Bring us your huddled masses, yearning to breathe free: Caring for children of immigrants

Recently, Alex, a 10 year-old boy in my pediatric practice, was in the office complaining of a stomachache.

I asked the usual questions: When did it start? Did it happen at certain times or in response to particular foods? Were there any other gastrointestinal changes? What made it better or worse?

Many questions later, I stumbled upon the cause of his pain. That’s when he began to cry and told me about his worry for his parents, who arrived undocumented in the US before he was born. Like so many others since this country’s inception, they left their birth country seeking safety, freedom, and the opportunity to work, hoping to raise healthy children with promising futures.

The following day during a routine well child visit, a Latino family explained their children could not get daily exercise because they did not feel safe leaving their apartment – that others had told them there would be raids in their neighborhood soon.  A few hours later, a tearful mom asked for a letter so that she would not be separated from her autistic child, should they be detained.

My patients and their families are not only ones worried about their futures. There are over 4 million US citizen children of undocumented parents who share Alex’s pain. They live with the impossible anxiety that tomorrow their parents, grandparents, classmates will be gone.

Pediatricians across the country are seeing the effects of harmful immigration Executive Orders on the health of their young patients. The American Academy of Pediatrics (AAP) swiftly released a statement following the Executive Orders signed in late January urging the Trump administration to ensure protection for families of seeking refuge in our country. The AAP and its members, including myself, remain committed to caring for children regardless of their or their parent’s country of birth. As physicians, we seek to prevent harm and to promote healing.

Some claim that undocumented immigrants pose “a significant threat”, and describe unauthorized immigration as “a clear and present danger”.  Data say otherwise. Pew Research describes 8 million employed undocumented immigrants, most residing in the US for over a decade, contributing to their communities through work and volunteer activities, and paying taxes while not collecting public assistance.

Harmful rhetoric and proposed policies that create a culture of fear have tangible negative impacts on the health of children.  Children sense stress and anxiety in their caregivers. Though a child may be far too young to be aware of the intricate details of public policy, their bodies and brains respond to the fears of their parents. This response, if sustained over a long period of time, is referred to by neuroscientists as “toxic stress”, which can have a cumulative negative effect on the health and development of a child.

I fear for Alex’s future, and that of the millions of children whose days are more frightening due to our immigration policies, and whose nights are filled with nightmares of walls and detention centers rather than dreams of hope.

And, just as passionately, I fear for the future of those other children who are not directly affected by these policies, but will suffer from a newly institutionalized US culture of xenophobia and suspicion which de-values human justice, diversity, and empathy; conveniently disregards our personal and national histories and the welcoming message written on the base of that New York port of entry iconic statue; and fails to recognize the much greater potential of our nation when our lives, happiness, and success are woven together.