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Appendix A

WORLD HEALTH ORGANIZATION


World Health Organization

GROWTH CHARTS
Growth Charts

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents
WORLD HEALTH ORGANIZATION
GROWTH CHARTS

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Birth to 24 months: Girls


Length-for-age and Weight-for-age percentiles

WORLD HEALTH ORGANIZATION


GROWTH CHARTS
98
95
90
75
50
25
10
5
2

98

95

90

75

50

25

10
5
2

Published by the Centers for Disease Control and Prevention, November 1, 2009
SOURCE: WHO Child Growth Standards (http://www.who.int/childgrowth/en)

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents
WORLD HEALTH ORGANIZATION
GROWTH CHARTS

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Birth to 24 months : Girls


Head circumference-for-age and NAME

WORLD HEALTH ORGANIZATION


Weight-for-length percentiles RECOR D #

GROWTH CHARTS
Birth
in cm cm in H
E
52 52 A
D
20 20
50 98 50 C
95 I
90 R
H 19 19
48 75 48 C
E U
50
A M
D 18 46 25 46 18 F
10 E
5 R
C 44 2 44 E
I 17 17 N
R C
C 42
24 E
U 52
16 23
M 40 50
F 22 48
E
15 38 21 46
R 98
E 95 20 44
N 36 90 42
14 19
C
E 75
18 40
34
50 38
13 17
25 36
32 16
10 34
12 5 15
30 2 32
14
30 W
28 13 28 E
12 12 I
26 26 G
24 11 11 24 H
22 10 10 22 T
20 9 9 20
18 8 8 18
16 7 7
16
W
E 14 14
6 6
I 12
14 12
G 5 5
10 kg lb
H 4 LENGTH
T 8
64 66 68 70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 100 102 104 106 108 110 cm
6 3
26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 in
4 2
Date Age Weight Length Hea d Circ. Comment
2 1
lb kg
cm 46 48 50 52 54 56 58 60 62
in 18 19 20 21 22 23 24
Published by the Centers for Disease Control and Prevention, November 1, 2009
SOURCE: WHO Child Growth Standards (http://www.who.int/childgrowth/en)

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Appendix B

Centers for Disease Control and Prevention


Growth Charts

CENTERS FOR DISEASE CONTROL AND


PREVENTION GROWTH CHARTS

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

2 to 20 years: Boys NAME


Stature-for-age and Weight-for-age percentiles RECORD #

12 13 14 15 16 17 18 19 20
Mother’s Stature Father’s Stature cm in
Date Age Weight Stature BMI*
AGE (YEARS) 76
95
190
74
90
185 S
75
72
180 T
50 70 A
175 T
25 68 U
170 R
10 66
165 E
in cm 5
CENTERS FOR DISEASE CONTROL AND

3 4 5 6 7 8 9 10 11
64
PREVENTION GROWTH CHARTS

160 160
62 62
155 155
S 60 60
T 150 150
A 58
T 145
U 56
140 105 230
R
54
E 135 100 220
52
130 95 95 210
50
125 90 200
90
48 190
120 85
46 180
115 80
75
44 170
110 75
42 160
105 50 70
150 W
40
100 65 140 E
25
38 I
95 60 130 G
10
36 90 5 H
55 120
T
34 85 50 110
32 80 45 100
30
40 90
80 35 35 80
W 70 70
30 30
E 60 60
I 25 25
G 50 50
H 20 20
40 40
T
15 15
30 30
10 10
lb kg AGE (YEARS) kg lb
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Published May 30, 2000 (modified 11/21/00).

830
SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).
http://www.cdc.gov/growthcharts

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

2 to 20 years: Girls NAME


Stature-for-age and Weight-for-age percentiles RECORD #

12 13 14 15 16 17 18 19 20
Mother’s Stature Father’s Stature cm in
Date Age Weight Stature BMI*
AGE (YEARS) 76
190
74
185 S
72
180 T
70 A
95
175 T
90
68 U
170 R
75 66
165 E
in cm

CENTERS FOR DISEASE CONTROL AND


3 4 5 6 7 8 9 10 11 50
64

PREVENTION GROWTH CHARTS


160 25 160
62 62
155 10 155
60 5 60
150 150
58
145
56
140 105 230
54
S 135 100 220
T 52
A 130 95 210
50
T 125 90 200
U
48 190
R 120 85
E 95 180
46
115 80
44 170
110 90 75
42 160
105 70
150 W
40 75
100 65 140 E
38 I
95 60 130 G
50
36 90 H
55 120
25 T
34 85 50 110
10
32 80
5
45 100
30
40 90
80 35 35 80
W 70 70
30 30
E 60 60
I 25 25
G 50 50
H 20 20
40 40
T
15 15
30 30
10 10
lb kg AGE (YEARS) kg lb
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Published May 30, 2000 (modified 11/21/00).

831
SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).
http://www.cdc.gov/growthcharts

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

2 to 20 years: Boys NAME


Body mass index-for-age percentiles RECORD #

Date Age Weight Stature BMI* Comments


BMI

35

34

33

32

31
CENTERS FOR DISEASE CONTROL AND
PREVENTION GROWTH CHARTS

30
95
29

BMI 28
90
27 27
26 85 26
25 25
75
24 24

23 23
50
22 22

21 21
25
20 20
10
19 19
5
18 18

17 17

16 16

15 15

14 14

13 13

12 12

2 2
kg/m AGE (YEARS) kg/m
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Published May 30, 2000 (modified 10/16/00).


SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).

832
http://www.cdc.gov/growthcharts

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

2 to 20 years: Girls NAME


Body mass index-for-age percentiles RECORD #

Date Age Weight Stature BMI* Comments


BMI

35

34

33

32

95
31

CENTERS FOR DISEASE CONTROL AND


PREVENTION GROWTH CHARTS
30

29

BMI 28
90

27 27
26 85 26
25 25

24 75 24

23 23

22 22
50
21 21

20 20
25
19 19
10
18 5
18

17 17

16 16

15 15

14 14

13 13

12 12

2 2
kg/m AGE (YEARS) kg/m
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Published May 30, 2000 (modified 10/16/00).


SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).

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http://www.cdc.gov/growthcharts

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

NAME
Weight-for-stature percentiles: Boys RECORD #

Date Age Weight Stature Comments kg lb


76
34
33
72
32
31 68
30
29 64
CENTERS FOR DISEASE CONTROL AND

28
97
95
PREVENTION GROWTH CHARTS

lb kg 27 60

26 26
56 56
25 25
90
24 85 24
52 52
23 75 23

48 22 22 48
50
21 21
25
44 20 20 44
10
19 3 19
40 18 18 40

17 17
36 36
16 16
15 15
32 32
14 14
13 13
28 28
12 12

24 11 11 24
10 10
20 9 9 20
8 8
lb kg STATURE kg lb
cm 80 85 90 95 100 105 110 115 120

in 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47

Published May 30, 2000 (modified 10/16/00).


SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).
http://www.cdc.gov/growthcharts
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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

NAME
Weight-for-stature percentiles: Girls RECORD #

Date Age Weight Stature Comments kg lb


76
34
33
72
32
31 68
30
29 64

CENTERS FOR DISEASE CONTROL AND


97
28

PREVENTION GROWTH CHARTS


lb kg 27 60

26 26
56 56
25 90 25
24 85 24
52 52
23 75 23

48 22 22 48
50
21 21

44 20 25 20 44
19 10 19
3
40 18 18 40

17 17
36 36
16 16
15 15
32 32
14 14
13 13
28 28
12 12

24 11 11 24
10 10
20 9 9 20
8 8
lb kg STATURE kg lb
cm 80 85 90 95 100 105 110 115 120

in 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47

Published May 30, 2000 (modified 10/16/00).


SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).
http://www.cdc.gov/growthcharts

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Appendix C
Bright Futures/American Academy of Pediatrics

Recommendations for
Preventive Pediatric Health Care
(Periodicity Schedule)

Available at
www.aap.org/periodicityschedule

PERIODICITY SCHEDULE

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Index
Page numbers followed by an f or a t or b denote a figure, table, or box, respectively.

A
Abuse. See Family violence; Intimate partner violence; Maltreat- decision-making skills in
ment and neglect; Sexual abuse 11 through 14 Year Visits, 749
Abusive head trauma (AHT), 121–122 15 through 17 Year Visits, 781
ACE Study. See Adverse Childhood Experiences (ACE) Study 18 through 21 Year Visits, 810
Acoustic trauma deficit models for, 110t
11 through 14 Year Visits, 761–762 depression in, 138–139
15 through 17 Year Visits, 793–794 screening for, 283
18 through 21 Year Visits, 819 development/developmental surveillance in, 78–79
ADHD. See Attention-deficit/hyperactivity disorder (ADHD) 11 through 14 Year Visits, 739
Adolescence 15 through 17 Year Visits, 771
acoustic trauma in 18 through 21 Year Visits, 802–803
11 through 14 Year Visits, 761–762 cognitive deficits, 139
15 through 17 Year Visits, 793–794 cognitive development/skills, 108
18 through 21 Year Visits, 819 developmental domains, 107t, 108–109
alcohol use/exposure in developmental highlights/milestones, 110
11 through 14 Year Visits, 745–746, 760–761 growth, nutrition for, 187–189
15 through 17 Year Visits, 777–778, 792–793 healthy development, promotion of, 106–110
18 through 21 Year Visits, 808, 818 sexual development and sexuality, 221–225
anxiety disorders in, 138–139 diet and nutrition in, 187–190
asset models for, 110, 110t dietary reference intakes, 183b, 188b
attachment patterns in, 138 growth, nutrition for, 187–189
attention deficits in, 139 oral health promotion, 213–214
behavioral concerns/problems in, 140 driving safely in, 248–249
bisexual, youth who identify as, 224–225 15 through 17 Year Visits, 795–796
body image in, 189–190 18 through 21 Year Visits, 820
11 through 14 Year Visits, 751 eating disorders in, 189–190
15 through 17 Year Visits, 783 eating habits in, 189–190
18 through 21 Year Visits, 811 11 through 14 Year Visits, 751–753
brushing teeth in, 214 15 through 17 Year Visits, 784–785
bullying in 18 through 21 Year Visits, 812
11 through 14 Year Visits, 743–744 eating disorders, 189–190
15 through 17 Year Visits, 775–776 e-cigarette use/exposure in
18 through 21 Year Visits, 805–806 11 through 14 Year Visits, 745–746, 760–761
calcium in, 183b, 188b 15 through 17 Year Visits, 777–778, 792–793
cheerleading safety, 252 18 through 21 Year Visits, 808, 818
cognitive development/skills in, 108 emotional development/well-being in, 108–109, 137, 137t
cognitive deficits, 139 family dynamic/relationships in
communication skills in, 108 11 through 14 Year Visits, 746–747
community connectedness/engagement in 15 through 17 Year Visits, 778–779
11 through 14 Year Visits, 747–748 18 through 21 Year Visits, 808–809
15 through 17 Year Visits, 779–780 family support in, 60–61
18 through 21 Year Visits, 809 fighting in
concussions from sports, 251 11 through 14 Year Visits, 743–744
conduct disturbances in, 140 15 through 17 Year Visits, 775–776
connectedness in, 138 18 through 21 Year Visits, 805–806
social connections/skills, 108–109 firearm safety in
contraception in, 222 11 through 14 Year Visits, 765
coping with stress in 15 through 17 Year Visits, 797
11 through 14 Year Visits, 749 18 through 21 Year Visits, 821
15 through 17 Year Visits, 781 fluoride in, 213–214
18 through 21 Year Visits, 810

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Adolescence (cont) performance-enhancing substances, use of, 190


