Health Care for Immigrant Children: Discussing Birth Country During Pediatric Appointments

Information about a child's country of birth (also called nativity) is highly relevant to pediatric care, as it informs the recommendations pediatricians will make regarding screening for serious conditions such as elevated blood lead levels, viral hepatitis, and tuberculosis. However, pediatricians may be uncertain how to respectfully inquire about a child's birth country. These uncertainties have been amplified in the current US political climate in which many immigrant families have heightened fear of detention and deportation. We suggest pediatricians ask about nativity when it shapes health care recommendations, use family-centered practices such as explaining the medical rationale for the question, and limit documentation to what is medically necessary. These recommendations are informed by prior publications; consultations with immigrant parents, youth, and community leaders; and health professionals with expertise in immigrant child health.