Home | Word from the President: Lori DeFrance, MD, FAAP

Word from the President: Lori DeFrance, MD, FAAP

January 5, 2020

When I returned from the American Academy of Pediatrics National Conference & Exhibition (NCE) that was held in New Orleans this year, I felt energized and rejuvenated after listening to the many speakers and mingling with pediatricians from across the United States and other countries. It is abundantly clear that children all over the world are faced with similar challenges including poverty, barriers to access, disparities and trauma to name a few.

I came away from the conference with many useful notes and pieces of information. I am going to share a few of the pearls that I took away from the NCE. I hope you find them interesting and helpful.

Lip tie and Ankyloglossia

  • There was no such thing as upper lip tie until 2012.
  • 85 percent of people have lip tie
  • There is inadequate research to support routine frenotomy for posterior ankyloglossia or upper lip tie for breastfeeding problems.


  • 50 percent of children have uncontrolled asthma
  • 30-70 percent report poor adherence
  • Inhaler technique should be reviewed at every visit
  • A spacer device can be purchased from Amazon for less than $20. Often the insurance copay is $50.

Dr. Peter Hotez, a pediatrician and a scientist, presented about the anti-vaccine movement and discussed ways to address the concerns of vaccine-hesitant parents. It struck a chord when he stated, “We have to build into our science training how to engage the public. This used to be thought of as grandstanding.”

Implicit Bias:

  • Going to medical school does not make you immune to bias.
  • Burnout can increase your bias.
  • The good news is that bias is modifiable.

You can help build resilience in families dealing with chronic illness. Look the parent/caretaker in the eye and ask, “how are you doing?” Then listen attentively.  This seemingly small thing can make a difference in building a family’s resilience.

A good website to check out for gun safety resources is It offers a framework to help parents and adults normalize conversations about gun safety and take responsible actions that can prevent child gun deaths and injuries.

Overcoming the Belief in Human Hierarchy

The speaker Gail Christopher stated, “To be biased does not make us racist – it makes us human.” Narrative change is the key. We must change the narrative to achieve racial healing. “Our greatest task is to learn to see ourselves in the face of others.”–Albert Einstein.

Suicide prevention:

  • The suicide rate for 10-14 year olds has doubled in the last decade.
  • Suicide isn’t a single cause-effect phenomenon.
  • Putting caring contacts in place has some of the most robust effectiveness in suicide prevention.

Josh Shipp spoke about his childhood in numerous foster care placements and how he started acting out so that he would get kicked out of each home as quickly as possible. “Every kid is one choice away from being a statistic,” said Shipp. “Every kid is one caring adult away from being a success story.” He shared that it is important for the caring adult to be tough and tender.  The child that is struggling must develop the intrinsic motivation to change their own life.

Child Health in the Warming World:

  • The climate crisis is a health crisis.
  • Addressing climate change is the greatest health opportunity.
  • We, as pediatricians, are taking care of children who are on the front lines of this climate problem.  “All we have to do to end their world is nothing,” stated Dr. Debra Hendrickson, an environmental analyst who later became a pediatrician.

There is so much to think about – it can easily become overwhelming. So, as we continue to take the best care of children and families that we can, please support each other, be kind to one another and know that the work that we do is a calling and a privilege.

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