food security/insecurity in periodontal conditions, 214
11 through 14 Year Visits, 745 physical activity in, 194t, 201–202
15 through 17 Year Visits, 777 11 through 14 Year Visits, 753–755
18 through 21 Year Visits, 807 15 through 17 Year Visits, 786–787
friends/peers in 18 through 21 Year Visits, 813–814
11 through 14 Year Visits, 746–747 physical examinations in, 271–273
15 through 17 Year Visits, 778–779 11 through 14 Year Visits, 740–741
18 through 21 Year Visits, 808–809 15 through 17 Year Visits, 772–773
gang membership, 250 18 through 21 Year Visits, 804
gay, youth who identify as, 224–225 pregnancy in, 222
gender nonconforming, youth who identify as, 219b, 224–225 11 through 14 Year Visits, 759–760
health supervision visits in 15 through 17 Year Visits, 791–792
11 through 14 Year Visits, 733–765 18 through 21 Year Visits, 817
15 through 17 Year Visits, 767–797 rates of pregnancy, 222
18 through 21 Year Visits, 799–821 safety and injury prevention in, 248–252
helmets, use of school-based health clinics, 273
11 through 14 Year Visits, 763 school performance in
15 through 17 Year Visits, 795–796 11 through 14 Year Visits, 748–749
18 through 21 Year Visits, 820 15 through 17 Year Visits, 780–781
histories (patient and family) 18 through 21 Year Visits, 809
11 through 14 Year Visits, 738 screening/surveillance in
15 through 17 Year Visits, 770 11 through 14 Year Visits, 741–742
18 through 21 Year Visits, 802 15 through 17 Year Visits, 773–774
immunizations in 18 through 21 Year Visits, 804–805
11 through 14 Year Visits, 742 substance use/misuse, 141–144
15 through 17 Year Visits, 774 seat belts, use of
18 through 21 Year Visits, 805 11 through 14 Year Visits, 763
learning deficits/disabilities in, 139 15 through 17 Year Visits, 795–796
lesbian, youth who identify as, 224–225 18 through 21 Year Visits, 820
lifelong health promotion in, 35 sexual abuse in, 140
linguistic skills in, 108 sexual decision-making in, 221
living situation in sexual development and sexuality in, 221–225
11 through 14 Year Visits, 745 11 through 14 Year Visits, 757–758
15 through 17 Year Visits, 777 15 through 17 Year Visits, 789–790
18 through 21 Year Visits, 807 18 through 21 Year Visits, 816
medications in (18 through 21 Year Visits), 818 sexual intercourse in, 221–222
mental health in sexually transmitted infections in, 222
11 through 14 Year Visits, 756–757 11 through 14 Year Visits, 759–760
15 through 17 Year Visits, 788–789 15 through 17 Year Visits, 791–792
promotion of, 136–145 18 through 21 Year Visits, 817
models of care for, 110t sexual orientation in, 224–225
mood disorders/regulation in sleep behaviors, patterns, and safety
11 through 14 Year Visits, 756–757 11 through 14 Year Visits, 753–755
15 through 17 Year Visits, 788–789 15 through 17 Year Visits, 786–787
18 through 21 Year Visits, 815–816 18 through 21 Year Visits, 813–814
motor skills in social connections/skills in, 108–109
fine motor skills, 108 social determinants of health in, 24b
gross motor skills, 108 social media use in, 233
oral health in, 213–214 special health care needs, adolescents with, 74–75
11 through 14 Year Visits, 750 healthy development of, 106–107
15 through 17 Year Visits, 782–783 nutrition for, 190
18 through 21 Year Visits, 811 physical activity for, 195–196
brushing teeth, 214 sports in, 250–252
orthodontics, 214 substance use/exposure in, 141–145
parent-child interaction/relationship in 11 through 14 Year Visits, 745–746, 760–761, 764–765
11 through 14 Year Visits, 740 15 through 17 Year Visits, 777–778, 792–793
15 through 17 Year Visits, 772 18 through 21 Year Visits, 808, 818
18 through 21 Year Visits, 803 suicide in, 140, 250

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

sun exposure/protection in Anemia


15 through 17 Year Visits, 796–797 screening for, 278–279
18 through 21 Year Visits, 820–821 sickle cell. See Sickling/sickle cell trait (SCT)
tobacco use/exposure in Anger management
11 through 14 Year Visits, 745–746, 760–761 5 and 6 Year Visits, 665
15 through 17 Year Visits, 777–778, 792–793 9 and 10 Year Visits, 716–717
18 through 21 Year Visits, 808, 818 Anticipatory guidance, 263, 270
transgender, youth who identify as, 219b, 224–225 Bright Futures anticipatory guidance materials, 8
violence in, 249–250 Anxiety disorders
vitamin D in, 183b in early childhood, 128t
weight in in middle childhood, 134
healthy weight, 164 in adolescence, 138–139
overweight and obesity, adolescents with, 153, 164 ASQ. See Ages and Stages Questionnaires (ASQ)
Adolescent parents Asset models for adolescence, 110, 110t
families with, 43–44 Athletics. See Sports
pregnancy. See Adolescence Attachment/attachment patterns
Adopted children, 44–45 in infancy, 119–120, 119t
Adult assistance/care 1 Month Visit guidance, 398–400
family support. See Family support in early childhood, 124
local community resources, 33b in middle childhood, 131–132
transitioning to, 814 in adolescence, 138
special health care needs, youth with, 75 separation anxiety. See Separation anxiety
Adverse Childhood Experiences (ACE) Study, 19–20, 19b Attention-deficit/hyperactivity disorder (ADHD), 133
After-school activities/care/programs Attention deficits
5 and 6 Year Visits, 667 in early childhood, 129t
7 and 8 Year Visits, 691–692 in middle childhood, 133
9 and 10 Year Visits, 725–726 in adolescence, 139
Ages and Stages Questionnaires (ASQ), 261 Autism spectrum disorder
Aggression. See also Behavioral concerns/problems; early identification of, 129–130
Mood disorders/regulation screening for, 280
in early childhood, chronic, 127t Autonomy, 54. See also Independence
anger management
5 and 6 Year Visits, 665 B
9 and 10 Year Visits, 716–717 Babies. See Infancy
AHT. See Abusive head trauma (AHT) Bedtime/bedtime routine
Alcohol use/exposure, 56 12 Month Visit, 514–515
in infancy 15 Month Visit, 535
Prenatal Visit, 314–315 bedtime struggles, 126t
Newborn Visit, 343–344 sleep patterns. See Sleep behaviors, patterns, and safety
1 Month Visit, 393–394 Behavior
6 Month Visit, 465 beliefs and, 54–55
in early childhood biological determinants of health and, 22f
12 Month Visit, 511 guidance. See Behavioral guidance
2 Year Visit, 572 management of. See Behavior management
3 Year Visit, 611 positive behaviors, promotion of, 53–55
4 Year Visit, 633 problems. See Behavioral concerns/problems
in middle childhood sleep. See Sleep behaviors, patterns, and safety
5 and 6 Year Visits, 661–662 Behavioral concerns/problems
7 and 8 Year Visits, 686 in early childhood, 124–125, 126t–129t
9 and 10 Year Visits, 712 in middle childhood, 134
in adolescence in adolescence, 140
11 through 14 Year Visits, 745–746, 760–761 Behavioral guidance
15 through 17 Year Visits, 777–778, 792–793 in infancy, 89–90
18 through 21 Year Visits, 808, 818 9 Month Visit guidance, 493–494
as a biological determinant of health, 21 in early childhood, 95–98
screening for, 298 12 Month Visit guidance, 513
Alternative care
Prenatal Visit guidance, 320, 324
family-centered care, 49–50

841

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Behavior management at the overall health system level, 5–6


