Children do not immigrate, they flee. Many of these children have been victims of unspeakable violence and trauma. They are fleeing countries with the highest rates of violence in the hemisphere and hopeless poverty. Families may have no other choice but to send a child alone. These children are vulnerable, scared, and in need of compassion. Most of all, they deserve to be healthy and safe.
When children and families reach the U.S. border and ask for protection, they face a complicated immigration system that includes being held in a detention center where they are often separated from each other.
The American Academy of Pediatrics (AAP) published a policy statement, Detention of Immigrant Children, in response to the increase in unaccompanied minors and immigrant families at U.S. borders. This statement calls for the following basic "standards of care" for immigrant and refugee children:
They deserve our compassion and assistance
They should never be separated from their parents or families
They should never be placed in detention centers
A Glimpse of Life at the Border
In 2016, several AAP pediatricians toured some of the processing and detention facilities where children are held at the U.S. border. They found that none of them met the basic standards of care mentioned above.
Dr. Alan Shapiro, a pediatrician who works in the South Bronx in New York, cares for hundreds of children who cross the border, mostly from Central America. They come here seeking a safe haven in the U.S.—sometimes alone, sometimes with their parents. He was invited to visit Berks County Residential Center, a 3-hour drive from NYC to interview mothers and children.
"After hearing countless stories about what happens to children and families once they reach the border, I wanted to see these detention centers first hand. On one trip, I interviewed women and children who had been detained for up to a year. I was amazed to learn that there were toddlers there who had spent half their life in a detention facility. My heart ached for the teens who managed to escape threats against their lives only to find themselves imprisoned in the U.S. waiting to find out if a judge would allow them to reunite with their family."
Dr. Julie Linton cares for children of immigrant families in Winston Salem, North Carolina.
"I always recall the clinging arms of a young girl in my clinic, who, days after being reunited with her mother following separation from her at the border, would not let her Mama out of her sight. And I'll never forget the strength and resilience of a young boy in tiger-striped pajamas, who tried to get his mother to smile within the cage-like confines of the processing center."
Dr. Marsha Griffin cares for immigrant children and their families from both Central America and Mexico in a mobile medical van and in a respite center for recently released parents along the Texas/Mexico border.
"I will never forget a father who cried when he told me about being separated from his 12-year-old daughter when they arrived at the processing center. He was allowed to have his two sons with him, but his daughter was placed in a cell with other females. She could not see her father or brothers from her cell. She spent three fear-filled days crying alone in a cell with strangers. I will also never forget the tears streaming down the face of another father, when I asked him where the mother of his son was. He said that the border patrol agents had separated them and sent his wife and daughter somewhere else. He had no idea where they were, nor how to find them. These stories and hundreds of others haunt me."
Why Detention is Harmful to Children
The AAP firmly believes that no child should be in detention. Children in processing centers do not have adequate bedding, food, or water. They may sleep on cement floors. Temperatures are very cold and lights are on 24 hours a day. Even short periods of detention can cause psychological trauma and long-term mental health problems.
Separating families is very frightening and stressful to children. As children grow and develop, their brains change in response to their environments and experiences. Fear and stress, especially if they occur over a period of time, can harm the developing brain. This is called toxic stress.
Toxic stress can cause the following health issues in children:
Problems with toileting, sleeping, eating, learning, and concentrating
Depression, anxiety, and symptoms of post-traumatic stress
Increased risk of heart disease, diabetes, and depression later in life
The recommended alternative to detention:
Instead of detention, the AAP recommends releasing children and their families into the community while their immigration cases proceed. Keeping families together—especially as they confront new experiences—is critical.
How to Help Children Understand & Cope
In these uncertain times, it's understandable that many immigrant families feel a great deal of stress, anxiety, and fear. However, there are things parents and caregivers can do to make sure children feel safe and protected in their day-to-day lives.
Talk. Talk with your children about the recent changes in immigration policies and what they could mean to your family and friends. The amount of information you give will depend on the ages of your children. For example, older children are generally ready for more details than younger children.
Pay attention. Notice and be alert to what your children are seeing on TV, the internet and in social media. When children watch the news, watch with them so you can talk about what they are seeing and how it makes them feel.
Listen. If your children experience discrimination or bullying, or witness the removal of someone from their home for deportation, encourage them to talk about how they feel—including their fear, anxiety, or anger. Listen as your children talk about it—again and again if necessary—and reassure them of what you are doing to keep them safe.
Take care of yourself. Children notice when their parents or loved ones are anxious or angry. If you are worried or struggling with your own emotions, find someone you trust to help with your personal concerns. Children depend on the adults around them to be and feel safe and secure.
Advice for Families Concerned About Immigration Status
Immigration enforcement actions can lead to the sudden removal of a parent or primary caregiver without notice or time to prepare. If you are worried about your legal status or fear being separated from your family, it is extremely important that you develop a plan to ensure your children's health and safety.
The AAP recommends taking the following steps:
Ask a trusted adult to serve as Power of Attorney so he or she can care for your children in the event of removal or deportation.
Keep copies of all medical records, including immunization history, medications and other health information. Give a copy to a trusted adult.
Keep copies of your child's birth certificate, social security card and passport(s). Give a copy to a trusted adult.
Keep copies of your children's school records. Give a copy to the adult that you have designated as Power of Attorney.
Families who need assistance with immigration cases should talk to a licensed attorney. See below for additional helpful resources.
A Final Call for Compassion
This is not the first time in our nation's history that people have sought refuge here while fleeing from war or violence. We must ensure children who are seeking safe haven in our country are cared for appropriately. We should treat them humanely and compassionately and avoid imposing additional trauma, particularly for the most vulnerable, our children.
Additional Information & Helpful Resources: