The National Association of Pediatric Nurse Practitioners (NAPNAP) has called on the US Department of Homeland Security, in collaboration with the Justice Department, to protect the health and wellness of immigrant children by voicing their opposition to the border separation of children and parents.

NAPNAP crafted a list of concerns to be considered by immigration and law enforcement on behalf of all children affected.

  • Many of these children have traveled for days through dangerous terrain without adequate protection, food, or water. Many fled violent, traumatic environments in their home country. Comprehensive pediatric health screenings and care for chronic and acute disease are needed to address urgent public health and individual physical and mental health needs.
  • Research shows that traumatic life experiences in childhood, especially those that involve loss of a caregiver or parent, cause lifelong risk for cardiovascular and mental health disease. Additionally, there is evidence that toxic stress in childhood may cause “turn on” genes that increase disease risk in affected individuals, and this risk may be passed to future generations.
  • Care should be taken during immigration proceedings to minimize emotional trauma. Adequate provision of interpreter services and legal representation during immigration proceedings is essential. Trauma-informed practices are grounded in child development and ensure that children are treated as children and not small adults.
  • For more than a century, child development experts have underscored the negative effects that institutional living environments have on children. These are highly stressful for children and do not provide needed social-emotional support and security. Research shows that overcrowded, institutional environments heighten children’s risk of physical, mental, or sexual abuse.  Every effort should be made to ensure children’s safety while in shelter residence and minimize the time children reside in border shelter facilities.

“We urge state and federal leaders to respond swiftly and compassionately to the health and emotional security needs of these vulnerable children and provide them just due process,” according to NAPNAP’s statement. “We encourage our members to contact their state and federal representatives to voice our shared concern and expertise.”

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The Nursing Coalition Community, on behalf of all 33 Nursing Community Coalition organizations, called on the Department of Homeland Security, and the overall administration, to protect the health and wellness of immigrant children in a letter crafted to Kirstjen M. Nielsen, director of the Department of Homeland Security.

“Our profession requests immediate action be taken to protect the health of immigrant children and reverse the current policy,” the letter states. “Their young minds, their health, and their ability to thrive in the future is of utmost importance.”

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On June 21, 2018, Rep. Raul Ruiz, MD (D-CA), hosted a press conference regarding the long-term effects of separating children from their parents. NAPNAP was represented by past president Susan Van Cleve, DNP, RN, CPNP-PC, PMHS, FAANP, and she discussed the long-term health effects of this separation and described the symptoms and long-lasting health implications associated with toxic stress during a child’s early development.


  1. NAPNAP statement opposing the border separation of children and parents [news release]. National Association of Pediatric Nurse Practitioners. June 11, 2018. Accessible at:
  2. NAPNAP to participate in press conference with democratic leadership on long-term health effects of separating children from their parents [news release]. National Association of Pediatric Nurse Practitioners. June 20, 2018.