AAP issues guidance on providing medical care to parents during pediatric visits

Pediatric visits often extend beyond the direct care of children and create opportunities to address health concerns affecting caregivers. A new policy statement from the American Academy of Pediatrics (AAP) provides guidance on when and how pediatricians may offer medical care to parents during a child’s visit, with a focus on improving child health outcomes while minimizing medical-legal risk. The policy, Providing Medical Care for Parents During the Pediatric Visit, was published in the February 2026 issue of Pediatrics.¹

The statement acknowledges that pediatricians “may be asked or choose to provide care for parents during a child’s visit,” including treatment of infectious diseases, immunizations, screening or referral for mental health conditions, and management of breastfeeding-related problems. By addressing parental health needs in this setting, pediatricians can reduce barriers to care and improve the timeliness of needed interventions, particularly for families facing challenges such as lack of insurance, transportation difficulties, or limited access to adult primary care.

The policy emphasizes that parental health directly affects child health. Healthy parents are better positioned to provide stable, nurturing environments, whereas untreated caregiver health conditions—such as depression, nicotine dependence, or infectious disease—may negatively influence a child’s development and well-being.² As noted in the statement, “Medical issues affecting family members can positively or negatively affect a child’s health,” underscoring the rationale for a family-centered approach to pediatric care.

Scope of care and common scenarios

The AAP outlines several situations in which pediatricians may reasonably consider providing care to parents. These include parental education and counseling to improve family health behaviors, screening and referral for mental health concerns, prescribing medications or durable medical equipment to support caregiving, administering immunizations, and, in some cases, providing direct medical care when it improves parental and child health outcomes.

Importantly, the statement clarifies that many routine counseling interactions—such as advice on smoking cessation, safe firearm storage, or breastfeeding—generally do not establish a formal physician–patient relationship (PPR) with the parent. However, activities such as examinations, prescribing medications, or administering vaccines are more likely to create a PPR and therefore a duty of care.

Medical-legal considerations

A central focus of the policy is helping pediatricians understand the medical-legal implications of caring for adults in a pediatric setting. Once a PPR is established, pediatricians assume legal responsibilities similar to those involved in caring for any patient, including appropriate documentation, follow-up, and termination of care when indicated. The policy states that “interactions involving examination, treatment (including delivering medication or injectables), or actionable advice generally qualifies as meeting the terms of creating a PPR and, therefore, a duty to the patient.”

The statement cautions that pediatricians cannot eliminate this duty through waivers and should be aware that legal precedent regarding PPRs may evolve. It also highlights the importance of ensuring that malpractice insurance covers care provided to adults and that employment agreements do not restrict such services.

Key clinical areas addressed

Several common clinical scenarios are examined in detail. For parental mental health, particularly perinatal depression, the policy reinforces the pediatrician’s role in screening and referral. The statement notes that the pediatrician “has a unique opportunity to identify perinatal depression and help prevent untoward developmental and mental health outcomes for the infant and family.” Documentation, suicide risk assessment, and coordination with adult care providers are emphasized when concerns are identified.

For tobacco and nicotine cessation, the policy supports evidence-based interventions such as the Ask/Advise/Refer model and, when appropriate, prescribing nicotine replacement therapy. In breastfeeding care, pediatricians frequently assess and counsel mothers as part of infant care; however, more extensive interventions, such as treating mastitis, may require separate documentation and follow-up with the mother’s primary care or obstetric provider.

The policy also addresses infection prevention and immunization of parents, including influenza, pertussis, and postexposure prophylaxis for certain infectious diseases, when doing so protects children and household contacts.

Recommendations and conclusion

The AAP concludes that providing selected health services to parents during pediatric visits can improve outcomes for children, families, and communities. Pediatricians are advised to assess their own training and comfort level, weigh benefits and risks, recognize when a PPR may be established, ensure proper documentation, and confirm liability coverage.

“Pediatric visits afford a unique opportunity for pediatricians to provide care for patients and to address health concerns of caregivers and improve children’s health,” the authors write. The policy provides a framework to help pediatricians navigate these opportunities responsibly and within their scope of practice.

References

1. O’Connor ME, Groner J, Wissow L, et al. Providing Medical Care for Parents During the Pediatric Visit: Policy Statement. Pediatrics. Published online January 26, 2026. doi:https://doi.org/10.1542/peds.2025-074113
2. Eckshtain D, Marchette LK, Schleider J, Evans S, Weisz JR. Parental depressive symptoms as a predictor of outcome in the treatment of child internalizing and externalizing problems. J Abnorm Child Psychol. 2019;47(3):459–474. PubMed doi: 10.1007/s10802-018-0446-2