15 Month Visit, 536–537 at the policy level, 5–6
18 Month Visit, 550–551 themes, 6, 9
anger management. See Anger management use for, 2
obesity prevention, use for, 155 health supervision visits. See Health supervision visits
Beliefs and behaviors, 54–55 implementing, 8–9
Brendtro’s Circle of Courage, 53–54 life course framework in, 21–30
Beverages organization of, 6–7
alcoholic. See Alcohol use/exposure preventive services prompting sheet, 8
juice. See Juice principles, 1
milk. See Milk quality of care, using to improve, 9
sugar-sweetened. See Sugar-sweetened beverages strategies, 1
water. See Water in early childhood systems oriented, 2
Bilirubin, 291, 277, 340 themes, 6, 13
Biological determinants of health, 21–23, 22f theory based, 1–2
Bisexual, youth who identify as, 224–225 tools, 1
Blood Bright Futures Tool and Resource Kit, 8–9, 265b
lead poisoning. See Lead poisoning who can use, 6
newborn screening, 291 Brushing teeth. See also Oral health
sickle cell trait. See Sickling/sickle cell trait (SCT) in early childhood, 211
Blood pressure screening, 281 12 Month Visit, 514–515
Body image, 189–190 15 Month Visit, 538
11 through 14 Year Visits, 751 in middle childhood, 212
15 through 17 Year Visits, 783 5 and 6 Year Visits, 668
18 through 21 Year Visits, 811 7 and 8 Year Visits, 693
Body mass index (BMI), 151, 152t 9 and 10 Year Visits, 722–723
interpreting, 269t in adolescence, 214
weight-change targets based on, 161, 162t special health care needs, children with, 208
Body weight. See Weight Bullying/cyberbullying
Brain development. See also Cognitive development/skills in middle childhood, 134–135, 247–248
biological determinants of health and, 22f 7 and 8 Year Visits, 684–685
early development (First Week Visit [3 to 5 Days]), 372 9 and 10 Year Visits, 710–711
Breakfast, importance of, 723–724 in adolescence
Breastfeeding, 174–175 11 through 14 Year Visits, 743–744
in infancy 15 through 17 Year Visits, 775–776
Prenatal Visit, 323–324, 325 18 through 21 Year Visits, 805–806
Newborn Visit, 352–354 conduct disturbances from, 756, 788
First Week Visit (3 to 5 Days), 376–377 emotional/social development and, 105t, 131, 135
1 Month Visit, 404–405 LGBTQ, youth who identify as, 224
2 Month Visit, 427–428 neighborhood and community safety and, 660-661
4 Month Visit, 451 parenting advice, 135, 231, 233, 239
6 Month Visit, 476–477 preventing, 135, 240, 241, 242
in early childhood, 516–517 school performance and, 707
benefits of, 174, 175t types of, 134
cultural influences, 175 StopBullying.gov, 135
family support of, 325 Burns, prevention of
frequency and amount of, 176–177 in infancy
weaning, 495 First Week Visit (3 to 5 Days), 381
Bright Futures, 1–6 2 Month Visit, 432
anticipatory guidance materials, 8 6 Month Visit, 480
culturally appropriate interventions, 2–3 9 Month Visit, 498–499
evidence driven, 1–2 in early childhood
health and well-being promotion 18 Month Visit, 561–562
at the clinical practice level, 4–5 2½ Year Visit, 601
at the community level, 5–6 Burping newborns, 375–376
current and emerging needs, 3
at the family level, 3–4

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

C Children’s health, definition of, 15b


Calcium Chlamydia trachomatis. See also Sexually transmitted
in infancy, 183b infections (STIs)
in early childhood, 183b screening for, 295, 296
in middle childhood, 186 Choking, prevention of
5 and 6 Year Visits, 669–670 in infancy, 480
7 and 8 Year Visits, 694–695 in early childhood, 183
dietary reference intakes, 183b 3 Year Visit, 622
in adolescence, 183b, 188b Choline, 172, 319, 352, 376, 404
dietary reference intakes, 183b, 188b Circumcision, 322
Calming the baby Cognitive behavior management. See Behavior management
Newborn Visit guidance, 350 Cognitive development/skills
First Week Visit (3 to 5 Days) guidance, 373–374 in infancy, 81–83
4 Month Visit guidance, 443 9 Month Visit guidance, 490
6 Month Visit guidance, 471 in early childhood, 91–93
self-calming, 443, 471 in middle childhood, 104
Caloric needs in infancy, 173 in adolescence, 108
Cardiopulmonary resuscitation (CPR), 236, 242 cognitive deficits, 139
Caries, prevention of. See Oral health attention deficits. See Attention deficits
Car safety cognitive deficits
safety seats. See Car safety seats in adolescence, 139
seat belts. See Seat belts special health care needs for children with. See Special
substance use/exposure health care needs, children with
driving under the influence, 820 Communication
riding in vehicles (11 through 14 Year Visits), 764–765 parent-infant. See Parent-child interaction/relationship
Car safety seats, 327–328 skills. See Communication skills
in infancy Communication skills. See also Linguistic skills
Newborn Visit, 355–356 in infancy, 81–83
First Week Visit (3 to 5 Days), 378–379 6 Month Visit, 468–469
1 Month Visit, 406 6 Month Visit guidance, 491
2 Month Visit, 430 in early childhood, 91–93
4 Month Visit, 453 15 Month Visit, 534
6 Month Visit, 478–479 2 Year Visit, 577
9 Month Visit, 496–497 in middle childhood, 104
in early childhood in adolescence, 108
12 Month Visit, 520 Community connectedness/engagement
15 Month Visit, 540 in early childhood (4 Year Visit), 635
18 Month Visit, 559 in adolescence
2 Year Visit, 581 11 through 14 Year Visits, 747–748
2½ Year Visit, 599–600 15 through 17 Year Visits, 779–780
3 Year Visit, 621 18 through 21 Year Visits, 809
booster seats, 644, 674, 697 Community partnerships/support
Cervical dysplasia, screening for, 282 for healthy nutrition, 170–171
Cheerleading safety, 252 identifying and building on, 32–35
Child care local community resources, 32, 33b
in infancy obesity prevention, role in, 157t
Prenatal Visit, 320 Community safety. See Neighborhood and community safety/
2 Month Visit, 418 violence
4 Month Visit, 442 Competence and mastery, 53
6 Month Visit, 467 Complementary and alternative care
early care, 84. See also Prenatal care Prenatal Visit guidance, 320, 324
in early childhood family-centered care, 49–50
12 Month Visit, 511–512 Complementary foods in infancy, 177–179
early care, 100–101 Computer viewing, 55. See also Media use/exposure
early care Concussions from sports, 251
in infancy, 84. See also Prenatal care Conduct disturbances. See Behavioral concerns/problems
in early childhood, 100–101 Confidentiality of health supervision visits, 268b
prenatal care. See Prenatal care Congenital heart disease, screening for, 292

