Using the Centers for Disease Control and Prevention's mortality database, the study published on Monday in the AAP's journal Pediatrics found that 4,752 children died from gun-related injuries in 2021, the latest year for which data was available, up from 4,368 in 2020 and 3,390 in 2019.
Gun violence has been the No. 1 cause of death for children in the United States since 2020.
The study was published as Tennessee lawmakers this week opened a special session on public safety after a Nashville school shooting earlier this year that killed three children and three teachers.
Annie Andrews, a South Carolina pediatrician and gun violence prevention researcher who was not involved in the study, said that when she became a doctor, "I never imagined I would take care of so many children with bullet holes in them.
"But the fact of the matter is, in every children's hospital across this country, there are children in the pediatric intensive care units suffering from firearm injuries."
The study further showed that Black children accounted for around 67% of firearm homicides, while white children made up about 78% of gun-assisted suicides.
Iman Omer, a junior at Vanderbilt University in Nashville and an anti-gun violence advocate with Students Demand Action, said the study's findings were devastating but unsurprising.
"Every year, I know that 128 children and teens in Tennessee die by guns," Omer said as she headed to the state's capitol Tuesday to join protesters who have been demanding tougher gun laws.
Tennessee Governor Bill Lee, who knew two of the teachers killed in the Nashville shooting, had asked lawmakers in the special session to bolster so-called red flag laws aimed at keeping firearms out of the hands of people deemed to be a threat. He has faced resistance from his fellow Republicans who control the statehouse.
In a statement Tuesday, the Tennessee Firearms Association expressed concern that "while some Republican legislators have said that no red flag laws will pass, far fewer have stated that no laws that would have any negative impact on Second Amendment protected rights would pass."