indications. This clinical report is a companion to the revised policy statement 'Contraception for Adolescents,' and it provides updates for pediatricians on adolescent-centered counseling approaches and contraceptive methods, including long-acting reversible contraceptives, hormonal contraceptives, barrier methods, and emergency contraceptives. Together, these documents provide the pediatrician with evidence-informed and equity-informed practices in counseling and prescribing...
PolicyContraceptive MethodsCounselingContraception, Postcoital
https://publications.aap.org/pediatrics/article/156/1/e2025072218/202151/Contraceptive-Counseling-and-Methods-for
Human Trafficking And Exploitation Of Children And Adolescents: Policy Statement
Pediatrics ·Volume 156·Number 1
July 1, 2025
Trafficking of children and adolescents for labor and sexual exploitation is associated with significant adverse physical and mental health implications. Pediatricians and other health care professionals may encounter affected patients who present with infections, injuries, posttraumatic stress disorder, suicidality, or a variety of other health and mental health conditions. The health sector response requires a public health approach based on scientific research using an equity and social justice lens, community participatory strategies, and rigorous study designs, including implementation science, which build a solid evidence base. It should include training for pediatric clinicians (eg, pediatricians, other physicians, and nonphysician clinicians treating children and adolescents) to recognize possible signs of exploitation and to intervene using a culturally responsive, community-centered, sensitive, trauma-informed, rights-based, and patient-centered approach. The health sector response should include a multidisciplinary approach to the provision of service, with clinicians working with a diverse group of professionals in the community to assist children and adolescents at risk for trafficking and exploitation. Advocacy is needed for legislation and policies that promote child rights and victim/survivor services for all children and adolescents, regardless of immigration status. The health sector should support policies that address the social drivers of health, which influence the vulnerability to human trafficking. This policy statement outlines major issues regardi...
PolicyEmigration And ImmigrationWounds And InjuriesPrinciples Of Law And JusticeChild LaborSurvivorsCommunityNeglectMental HealthLens, Crystalline
https://publications.aap.org/pediatrics/article/156/1/e2025072214/202226/Human-Trafficking-and-Exploitation-of-Children-and
New And Evolving Dimensions In The Pediatrician-Family-Patient Relationship: Maintaining And Managing Boundaries: Clinical Report
Pediatrics ·Volume 156·Number 1
July 1, 2025
Maintaining and managing boundaries in relationships with patients and their family members remains extremely important for the practicing pediatrician. Technological innovations that facilitate communication and information sharing, such as social media, have created new dimensions within the pediatrician-family-patient relationship. Shifts in patient and family expectations of the medical profession that have occurred over time, such as a greater desire among patients and families to have increased access to their pediatrician, also present novel challenges to traditional professional boundaries. Further, social and political issues that have bearing on the practice of medicine have raised questions about pediatricians' role as advocates for individual patients and child health within the pediatrician-family-patient relationship. The 2009 AAP policy statement, 'Pediatrician-Family-Patient Relationships: Managing the Boundaries,' offers guidance for pediatricians in navigating several key scenarios regarding professional boundaries, including accepting gifts, dual relationships, and romantic relationships with patients or caregivers. Since the content in this 2009 policy statement remains relevant, the intent of this clinical report is to complement the 2009 statement and provide guidance for navigating new and evolving dimensions of the traditional pediatrician-family-patient relationship, inc...
PolicySelf DisclosureAdvocacyEmotions
https://publications.aap.org/pediatrics/article/156/1/e2025072215/202228/New-and-Evolving-Dimensions-in-the-Pediatrician
Genetic Evaluation Of The Child With Intellectual Disability Or Global Developmental Delay: Clinical Report
Pediatrics ·Volume 156·Number 1
July 1, 2025
Genetic neurodevelopmental disorders are common in the pediatric population, and establishing a specific diagnosis early provides multiple benefits including prognostication, surveillance for disorder-related complications, accurate recurrence risk, and specific management. This report provides an approach to the genetic evaluation of developmental delay/intellectual disability for the general pediatrician. When possible, genetic testing should be selected by phenotype, and typical distinguishing clinical features to facilitate this are presented. If a specific disorder or group of disorders cannot be ascertained by phenotype, an agnostic (or hypothesis-free) approach is utilized. Recommendations are provided for this agnostic approach based on diagnostic yield and also practical considerations such as test complexity and impact on management. The general guidance in this report for genetic testing does not preclude further evaluation by relevant subspecialists as necessary...
PolicyFragile X SyndromeGenesInborn Errors Of MetabolismGeneticsGenetic ScreeningGlobal Developmental DelayNeuroimagingNeurodevelopmental Disorders
https://publications.aap.org/pediatrics/article/156/1/e2025072219/202230/Genetic-Evaluation-of-the-Child-With-Intellectual
Genetic Evaluation Of The Child With Intellectual Disability Or Global Developmental Delay: Clinical Report
Pediatrics ·Volume 156·Number 1
July 1, 2025
Genetic neurodevelopmental disorders are common in the pediatric population, and establishing a specific diagnosis early provides multiple benefits including prognostication, surveillance for disorder-related complications, accurate recurrence risk, and specific management. This report provides an approach to the genetic evaluation of developmental delay/intellectual disability for the general pediatrician. When possible, genetic testing should be selected by phenotype, and typical distinguishing clinical features to facilitate this are presented. If a specific disorder or group of disorders cannot be ascertained by phenotype, an agnostic (or hypothesis-free) approach is utilized. Recommendations are provided for this agnostic approach based on diagnostic yield and also practical considerations such as test complexity and impact on management. The general guidance in this report for genetic testing does not preclude further evaluation by relevant subspecialists as necessary...
PolicyPhenotypeChromosomesIntellectual DisabilityGenetic AnalysisGenome SequencingWhole Exome SequencingSigns And SymptomsDevelopmental Delay
https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-072219/202230/Genetic-Evaluation-of-the-Child-With-Intellectual
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