Toxic stress and immigrant children: a pediatrician’s view on the border crisis

As a pediatrician who often cares for the less fortunate, I often see humanity at its worst. Infants being tragically abused by parents, ending up brain dead in the ICU. Children neglected and essentially abandoned by their caregivers as the devastating effects of drug abuse ravage their lives. Teens running away from home, raped, trafficked, forced into prostitution.

Indeed, these atrocities happen in our backyard every day, whether we choose to become aware of them or not. I thought after nearly 20 years of being in medicine, I had seen the worst of the worst. The past several weeks, however, have proven to me that even greater and broader evil exists in our world. The pictures and stories of families at the Texas/Mexico border have horrified our nation. Infants and children being stripped from their parents, caged in shelters, or flown across the country to foster homes thousands of miles from the only family they know is our new reality. As a pediatrician and a mother, I look around and have to wonder, “What tragic effect is this unspeakable trauma going to have on these children?”

To be honest, I wasn’t sure I completely comprehended the news of the horrors coming from our border when I began hearing the stories. After all, I have become somewhat of a skeptic, not knowing whom or what to believe when it comes to the media these days. Surely these had to be exaggerations, happening only to a few families, only to the “bad guys” who were trying to traffic these children for their own personal gain. But as the pictures and real-life stories began filling my Facebook and Twitter feeds, it became harder and harder to deny. And it made me wonder just how horrific the conditions must be in these Central American countries for parents to risk their lives and the custody of their children for hope of a better life.

Dr. Colleen Kraft, president of the American Academy of Pediatrics (AAP), visited one of the shelters for immigrant children on the Texas border last week. After her firsthand experience observing these children and their surroundings, she led the AAP in releasing a statement. In summary, the statement concludes that “separating children from their parents contradicts every thing we stand for as pediatricians—protecting and promoting children’s health. We know that family separation causes irreparable harm to children…[and] can disrupt the building of children’s brain architecture. Prolonged exposure to serious stress—known as toxic stress—can lead to lifelong health consequences.” So basically, Dr. Kraft and the AAP are saying that what we know intuitively as parents and members of the human race is actually backed by science and medicine.

The President of the United States finally signed an executive order ending the practice of separating children from their parents, due to tremendous outcry from both political parties, and even his own family. Undoubtedly, this is a small victory in the humanitarian crisis for these children. But unfortunately, the battle is not over. How will these 2,300 children ever be reunited with their families, some of whom have already been deported back to their home countries? What effect will this prolonged separation have on them going forward? And even though they will be with their families, where will they go? These questions remain unanswered.

The toxic stress described in the AAP statement will inevitably follow these children and others who are soon to cross our borders for years to come as they face insurmountable challenges. As a pediatrician, I feel completely helpless in this situation. Yet while I may not have the opportunity to care for the children directly affected by this crisis, I feel a tremendous responsibility to support and fight for the rights of children everywhere. I hope this crisis also inspires you to continue to stand up for what you believe to be true and right and just. So we can continue to bravely lead our own children by our example, showing them that we really can make a difference in this ever-changing world.

Image © Stephanie Kenner /


  1. May we know the boundaries


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