, BrightFutures
FOURTHnEDITION
n
Guidelines for Health Supervision of Infants, Children, and Adolescents
n n n n n n n n
POCKET GUIDE n
EDITORS
JosephnF.nHagan,nJr,nMD,nFAAPnJu
dithnS.nShaw,nEdD,nMPH,nRN,nFAAPn
PaulanM.nDuncan,nMD,nFAAP
SUPPORTED,nINnPART,nBY
USnDepartmentnofnHealthnandnHumannServicesnHeal
thnResourcesnandnServicesnAdministrationnMaternal
nandnChildnHealthnBureau
PUBLISHEDn BY
AmericannAcademynofnPediatrics
,ThisnpublicationnhasnbeennproducednbynthenAmericannAcademynofnPediatric Thenrecommendationsninnthisnpublicationndonnotnindicatenannexclusivencoursenof
s.n Supported,ninnpart,nundernitsncooperativenagreementn(U04MC07853)nwith n treatmentnornservenasnanstandardnofnmedicalncare.nVariations,ntakingnintonaccou
nthen USnDepartmentnofnHealthnandnHumannServices,nHealthnResourcesnandnS ntn individualncircumstances,nmaynbenappropriate.
ervicesn Administrationn(HRSA),nMaternalnandnChildnHealthnBureaun(MCH ThenAmericannAcademynofnPediatricsnisnnotnresponsiblenfornthencontentnofnth
B). en resourcesnmentionedninnthisnpublication.nWebnsitenaddressesnarenasncurrent
Suggestedncitation:nHagannJF,nShawnJS,nDuncannPM,neds.nBrightnFutures:nGuideli nasn possiblenbutnmaynchangenatnanyntime.
nesn fornHealthnSupervisionnofnInfants,nChildren,nandnAdolescentsn[pocketnguide]. ThenAmericannAcademynofnPediatricsnhasnneithernsolicitednnornacceptednany
n4thned.n ElknGrovenVillage,nIL:nAmericannAcademynofnPediatrics;n2017 n commercialninvolvementninnthendevelopmentnofnthencontentnofnthisnpublicati
AmericannAcademynofnPediatricsnBrightnFuturesnNationalnCenternStaff on.
ChiefnMedicalnOfficer Thenpublishersnhavenmadeneveryneffortntontracenthencopyrightnholdersn
SeniornVicenPresident,nChildnHealthnandnWellnessn Ame forn borrowednmaterials.nIfntheynhaveninadvertentlynoverlookednany,nt
ricannAcademynofnPediatrics:nV.nFannTait,nMD heynwilln benpleasedntonmakenthennecessarynarrangementsnatnthenfirstn
Director,nDivisionnofnDevelopmentalnPediatricsnandnPreventivenServices:nDarc opportunity.
yn Steinberg-Hastings,nMPH AllnauthorsnhavenfilednconflictnofninterestnstatementsnwithnthenAmerica
Manager,nBrightn FuturesnNationaln Center:n JanenBassewitz,nMA nn AcademynofnPediatrics.nAnynconflictsnhavenbeennresolvednthroughnanp
Manager,n Brightn Futuresn Implementation:n Kathrynn Janies rocessn approvednbynthenBoardnofnDirectors.
AmericannAcademynofnPediatricsnPublishingnStaff EveryneffortnisnmadentonkeepnthenGuidelinesnconsistentnwithnthenmostnrecent
Director,nDepartmentnofnPublishing:nMarknGrimes n advicen andn informationn availablen fromn then Americann Academyn ofn Pediatrics.
Seniorn Editor,n Professional/Clinicaln Publishing:n Eileenn Glasstetter,n MS
ProductionnManager,nClinical/ProfessionalnPublications: Specialndiscountsnarenavailablenfornbulknpurchasesnofnthisnpublication.nE-
TheresanWiener mailn
Editorialn Specialist:n Amandan Helmholz mation.
Manager,nArtnDirectionnandnProduction:nLindanDiamond ©n2017nAmericannAcademynofnPediatrics
Manager,nArtnDirectionnandnProduction:nPegnMulcahy
Allnrightsnreserved.nNonpartnofnthisnpublicationnmaynbenreproduced,nstor
SeniornVicenPresident,nMembershipnEngagementnandnMarketing
edn innanretrievalnsystem,norntransmittedninnanynformnornbynanynmeans—
n andnSales:nMarynLounWhite
electronic,
Marketingn Manager,n Practicen Publications:n MarynJonReynolds
mechanical,nphotocopying,nrecording,nornotherwise—
ISBN:n 978-1-61002-082-4 withoutnpriornpermissionn fromnthenpublishern(locatentitlenatnhttp://ebooks.aapp
eBook:n978-1-61002-083-1 ublications.org;nclicknon
©nGetnPermissions);nyounmaynalsonfaxnthenpermissionsneditornatn847/434-
8780norn .
PrintedninnthenUnitednStatesnofnAmeri
can 1n2n3n4n5n6n7n8n9n10
, 3-340/0217
BF0044
LibrarynofnCongressnControlnNumber:n2016940256