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, BrightFutures
FOURTHxEDITION
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x GuidelinesxforxHealthxSupervisionxofxInfants,xChildren,xandxAdolescents
POCKET GUIDEx
EDITORS
JosephxF.xHagan,xJr,xMD,xFAAPxJud
ithxS.xShaw,xEdD,xMPH,xRN,xFAAPxP
aulaxM.xDuncan,xMD,xFAAP
SUPPORTED,xINxPART,xBY
USxDepartmentxofxHealthxandxHumanxService
sxHealthxResourcesxandxServicesxAdministrati
onxMaternalxandxChildxHealthxBureau
PUBLISHEDxBY
AmericanxAcademyxofxPediatrics
,ThisxpublicationxhasxbeenxproducedxbyxthexAmericanxAcademyxofxPediatri Thexrecommendationsxinxthisxpublicationxdoxnotxindicatexanxexclusivexcou
cs.xSupported,xinxpart,xunderxitsxcooperativexagreementx(U04MC07853)xwi rsexofxtreatmentxorxservexasxaxstandardxofxmedicalxcare.xVariations,xtakingx
thxthexUSxDepartmentxofxHealthxandxHumanxServices,xHealthxResourcesxa intoxaccountxindividualxcircumstances, xmayxbexappropriate.
ndxServicesxAdministrationx(HRSA),xMaternalxandxChildxHealthxBureaux(M ThexAmericanxAcademyxofxPediatricsxisxnotxresponsiblexforxthexcontentxofxthexr
CHB). esourcesxmentionedxinxthisxpublication.xWebxsitexaddressesxarexasxcurrentxasxp
Suggestedxcitation:xHaganxJF,xShawxJS,xDuncanxPM,xeds.xBrightxFutures:xGuid ossiblexbutxmayxchangexatxanyxtime.
elinesxforxHealth xSupervisionxofxInfants,xChildren,xandxAdolescentsx[pocketxguid ThexAmericanxAcademyxofxPediatricsxhasxneitherxsolicitedxnorxacceptedxanyxc
e].x4thxed.xElkxGrovexVillage,xIL:xAmericanxAcademyxofxPediatrics;x2017 ommercialxinvolvementxinxthexdevelopmentxofxthexcontentxofxthisxpublication.
AmericanxAcademyxofxPediatricsxBrightxFuturesxNationalxCenterxStaff Thexpublishersxhavexmadexeveryxeffortxtoxtracexthexcopyrightxholde
ChiefxMedicalxOfficer rsxforxborrowedxmaterials.xIfxtheyxhavexinadvertentlyxoverlookedxan
SeniorxVicexPresident,xChildxHealthxandxWellnessxAme y,xtheyxwillxbexpleasedxtoxmakexthexnecessaryxarrangementsxatxthex
ricanxAcademyxofxPediatrics:xV.xFanxTait,xMD firstxopportunity.
Director,xDivisionxofxDevelopmentalxPediatricsxandxPreventivexServices:xD AllxauthorsxhavexfiledxconflictxofxinterestxstatementsxwithxthexAmerica
arcyxSteinberg-Hastings,xMPH nxAcademyxofxPediatrics.xAnyxconflictsxhavexbeenxresolvedxthroughxaxpr
Manager,xBrightxFuturesxNationalxCenter:xJanexBassewitz,xMA ocessxapprovedxbyxthexBoardxofxDirectors.
Manager,xBrightxFuturesxImplementation:xKathrynxJanies
EveryxeffortxisxmadextoxkeepxthexGuidelinesxconsistentxwithxthexmostxr
AmericanxAcademyxofxPediatricsxPublishingxStaff ecentxadvicexandxinformationxavailablexfromxthexAmericanxAcademyxofx
Director,xDepartmentxofxPublishing:xMarkxGrimes Pediatrics.
SeniorxEditor,xProfessional/ClinicalxPublishing:xEileenxGlasstetter,xMS
ProductionxManager,xClinical/ProfessionalxPublications: Specialxdiscountsxarexavailablexforxbulkxpurchasesxofxthisxpublication.xE-
TheresaxWiener mailxourxSpecialxSalesxDepartmentxatxaapsales@aap.orgxforxmorexinform
EditorialxSpecialist:xAmandaxHelmholz ation.
Manager,xArtxDirectionxandxProduction:xLindaxDiamond ©x2017xAmericanxAcademyxofxPediatrics
Manager,xArtxDirectionxandxProduction:xPegxMulcahy
Allxrightsxreserved.xNoxpartxofxthisxpublicationxmayxbexreproduced,x
SeniorxVicexPresident,xMembershipxEngagementxandxMarket
storedxinxaxretrievalxsystem,xorxtransmittedxinxanyxformxorxbyxanyxmeans
ingxandxSales:xMaryxLouxWhite
—electronic,
MarketingxManager,xPracticexPublications:xMaryxJoxReynolds mechanical,xphotocopying,xrecording,xorxotherwise—
ISBN:x978-1-61002-082-4 withoutxpriorxpermissionxfromxthexpublisherx(locatextitlexatxhttp://ebooks.a
eBook:x978-1-61002-083-1 appublications.org;xclickxon
©xGetxPermissions);xyouxmayxalsoxfaxxthexpermissionsxeditorxatx847/434-
8780xorxe-mailxpermissions@aap.org.
PrintedxinxthexUnitedxStatesxofxAmer
icax1x2x3x4x5x6x7x8x9x10
, 3-340/0217
BF0044
LibraryxofxCongressxControlxNumber:x2016940256