843

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Connectedness, 54 Dental checkups. See also Oral health


in early childhood 12 Month Visit, 519
community connectedness/engagement, 635 7 and 8 Year Visits, 693
difficulty in forming friendships, 128t 9 and 10 Year Visits, 722–723
social connections/skills, 93, 95, 128t Dental home. See also Oral health
in middle childhood, 131–132 importance of, 206–207
social connections/skills, 104, 105t responsibilities of, 206t
in adolescence, 138 Depression
community connectedness. See Community in adolescence, 138–139
connectedness/engagement screening for, 283
social connections/skills, 108–109 maternal/parental. See Maternal/parental depression
with the community. See Community connectedness/ screening for
engagement adolescent depression, 283
with the family. See Family dynamic/relationships maternal depression, 283
social connections. See Friends/peers; Social Determinants of health
connections/skills biological, 21–23, 22f
Contraception in adolescence, 222 physical, 28–30
Coping with stress in adolescence social. See Social determinants of health
11 through 14 Year Visits, 749 Development/developmental surveillance, 77–79, 284
15 through 17 Year Visits, 781 in infancy, 78
18 through 21 Year Visits, 810 Prenatal Visit, 308
CPR. See Cardiopulmonary resuscitation (CPR) Newborn Visit, 337
Crying, 88. See also Calming the baby; Fussiness in infancy First Week Visit (3 to 5 Days), 363–364
Cultural influences, 54–55 1 Month Visit, 386
in infancy, 84 2 Month Visit, 412
Prenatal Visit guidance, 317 4 Month Visit, 436
in early childhood, 93 6 Month Visit, 460
appropriate interventions, 2–3 9 Month Visit, 484
breastfeeding, 175 cognitive development/skills, 81–83, 490
families, beliefs and culture of, 54–55 developmental domains, 81–84
on food, 168–169 developmental highlights/milestones, 84–90
in safety and injury prevention, 237–238 growth, nutrition for, 172–173
weight, 169 healthy development, promotion of, 79–90
Cup drinking in infancy, 494–495 sexual development and sexuality, 217–218
Cyberbullying. See Bullying/cyberbullying in early childhood, 78
12 Month Visit, 506, 513
D 15 Month Visit, 528
Daily routines and rituals, 54 18 Month Visit, 546
in infancy (4 Month Visit), 444 2 Year Visit, 566, 574
in early childhood 2½ Year Visit, 588
2½ Year Visit, 592 3 Year Visit, 606
4 Year Visit, 641 4 Year Visit, 628
daily living tasks, 94 cognitive development/skills, 91–93
bedtime routine. See Bedtime/bedtime routine developmental domains, 91–93
familial. See Family rules and routines developmental highlights/milestones, 94–102
Dampness in home growth, nutrition for, 182–184
Prenatal Visit guidance, 311 healthy development, promotion of, 90–102
1 Month Visit guidance, 391–392 sexual development and sexuality, 218–219
Decision-making skills in middle childhood, 78–79
in early childhood 5 and 6 Year Visits, 656
2½ Year Visit, 595 7 and 8 Year Visits, 681
giving children choices, 595 9 and 10 Year Visits, 707
in adolescence cognitive development/skills, 104
11 through 14 Year Visits, 749 developmental domains, 103–104, 105t
15 through 17 Year Visits, 781 developmental highlights/milestones, 106
18 through 21 Year Visits, 810 growth, nutrition for, 185–186
shared decision-making, 31–32 healthy development, promotion of, 102–106
Deficit models for adolescence, 110t puberty/pubertal development, 690, 718–721
Dental caries, prevention of. See Oral health sexual development and sexuality, 219–221

844

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

in adolescence, 78–79 Discipline. See also Behavior management


11 through 14 Year Visits, 739 in infancy, 89–90
15 through 17 Year Visits, 771 in early childhood, 95–98, 98b
18 through 21 Year Visits, 802–803 15 Month Visit, 536–537
cognitive deficits, 139 Disease prevention, 262
cognitive development/skills, 108 Distracted driving, prevention of, 249
developmental domains, 107t, 108–109 Divorce, impact of, 28
developmental highlights/milestones, 110 Domestic violence. See Family violence; Intimate partner violence
growth, nutrition for, 187–189 Domestic violence hotline, 28
healthy development, promotion of, 106–110 Down syndrome, 72. See also Special health care needs, children with
sexual development and sexuality, 221–225 National Down Syndrome Society, 72
brain. See Brain development Drinking, 56. See also Fluids
cognitive. See Cognitive development/skills Driving safely
Eco-Bio-Developmental Model of Human Health in adolescence, 248–249
and Disease, 16–17, 16f 15 through 17 Year Visits, 795–796
healthy development, promotion of, 77–110 18 through 21 Year Visits, 820
life course perspective of, 18f. See also Life course framework distracted driving, prevention of, 249
local community resources, 33b Driving under the influence, 820
mobility, 490 Drooling in infancy, 447
in puberty. See Puberty/pubertal development Drowning, prevention of
and safety, 236–237 in infancy
special health care needs, children with 2 Month Visit, 432
in infancy, 80–81 6 Month Visit, 480
in early childhood, 90 9 Month Visit, 498–499
in middle childhood, 103 in early childhood (12 Month Visit), 521
in adolescence, 106–107 Drugs
Diet and nutrition. See also Food/feeding Prenatal Visit guidance, 324
in preconception/prenatal periods, 171–172 medications. See Medications
Prenatal Visit guidance, 319 performance-enhancing substances, 190
in infancy, 172–182 use/misuse. See Substance use/exposure
Prenatal Visit guidance, 319 Dyslipidemia, screening for, 285
Newborn Visit guidance, 346
in early childhood, 182–185 E
oral health promotion, 211 Early adverse experiences
in middle childhood, 185–187 Adverse Childhood Experiences (ACE) Study, 19–20, 19b
5 and 6 Year Visits, 668–670 focus on the effects of, 19–20
7 and 8 Year Visits, 694–695 moderating factors, use of, 20
9 and 10 Year Visits, 723–724 Early care. See also Early childhood programs
oral health promotion, 212 in infancy, 84. See also Prenatal care
saturated fat, 723–724 in early childhood, 100–101
in adolescence, 187–190 Early childhood
dietary reference intakes, 183b, 188b alcohol use/exposure in
growth, nutrition for, 187–189 12 Month Visit, 511
oral health promotion, 213–214 2 Year Visit, 572
as a biological determinant of health, 22 3 Year Visit, 611
community partnerships, 170–171 4 Year Visit, 633
essential components of, 171 attachment patterns in, 124
familial influences on, 55 attention deficits in, 129t
feeding environment, 167–168 autism spectrum disorder, 129–130. See also Autism
healthy nutrition, promotion of, 167–190 spectrum disorder
maternal nutrition, 346 bedtime/bedtime routine in
oral health, promotion of 12 Month Visit, 514–515
in early childhood, 211 15 Month Visit, 535
in middle childhood, 212 bedtime struggles, 126t
in adolescence, 213–214 behavioral guidance in, 95–98
saturated fats, 723–724 12 Month Visit guidance, 513
snacks. See Snacks behavioral problems in, 124–125, 126t–129t
for sports activities, 196–198 behavior management in
sugar intake. See Sugar intake 15 Month Visit, 536–537
whole-grain consumption, 669–670 18 Month Visit, 550–551
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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Early childhood (cont) emotional development/well-being in, 93


