TM
, Bright Futures
FOURTHrEDITION
r GuidelinesforHealthSupervisionofInfants,Children,andAdolescents
r r r r r r r r
POCKET GUIDE r
EDITORS
JosephrF.rHagan,rJr,rMD,rFAAPrJudit
hrS.rShaw,rEdD,rMPH,rRN,rFAAPrPaula
rM.rDuncan,rMD,rFAAP
SUPPORTED,rINrPART,rBY
USrDepartmentrofrHealthrandrHumanrServicesr
HealthrResourcesrandrServicesrAdministrationr
MaternalrandrChildrHealthrBureau
PUBLISHEDrBY
AmericanrAcademyrofrPediatrics
,ThisrpublicationrhasrbeenrproducedrbyrtherAmericanrAcademyrofrPediatrics.rSu Therrecommendationsrinrthisrpublicationrdornotrindicateranrexclusivercourserofr
pported,rinrpart,runderritsrcooperativeragreementr(U04MC07853)rwithrtherUSr treatmentrorrserverasrarstandardrofrmedicalrcare.rVariations,rtakingrintoraccountr
DepartmentrofrHealthrandrHumanrServices,rHealthrResourcesrandrServicesrAdm individualrcircumstances,rmayrberappropriate.
inistrationr(HRSA),rMaternalrandrChildrHealthrBureaur(MCHB). TherAmericanrAcademyrofrPediatricsrisrnotrresponsiblerforrthercontentrofrtherresourc
Suggestedrcitation:rHaganrJF,rShawrJS,rDuncanrPM,reds.rBrightrFutures:rGuideline esrmentionedrinrthisrpublication.rWebrsiteraddressesrarerasrcurrentrasrpossiblerbutrm
srforrHealth rSupervision rofrInfants, rChildren, rand rAdolescentsr[pocket rguide]. r4thre ayrchangeratranyrtime.
d.rElkrGroverVillage,rIL:rAmericanrAcademyrofrPediatrics;r2017 TherAmericanrAcademyrofrPediatricsrhasrneitherrsolicitedrnorracceptedranyrcomm
AmericanrAcademyrofrPediatricsrBrightrFuturesrNationalrCenterrStaff ercialrinvolvementrinrtherdevelopmentrofrthercontentrofrthisrpublication.
ChiefrMedicalrOfficer Therpublishersrhavermadereveryreffortrtortracerthercopyrightrholdersrfor
SeniorrVicerPresident,rChildrHealthrandrWellnessrAmerica rborrowedrmaterials.rIfrtheyrhaverinadvertentlyroverlookedrany,rtheyrwil
nrAcademyrofrPediatrics:rV.rFanrTait,rMD lrberpleasedrtormakerthernecessaryrarrangementsratrtherfirstropportunity.
Director,rDivisionrofr Developmental rPediatricsrand rPreventive rServices:rDarcyr AllrauthorsrhaverfiledrconflictrofrinterestrstatementsrwithrtherAmericanrAca
Steinberg-Hastings,rMPH demyrofrPediatrics.rAnyrconflictsrhaverbeenrresolvedrthroughrarprocessrappro
Manager,rBrightrFuturesrNationalrCenter:rJanerBassewitz,rMA vedrbyrtherBoardrofrDirectors.
Manager,rBrightrFuturesrImplementation:rKathrynrJanies
EveryreffortrisrmadertorkeeprtherGuidelinesrconsistentrwithrthermostrrecentr
AmericanrAcademyrofrPediatricsrPublishingrStaff advicerandrinformationravailablerfromrtherAmericanrAcademyrofrPediatrics.
Director,rDepartmentrofrPublishing:rMarkrGrimes
SeniorrEditor,rProfessional/ClinicalrPublishing:rEileenrGlasstetter,rMS Specialrdiscountsrareravailablerforrbulkrpurchasesrofrthisrpublication.rE-
ProductionrManager,rClinical/ProfessionalrPublications:
TheresarWiener .
EditorialrSpecialist:rAmandarHelmholz ©r2017rAmericanrAcademyrofrPediatrics
Manager,rArtrDirectionrandrProduction:rLindarDiamond
Allrrightsrreserved.rNorpartrofrthisrpublicationrmayrberreproduced,rstoredr
Manager,rArtrDirectionrandrProduction:rPegrMulcahy
inrarretrievalrsystem,rorrtransmittedrinranyrformrorrbyranyrmeans—electronic,
SeniorrVicerPresident,rMembershiprEngagementrandrMarketingr
mechanical,rphotocopying,rrecording,rorrotherwise—
andrSales:rMaryrLourWhite
withoutrpriorrpermissionrfromrtherpublisherr(locatertitleratrhttp://ebooks.aappu
MarketingrManager,rPracticerPublications:rMaryrJorReynolds
blications.org;rclickron
ISBN:r978-1-61002-082-4 ©rGetrPermissions);ryourmayralsorfaxrtherpermissionsreditorratr847/434-
eBook:r978-1-61002-083-1 .
PrintedrinrtherUnitedrStatesrofrAmericar
1r2r3r4r5r6r7r8r9r10
3-340/0217
BF0044
, Library rofrCongressr ControlrNumber:r 2016940256
, Bright Futures
FOURTHrEDITION
r GuidelinesforHealthSupervisionofInfants,Children,andAdolescents
r r r r r r r r
POCKET GUIDE r
EDITORS
JosephrF.rHagan,rJr,rMD,rFAAPrJudit
hrS.rShaw,rEdD,rMPH,rRN,rFAAPrPaula
rM.rDuncan,rMD,rFAAP
SUPPORTED,rINrPART,rBY
USrDepartmentrofrHealthrandrHumanrServicesr
HealthrResourcesrandrServicesrAdministrationr
MaternalrandrChildrHealthrBureau
PUBLISHEDrBY
AmericanrAcademyrofrPediatrics
,ThisrpublicationrhasrbeenrproducedrbyrtherAmericanrAcademyrofrPediatrics.rSu Therrecommendationsrinrthisrpublicationrdornotrindicateranrexclusivercourserofr
pported,rinrpart,runderritsrcooperativeragreementr(U04MC07853)rwithrtherUSr treatmentrorrserverasrarstandardrofrmedicalrcare.rVariations,rtakingrintoraccountr
DepartmentrofrHealthrandrHumanrServices,rHealthrResourcesrandrServicesrAdm individualrcircumstances,rmayrberappropriate.
inistrationr(HRSA),rMaternalrandrChildrHealthrBureaur(MCHB). TherAmericanrAcademyrofrPediatricsrisrnotrresponsiblerforrthercontentrofrtherresourc
Suggestedrcitation:rHaganrJF,rShawrJS,rDuncanrPM,reds.rBrightrFutures:rGuideline esrmentionedrinrthisrpublication.rWebrsiteraddressesrarerasrcurrentrasrpossiblerbutrm
srforrHealth rSupervision rofrInfants, rChildren, rand rAdolescentsr[pocket rguide]. r4thre ayrchangeratranyrtime.
d.rElkrGroverVillage,rIL:rAmericanrAcademyrofrPediatrics;r2017 TherAmericanrAcademyrofrPediatricsrhasrneitherrsolicitedrnorracceptedranyrcomm
AmericanrAcademyrofrPediatricsrBrightrFuturesrNationalrCenterrStaff ercialrinvolvementrinrtherdevelopmentrofrthercontentrofrthisrpublication.
ChiefrMedicalrOfficer Therpublishersrhavermadereveryreffortrtortracerthercopyrightrholdersrfor
SeniorrVicerPresident,rChildrHealthrandrWellnessrAmerica rborrowedrmaterials.rIfrtheyrhaverinadvertentlyroverlookedrany,rtheyrwil
nrAcademyrofrPediatrics:rV.rFanrTait,rMD lrberpleasedrtormakerthernecessaryrarrangementsratrtherfirstropportunity.
Director,rDivisionrofr Developmental rPediatricsrand rPreventive rServices:rDarcyr AllrauthorsrhaverfiledrconflictrofrinterestrstatementsrwithrtherAmericanrAca
Steinberg-Hastings,rMPH demyrofrPediatrics.rAnyrconflictsrhaverbeenrresolvedrthroughrarprocessrappro
Manager,rBrightrFuturesrNationalrCenter:rJanerBassewitz,rMA vedrbyrtherBoardrofrDirectors.
Manager,rBrightrFuturesrImplementation:rKathrynrJanies
EveryreffortrisrmadertorkeeprtherGuidelinesrconsistentrwithrthermostrrecentr
AmericanrAcademyrofrPediatricsrPublishingrStaff advicerandrinformationravailablerfromrtherAmericanrAcademyrofrPediatrics.
Director,rDepartmentrofrPublishing:rMarkrGrimes
SeniorrEditor,rProfessional/ClinicalrPublishing:rEileenrGlasstetter,rMS Specialrdiscountsrareravailablerforrbulkrpurchasesrofrthisrpublication.rE-
ProductionrManager,rClinical/ProfessionalrPublications:
TheresarWiener .
EditorialrSpecialist:rAmandarHelmholz ©r2017rAmericanrAcademyrofrPediatrics
Manager,rArtrDirectionrandrProduction:rLindarDiamond
Allrrightsrreserved.rNorpartrofrthisrpublicationrmayrberreproduced,rstoredr
Manager,rArtrDirectionrandrProduction:rPegrMulcahy
inrarretrievalrsystem,rorrtransmittedrinranyrformrorrbyranyrmeans—electronic,
SeniorrVicerPresident,rMembershiprEngagementrandrMarketingr
mechanical,rphotocopying,rrecording,rorrotherwise—
andrSales:rMaryrLourWhite
withoutrpriorrpermissionrfromrtherpublisherr(locatertitleratrhttp://ebooks.aappu
MarketingrManager,rPracticerPublications:rMaryrJorReynolds
blications.org;rclickron
ISBN:r978-1-61002-082-4 ©rGetrPermissions);ryourmayralsorfaxrtherpermissionsreditorratr847/434-
eBook:r978-1-61002-083-1 .
PrintedrinrtherUnitedrStatesrofrAmericar
1r2r3r4r5r6r7r8r9r10
3-340/0217
BF0044
, Library rofrCongressr ControlrNumber:r 2016940256
