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AAP Opposes Efforts to Roll Back Protections for Children Under the Flores Settlement Agreement

8/22/2019 by: Kyle Yasuda, MD, FAAP, President, American Academy of Pediatrics

"The American Academy of Pediatrics (AAP) is speaking out against the Trump Administration's announcement to roll back critical protections for children put in place by the Flores Settlement Agreement, effectively allowing immigrant children to be held in unsafe federal detention facilities for months, years, or even indefinitely. This is inconsistent with the Flores agreement and federal law, and puts children's lives and safety at risk.

"No amount of time in detention is safe for a child. When children are detained, they experience physical and emotional stress, placing them at risk for serious short- and long-term health problems, such as developmental delays, poor psychological adjustment, anxiety, depression and suicidal ideation. Even short periods of detention can have long-lasting consequences for children.

"Detention is no place for a child. Pediatricians have visited these centers, and what we saw was shocking and devastating to anyone who cares for children. Children are held in metal cages with fencing extending from floor to ceiling. They sleep on cold, concrete floors beneath thin Mylar blankets. Harsh overhead lights remain on 24-7. They have no access to pediatricians. They receive food that is often not palatable. Children don't have regular access to showers, and must use toilets that are in semi-public locations. These conditions are commonplace for children detained in DHS-run facilities, which is why the agency is not equipped to detain children for even longer periods of time.

"Lack of sleep and stress can affect a child's ability to fight off infection, so it's no wonder that our pediatrician colleagues who care for children who have been through DHS-run detention facilities are reporting that they are in increasingly poor health. Six children have died in federal custody, some from conditions like dehydration and flu. We fear the consequence of the Administration's announcement will only further jeopardize children's health and safety.

"Weakening protections for children runs counter to the Flores Settlement Agreement, making it more likely that children would be detained for even longer in conditions unfit for any child. All attempts to do so should be rejected. Instead, the Academy calls on policymakers to work to protect and promote the health and well-being of immigrant children in federal custody."


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds