TM
, BrightFutures
FOURTHfEDITION
f
f GuidelinesforHealthSupervisionofInfants,Children,andAdolescents
f f f f f f f f
POCKET GUIDE f
EDITORS
JosephfF.fHagan,fJr,fMD,fFAAPfJudithf
S.fShaw,fEdD,fMPH,fRN,fFAAPfPaulafM
.fDuncan,fMD,fFAAP
SUPPORTED,fINfPART,fBY
USfDepartmentfoffHealthfandfHumanfServicesf
HealthfResourcesfandfServicesfAdministrationf
MaternalfandfChildfHealthfBureau
PUBLISHEDfBY
AmericanfAcademyfoffPediatrics
,ThisfpublicationfhasfbeenfproducedfbyfthefAmericanfAcademyfoffPediatrics.fSu Thefrecommendationsfinfthisfpublicationfdofnotfindicatefanfexclusivefcoursefoff
pported,finfpart,funderfitsfcooperativefagreementf(U04MC07853)fwithfthefUSf treatmentforfservefasfafstandardfoffmedicalfcare.fVariations,ftakingfintofaccountf
DepartmentfoffHealthfandfHumanfServices,fHealthfResourcesfandfServicesfAdm individualfcircumstances,fmayfbefappropriate.
inistrationf(HRSA),fMaternalfandfChildfHealthfBureauf(MCHB). ThefAmericanfAcademyfoffPediatricsfisfnotfresponsiblefforfthefcontentfoffthefresourc
Suggestedfcitation:fHaganfJF,fShawfJS,fDuncanfPM,feds.fBrightfFutures:fGuidelinesf esfmentionedfinfthisfpublication.fWebfsitefaddressesfarefasfcurrentfasfpossiblefbutfm
orfHealth fSupervision foffInfants,fChildren,fandfAdolescentsf[pocketfguide].f4thfed.fE ayfchangefatfanyftime.
lkfGrovefVillage,fIL:fAmericanfAcademyfoffPediatrics;f2017 ThefAmericanfAcademyfoffPediatricsfhasfneitherfsolicitedfnorfacceptedfanyfcomm
AmericanfAcademyfoffPediatricsfBrightfFuturesfNationalfCenterfStaff ercialfinvolvementfinfthefdevelopmentfoffthefcontentfoffthisfpublication.
ChieffMedicalfOfficer Thefpublishersfhavefmadefeveryfeffortftoftracefthefcopyrightfholdersffor
SeniorfVicefPresident,fChildfHealthfandfWellnessfAmerica fborrowedfmaterials.fIfftheyfhavefinadvertently foverlookedfany,ftheyfwil
nfAcademyfoffPediatrics:fV.fFanfTait,fMD lfbefpleasedftofmakefthefnecessaryfarrangementsfatftheffirstfopportunity.
Director,fDivisionfoffDevelopmental fPediatricsfandfPreventivefServices:fDarcyf AllfauthorsfhaveffiledfconflictfoffinterestfstatementsfwithfthefAmericanfAca
Steinberg-Hastings,fMPH demyfoffPediatrics.fAnyfconflictsfhavefbeenfresolvedfthroughfafprocessfappro
Manager,fBrightfFuturesfNationalfCenter:fJanefBassewitz,fMA vedfbyfthefBoardfoffDirectors.
Manager,fBrightfFuturesfImplementation:fKathrynfJanies
EveryfeffortfisfmadeftofkeepfthefGuidelinesfconsistentfwithfthefmostfrecentf
AmericanfAcademyfoffPediatricsfPublishingfStaff advicefandfinformationfavailableffromfthefAmericanfAcademyfoffPediatrics.
Director,fDepartmentfoffPublishing:fMarkfGrimes
SeniorfEditor,fProfessional/ClinicalfPublishing:fEileenfGlasstetter,fMS Specialfdiscountsfarefavailablefforfbulkfpurchasesfoffthisfpublication.fE-
ProductionfManager,fClinical/ProfessionalfPublications:
TheresafWiener .
EditorialfSpecialist:fAmandafHelmholz ©f2017fAmericanfAcademyfoffPediatrics
Manager,fArtfDirectionfandfProduction:fLindafDiamond
Allfrightsfreserved.fNofpartfoffthisfpublicationfmayfbefreproduced,fstoredf
Manager,fArtfDirectionfandfProduction:fPegfMulcahy
infafretrievalfsystem,forftransmittedfinfanyfformforfbyfanyfmeans—electronic,
SeniorfVicefPresident,fMembershipfEngagementfandfMarketingf
mechanical,fphotocopying,frecording,forfotherwise—
andfSales:fMaryfLoufWhite
withoutfpriorfpermissionf romfthefpublisherf(locateftitlefatfhttp://ebooks.aappu
MarketingfManager,fPracticefPublications:fMaryfJofReynolds
blications.org;fclickfon
ISBN:f978-1-61002-082-4 ©fGetfPermissions);fyoufmayfalsoffaxfthefpermissionsfeditorfatf847/434-
eBook:f978-1-61002-083-1 .
PrintedfinfthefUnitedfStatesfoffAmericaf
1f2f3f4f5f6f7f8f9f10
3-340/0217
BF0044
, Library foffCongressf ControlfNumber:f 2016940256
, BrightFutures
FOURTHfEDITION
f
f GuidelinesforHealthSupervisionofInfants,Children,andAdolescents
f f f f f f f f
POCKET GUIDE f
EDITORS
JosephfF.fHagan,fJr,fMD,fFAAPfJudithf
S.fShaw,fEdD,fMPH,fRN,fFAAPfPaulafM
.fDuncan,fMD,fFAAP
SUPPORTED,fINfPART,fBY
USfDepartmentfoffHealthfandfHumanfServicesf
HealthfResourcesfandfServicesfAdministrationf
MaternalfandfChildfHealthfBureau
PUBLISHEDfBY
AmericanfAcademyfoffPediatrics
,ThisfpublicationfhasfbeenfproducedfbyfthefAmericanfAcademyfoffPediatrics.fSu Thefrecommendationsfinfthisfpublicationfdofnotfindicatefanfexclusivefcoursefoff
pported,finfpart,funderfitsfcooperativefagreementf(U04MC07853)fwithfthefUSf treatmentforfservefasfafstandardfoffmedicalfcare.fVariations,ftakingfintofaccountf
DepartmentfoffHealthfandfHumanfServices,fHealthfResourcesfandfServicesfAdm individualfcircumstances,fmayfbefappropriate.
inistrationf(HRSA),fMaternalfandfChildfHealthfBureauf(MCHB). ThefAmericanfAcademyfoffPediatricsfisfnotfresponsiblefforfthefcontentfoffthefresourc
Suggestedfcitation:fHaganfJF,fShawfJS,fDuncanfPM,feds.fBrightfFutures:fGuidelinesf esfmentionedfinfthisfpublication.fWebfsitefaddressesfarefasfcurrentfasfpossiblefbutfm
orfHealth fSupervision foffInfants,fChildren,fandfAdolescentsf[pocketfguide].f4thfed.fE ayfchangefatfanyftime.
lkfGrovefVillage,fIL:fAmericanfAcademyfoffPediatrics;f2017 ThefAmericanfAcademyfoffPediatricsfhasfneitherfsolicitedfnorfacceptedfanyfcomm
AmericanfAcademyfoffPediatricsfBrightfFuturesfNationalfCenterfStaff ercialfinvolvementfinfthefdevelopmentfoffthefcontentfoffthisfpublication.
ChieffMedicalfOfficer Thefpublishersfhavefmadefeveryfeffortftoftracefthefcopyrightfholdersffor
SeniorfVicefPresident,fChildfHealthfandfWellnessfAmerica fborrowedfmaterials.fIfftheyfhavefinadvertently foverlookedfany,ftheyfwil
nfAcademyfoffPediatrics:fV.fFanfTait,fMD lfbefpleasedftofmakefthefnecessaryfarrangementsfatftheffirstfopportunity.
Director,fDivisionfoffDevelopmental fPediatricsfandfPreventivefServices:fDarcyf AllfauthorsfhaveffiledfconflictfoffinterestfstatementsfwithfthefAmericanfAca
Steinberg-Hastings,fMPH demyfoffPediatrics.fAnyfconflictsfhavefbeenfresolvedfthroughfafprocessfappro
Manager,fBrightfFuturesfNationalfCenter:fJanefBassewitz,fMA vedfbyfthefBoardfoffDirectors.
Manager,fBrightfFuturesfImplementation:fKathrynfJanies
EveryfeffortfisfmadeftofkeepfthefGuidelinesfconsistentfwithfthefmostfrecentf
AmericanfAcademyfoffPediatricsfPublishingfStaff advicefandfinformationfavailableffromfthefAmericanfAcademyfoffPediatrics.
Director,fDepartmentfoffPublishing:fMarkfGrimes
SeniorfEditor,fProfessional/ClinicalfPublishing:fEileenfGlasstetter,fMS Specialfdiscountsfarefavailablefforfbulkfpurchasesfoffthisfpublication.fE-
ProductionfManager,fClinical/ProfessionalfPublications:
TheresafWiener .
EditorialfSpecialist:fAmandafHelmholz ©f2017fAmericanfAcademyfoffPediatrics
Manager,fArtfDirectionfandfProduction:fLindafDiamond
Allfrightsfreserved.fNofpartfoffthisfpublicationfmayfbefreproduced,fstoredf
Manager,fArtfDirectionfandfProduction:fPegfMulcahy
infafretrievalfsystem,forftransmittedfinfanyfformforfbyfanyfmeans—electronic,
SeniorfVicefPresident,fMembershipfEngagementfandfMarketingf
mechanical,fphotocopying,frecording,forfotherwise—
andfSales:fMaryfLoufWhite
withoutfpriorfpermissionf romfthefpublisherf(locateftitlefatfhttp://ebooks.aappu
MarketingfManager,fPracticefPublications:fMaryfJofReynolds
blications.org;fclickfon
ISBN:f978-1-61002-082-4 ©fGetfPermissions);fyoufmayfalsoffaxfthefpermissionsfeditorfatf847/434-
eBook:f978-1-61002-083-1 .
PrintedfinfthefUnitedfStatesfoffAmericaf
1f2f3f4f5f6f7f8f9f10
3-340/0217
BF0044
, Library foffCongressf ControlfNumber:f 2016940256
