The highly publicized imposition and retraction of the "family separation" border policy by the current U.S. Administration was not an anomaly in U.S. history. In this manuscript, we place these troubling recent events in the context of decades of U.S. immigration policies and politics. We then describe the consequences of family separation and other current immigration policies on child health. We end with a call to action: Pediatricians and other advocates for child health should demand a new direction in immigration policy that stops the use of children as pawns. Instead, the United States should adopt as a fundamental guiding principle support for children and families, both abroad and at home.