breastfeeding in, 516–517 4 Year Visit, 637
brushing teeth in, 211 falls, prevention of
12 Month Visit, 514–515 15 Month Visit, 541
15 Month Visit, 538 18 Month Visit, 561–562
burns, prevention of 3 Year Visit, 622
18 Month Visit, 561–562 family activities in (2½ Year Visit), 592
2½ Year Visit, 601 family dynamic/relationships in
calcium in, 183b 12 Month Visit, 511–512
car safety seats, use of 3 Year Visit, 612
12 Month Visit, 520 family support in, 59
15 Month Visit, 540 15 Month Visit, 533
18 Month Visit, 559 family time in (12 Month Visit), 514
2 Year Visit, 581 firearm safety in
2½ Year Visit, 599–600 18 Month Visit, 560–561
3 Year Visit, 621 2 Year Visit, 583
child care in 3 Year Visit, 623–624
12 Month Visit, 511–512 4 Year Visit, 647
early care, 100–101 fire safety in
choking, prevention of, 183 15 Month Visit, 541
3 Year Visit, 622 18 Month Visit, 561–562
cognitive development/skills in, 91–93 2½ Year Visit, 601
communication skills in, 91–93 fluids in, 557, 619, 639. See also Juice; Milk; Water in
15 Month Visit, 534 early childhood
2 Year Visit, 577 fluoride in, 211
community connectedness/engagement in, 635 food/feeding in
connectedness in 12 Month Visit, 516–518
community connectedness/engagement, 635 18 Month Visit, 556–558
difficulty in forming friendships, 128t 3 Year Visit, 619
cultural influences in, 93 4 Year Visit, 640
daily routines and rituals in appetite changes, 182, 182b
2½ Year Visit, 592 continued breastfeeding, 516–517
4 Year Visit, 641 eating/feeding skills, 184–185
daily living tasks, 94 expressing likes/dislikes, 558
decision-making skills in family meals, transition to, 516–517
2½ Year Visit, 595 fluids in, 557, 619, 639. See also Juice; Milk;
giving children choices, 595 Water in early childhood
development/developmental surveillance in, 78 nutritious foods, 517–518, 556–557, 619, 640
12 Month Visit, 506, 513 self-feeding, 516
15 Month Visit, 528 food security/insecurity in
18 Month Visit, 546 12 Month Visit, 510
2 Year Visit, 566, 574 2 Year Visit, 571
2½ Year Visit, 588 3 Year Visit, 610–611
3 Year Visit, 606 4 Year Visit, 632–633
4 Year Visit, 628 friends/peers in
cognitive development/skills, 91–93 12 Month Visit, 511–512
developmental domains, 91–93 difficulty in forming friendships, 128t
developmental highlights/milestones, 94–102 growth, nutrition for, 182–184
growth, nutrition for, 182–184 health supervision visits in
healthy development, promotion of, 90–102 12 Month Visit, 503–523
sexual development and sexuality, 218–219 15 Month Visit, 525–541
diet and nutrition in, 182–185 18 Month Visit, 543–562
oral health promotion, 211 2 Year Visit, 563–583
discipline in, 95–98, 98b 2½ Year Visit, 585–601
15 Month Visit, 536–537 3 Year Visit, 603–624
drowning, prevention of (12 Month Visit), 521 4 Year Visit, 625–647
early care in, 100–101 histories (patient and family)
early education in, 100–101. See also Early childhood 12 Month Visit, 505
programs; Preschool 15 Month Visit, 527
18 Month Visit, 545
846

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

2 Year Visit, 565 outdoor safety in


2½ Year Visit, 587 2 Year Visit, 582
3 Year Visit, 605 4 Year Visit, 645
4 Year Visit, 627 parent-child interaction/relationship in
home safety in 12 Month Visit, 507
12 Month Visit, 522–523 15 Month Visit, 529, 536
15 Month Visit, 541 18 Month Visit, 547
18 Month Visit, 561–562 2 Year Visit, 567
immunizations in 2½ Year Visit, 589
12 Month Visit, 509 3 Year Visit, 607
15 Month Visit, 531 4 Year Visit, 629
18 Month Visit, 549 pedestrian safety in, 622
2 Year Visit, 569 personal hygiene in, 580
2½ Year Visit, 591 pets/pet safety in
3 Year Visit, 609 12 Month Visit, 522
4 Year Visit, 631 3 Year Visit, 623
individuation in, 100 4 Year Visit, 646
15 Month Visit, 532 physical activity in, 194t, 199–200
interventions/programs. See Early childhood programs 18 Month Visit, 554–555
intimate partner violence in 2 Year Visit, 576
2 Year Visit, 570–571 3 Year Visit, 620
4 Year Visit, 634 4 Year Visit, 643
language development in, 91–93 physical examinations in, 271, 272b
3 Year Visit, 617 12 Month Visit, 508
4 Year Visit, 636 15 Month Visit, 530
learning/learning experiences in 18 Month Visit, 548
4 Year Visit, 638 2 Year Visit, 568
early childhood programs. See Early childhood programs 2½ Year Visit, 590
lifelong health promotion in, 35 3 Year Visit, 608
linguistic skills in, 91–93 4 Year Visit, 630
18 Month Visit, 553–555 calming technique, 272b
2 Year Visit, 577 play/playtime in, 99–100
2½ Year Visit, 594 18 Month Visit, 553–555
literacy skills in, 98–99 2 Year Visit, 575, 576
living situation in 2½ Year Visit, 595
12 Month Visit, 510 3 Year Visit, 603–624, 614
2 Year Visit, 571 4 Year Visit, 643
3 Year Visit, 610–611 poisoning, prevention of
4 Year Visit, 632–633 12 Month Visit, 522–523
media use/exposure in 15 Month Visit, 541
12 Month Visit, 515 18 Month Visit, 560
2 Year Visit, 576 reading/reading skills in
2½ Year Visit, 596 18 Month Visit, 553–555
4 Year Visit, 642–643 2 Year Visit, 578
social media, 231 2½ Year Visit, 594
mental health promotion in, 123–130 3 Year Visit, 616
motor skills in safety and injury prevention in, 245–246
3 Year Visit, 620 school readiness in, 101–102, 102b
fine motor skills, 91 screening/surveillance in
gross motor skills, 91, 284 12 Month Visit, 509
screening for, 284 18 Month Visit, 549
naptime in, 514–515 2 Year Visit, 569
neighborhood and community safety/violence in, 635 2½ Year Visit, 590
oral health in, 210–212 3 Year Visit, 609
12 Month Visit, 514–515, 519 4 Year Visit, 631
15 Month Visit, 538–539 self-regulation in, 94
caries, reduction of, 538–539 separation anxiety in, 100
dental hygiene, 519 15 Month Visit, 533
first dental checkup, 519 18 Month Visit, 550–551

847

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Early childhood (cont) Early childhood programs


sexual development and sexuality in, 218–219 health supervision visits
sibling adjustment/relationships in, 615 2½ Year Visit, 597
singing in 4 Year Visit, 638
18 Month Visit, 553 rate of return on investments in, 17f
3 Year Visit, 616 readiness for, 597–598
sleep behaviors, patterns, and safety, 94 Early education
12 Month Visit, 514–515 in infancy, 84
15 Month Visit, 535 in early childhood, 100–101. See also Early childhood
bedtime struggles, 126t programs; Preschool
social connections/skills in, 93, 95 as a social determinant of health, 23
12 Month Visit, 511–512 Early Head Start, 23
4 Year Visit, 637 Eating disorders
difficulty in forming friendships, 128t in middle childhood (9 and 10 Year Visits), 723–724
social media use in, 231 in adolescence, 189–190
special health care needs, children with, 72–73 Eating habits. See also Diet and nutrition
healthy development of, 90 in middle childhood, 186–187
nutritional health for, 185 7 and 8 Year Visits, 694–695
substance use/exposure in 9 and 10 Year Visits, 723–724
12 Month Visit, 511 in adolescence, 189–190
2 Year Visit, 572 11 through 14 Year Visits, 751–753
3 Year Visit, 611 15 through 17 Year Visits, 784–785
4 Year Visit, 633 18 through 21 Year Visits, 812
sun exposure/protection in eating disorders, 189–190
12 Month Visit, 522 E-cigarette use/exposure
18 Month Visit, 560 in middle childhood
2½ Year Visit, 601 5 and 6 Year Visits, 661–662
4 Year Visit, 646 7 and 8 Year Visits, 686
talking in 9 and 10 Year Visits, 712
18 Month Visit, 553 in adolescence
3 Year Visit, 616 11 through 14 Year Visits, 745–746, 760–761
tantrums in 15 through 17 Year Visits, 777–778, 792–793
12 Month Visit, 513 18 through 21 Year Visits, 808, 818
15 Month Visit, 536 Eco-Bio-Developmental Model of Human Health and Disease,
excessive, 127t 16–17, 16f
teaching children in, 95–98 Ecological determinants of health
temperament in, 93 physical determinants, 28–30
2 Year Visit, 575 social determinants. See Social determinants of health
tobacco use/exposure in Emergency preparedness/readiness
12 Month Visit, 511 First Week Visit (3 to 5 Days) guidance, 374
2 Year Visit, 572 1 Month Visit, 408
3 Year Visit, 611 for parents, 236b, 374
4 Year Visit, 633 Emotional development/well-being. See also Mental health
toilet training in, 95 in infancy, 83–84
18 Month Visit, 551 in early childhood, 93
2 Year Visit, 579 4 Year Visit, 637
readiness, signs of, 551 in middle childhood, 104, 105t
resistance to, 126t 5 and 6 Year Visits, 662
vitamin D in, 183b 7 and 8 Year Visits, 687
water safety in 9 and 10 Year Visits, 714
12 Month Visit, 521 in adolescence, 108–109, 137, 137t
2½ Year Visit, 600 anger management. See Anger management
3 Year Visit, 623 anxiety disorders. See Anxiety disorders
4 Year Visit, 645 attachment/attachment patterns. See Attachment/attachment
weight in patterns
healthy weight, 163 mood disorders. See Mood disorders/regulation
overweight and obesity, children with, 152–153, 163 self-esteem. See Self-esteem
separation anxiety. See Separation anxiety

848

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Empathy, 53–54 Family dynamic/relationships. See also Parent-child interaction/


in middle childhood (5 and 6 Year Visits), 664–665 relationship; Sibling adjustment/
Energy needs in infancy, 173 relationships
Environment in infancy
consistency in child’s environment, 593 Prenatal Visit, 308
home environment, 47–48. See also Home safety; 1 Month Visit, 397
Living situation 4 Month Visit, 441
Epigenetics, 3, 16f, 19, 22f, 77 6 Month Visit, 466
9 Month Visit, 490
F in early childhood
Falls, prevention of 12 Month Visit, 511–512
in infancy 3 Year Visit, 612
1 Month Visit, 408 in middle childhood
2 Month Visit, 432 5 and 6 Year Visits, 663
6 Month Visit, 480 7 and 8 Year Visits, 688
9 Month Visit, 498–499 9 and 10 Year Visits, 715
in early childhood in adolescence
15 Month Visit, 541 11 through 14 Year Visits, 746–747
18 Month Visit, 561–562 15 through 17 Year Visits, 778–779
3 Year Visit, 622 18 through 21 Year Visits, 808–809
Families, 42–43 Family media use plan, 232
with adolescent parents, 43–44 Family rules and routines
with adopted children, 44–45 5 and 6 Year Visits, 664–665
alcohol use. See Alcohol use/exposure 7 and 8 Year Visits, 689–690
beliefs and culture of, 54–55. See also Cultural influences daily routines and rituals, 54
change and stress in, 51–52 Family support. See also Family-centered care
with children who have special health care needs, 47 in infancy, 58–59
connectedness to. See Family dynamic/relationships Prenatal Visit, 316–317
description of, 41 Newborn Visit, 345
environment First Week Visit (3 to 5 Days), 368–369
effect of, 47–48 1 Month Visit, 395
living situation. See Living situation 2 Month Visit, 417
father’s role, 43 4 Month Visit, 441
with foster care children, 45–47 6 Month Visit, 466
grandparents’ role, 42 9 Month Visit, 490
histories. See Histories (patient and family) mental health support for infant illness, 122–123
immigrant families, 42 in early childhood, 59
obesity prevention, role in, 154, 156t–157t 15 Month Visit, 533
partnering effectively with, 48–53. See also Family support in middle childhood, 59–60
promoting positive behaviors in children, 53–55 in adolescence, 60–61
protective factors for, 26b of breastfeeding, 325
rules and routines. See Family rules and routines local community resources, 32, 33b
safety and injury prevention, 237–238 mental health support for infant illness, 122–123
with same-sex parents, 44 promotion of, 41–61
siblings. See Sibling adjustment/relationships special health care needs, children with, 47
social media use, family plan for, 232b family-centered team approach, 68t
substance use. See Substance use/exposure Family violence
support for. See Family support 5 and 6 Year Visits, 660–661
tobacco use. See Tobacco use/exposure 7 and 8 Year Visits, 684–685
violence in. See Family violence; Intimate partner violence; 9 and 10 Year Visits, 710–711
Maltreatment and neglect; intimate partner violence. See Intimate partner violence
Sexual abuse maltreatment. See Maltreatment and neglect
Family-centered care, 48–49 sexual abuse. See Sexual abuse
complementary and alternative care, 49–50 Father’s role, 43
immunization refusal, 50–51 Feeding. See Breastfeeding; Diet and nutrition; Food/feeding;
Family constellation, 42–47 Formula feeding
Prenatal Visit guidance, 317 Feelings. See Emotional development/well-being

849

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4. Choose “Apply Head A and then Next Style”)

Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Fighting Food/feeding. See also Diet and nutrition


in middle childhood in infancy
7 and 8 Year Visits, 684–685 Newborn Visit, 351–354
9 and 10 Year Visits, 710–711 First Week Visit (3 to 5 Days), 375–378
in adolescence 1 Month Visit, 402–405
11 through 14 Year Visits, 743–744 2 Month Visit, 426–429
15 through 17 Year Visits, 775–776 4 Month Visit, 449–452
18 through 21 Year Visits, 805–806 6 Month Visit, 473–477
Finger sucking, 206b, 211–212, 214, 519 9 Month Visit, 494–495
Firearm safety allergies/sensitivities, 179
in infancy breastfeeding. See Breastfeeding
Prenatal Visit, 331 complementary foods, 177–179
9 Month Visit, 498 cup drinking, 494–495
in early childhood delaying solid foods, 426, 450
18 Month Visit, 560–561 eating/feeding problems, 179–180
2 Year Visit, 583 feeding environment, 180
3 Year Visit, 623–624 financial resources for feeding, 326
4 Year Visit, 647 food insecurity. See Food security/insecurity
in middle childhood formula feeding. See Formula feeding
5 and 6 Year Visits, 676 grazing, 449–450
7 and 8 Year Visits, 701 hunger cues, 176, 375–376, 427
9 and 10 Year Visits, 730 mealtime routines, 494–495
in adolescence pesticide exposure. See Pesticide exposure
11 through 14 Year Visits, 765 satiation cues, 375–376, 427
15 through 17 Year Visits, 797 self-feeding, 494–495
18 through 21 Year Visits, 821 solid foods, 426, 450, 474–475, 494–495
Fire safety. See also Burns, prevention of strategies, 375–376
in early childhood table food, introduction to, 494–495
15 Month Visit, 541 weaning, 495
18 Month Visit, 561–562 in early childhood
2½ Year Visit, 601 12 Month Visit, 516–518
in middle childhood (5 and 6 Year Visits), 675–676 18 Month Visit, 556–558
Flossing. See also Oral health 3 Year Visit, 619
5 and 6 Year Visits, 668 4 Year Visit, 640
7 and 8 Year Visits, 693 appetite changes, 182, 182b
9 and 10 Year Visits, 722–723 continued breastfeeding, 516–517
special health care needs, children with, 208 eating/feeding skills, 184–185
Fluids expressing likes/dislikes, 558
in infancy, 476 family meals, transition to, 516–517
cup drinking, 494–495 fluids in, 557, 619, 639. See also Juice; Milk;
in early childhood, 557, 618, 639. See also Juice; Milk; Water in early childhood
Water in early childhood food insecurity. See Food security/insecurity
Fluoride, 207–208 nutritious foods, 517–518, 556–557, 619, 640
in infancy (6 Month Visit), 472 self-feeding, 516
in early childhood, 211 breakfast, importance of, 723–724
in middle childhood, 212 breastfeeding. See Breastfeeding
5 and 6 Year Visits, 668 cultural influences, 168–169
7 and 8 Year Visits, 693 family meals, early childhood transition to, 516–517
9 and 10 Year Visits, 722–723 feeding environment, 167–168
in adolescence, 213–214 in infancy, 180
dental varnishing, 293, 294 formula feeding. See Formula feeding
supplementation, 293, 294 hunger. See Hunger
toothpaste, 207, 209, 211, 212, 214 insecurity. See Food security/insecurity
Folate intake, 188b lactose intolerance, 169
Folic acid, 171 pesticide exposure. See Pesticide exposure
security. See Food security/insecurity
self-feeding
in infancy, 494–495
in early childhood, 516

850

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

snacks. See Snacks Gay, youth who identify as, 224–225


sugar intake. See Sugar intake Gender. See also Sexual development and sexuality
Food security/insecurity, 169–170 definitions related to, 219b
in infancy Gender dysphoria, 219b
Prenatal Visit, 310–311 Gender expression, 219b
Newborn Visit, 341–342 Gender identity, 219b
First Week Visit (3 to 5 Days), 367–368 Gender nonconforming, youth who identify as, 219b, 224–225
1 Month Visit, 390–391 Gender role, 219b
2 Month Visit, 416–417 Gonorrhea. See also Sexually transmitted infections (STIs)
4 Month Visit, 464–465 screening for, 296, 297
in early childhood Grandparents’ role, 42
12 Month Visit, 510 “Grazing,” 449–450
2 Year Visit, 571 Growth
3 Year Visit, 610–611 development. See Development/developmental surveillance
4 Year Visit, 632–633 nutrition for
in middle childhood in infancy, 172–173
5 and 6 Year Visits, 661 in early childhood, 182–184
7 and 8 Year Visits, 685 in middle childhood, 185–186, 718–719
9 and 10 Year Visits, 711 in adolescence, 187–189
in adolescence spurt in puberty, 718–719
11 through 14 Year Visits, 745 Gums. See Oral health
15 through 17 Year Visits, 777
18 through 21 Year Visits, 807 H
Formula feeding, 175–176 Handwashing guidance
Prenatal Visit, 325–326 First Week Visit (3 to 5 Days) guidance, 374–375
Newborn Visit, 354 newborn health risks, 322
First Week Visit (3 to 5 Days), 378 Head Start, 23
1 Month Visit, 405 Health behaviors, 55
2 Month Visit, 429 Health care professionals
4 Month Visit, 452 as community advocates for safety, 242
6 Month Visit, 477 community supports
frequency and amount of, 176–177 building on, 32–35
weaning, 495 identification of, 32–35
Foster care children, 44–47 family support, 42–43. See also Family support
Friends/peers inter-conceptional guidance, 56
in early childhood life course framework implications for, 30–35
12 Month Visit, 511–512 obesity prevention, role in, 155, 156t
difficulty in forming friendships, 128t pre-conceptional guidance, 56
in middle childhood prenatal guidance, 56–57. See also Prenatal care
5 and 6 Year Visits, 666 protective factors, identification of, 31
7 and 8 Year Visits, 688 risks
9 and 10 Year Visits, 729 addressing, 31
in adolescence identification of, 31
11 through 14 Year Visits, 746–747 sexuality and sexual development, role in, 222–225
15 through 17 Year Visits, 778–779 shared decision-making, establishment of, 31–32
18 through 21 Year Visits, 808–809 strengths, identification of, 31
Fruit Health disparity, definition of, 15b
in middle childhood (5 and 6 Year Visits), 669–670 Health equity, definition of, 15b
pesticides in. See Pesticide exposure Health supervision visits, 7, 7b, 259–260
Fussiness in infancy in infancy. See Infancy
1 Month Visit, 398–400 in early childhood. See Early childhood
2 Month Visit, 424–425 in middle childhood. See Middle childhood
calming the baby. See Calming the baby in adolescence. See Adolescence
Anticipatory Guidance section of, 263, 270
G chart documentation form, 8
Games. See also Play/playtime components of, 265–270
interactive games in early childhood, 614 confidentiality of, 268b
Gang membership, 250 content of, 260–265
Gastroesophageal reflux disease in infancy, 179–180 context of, 265

851

22 INDEX - BF.indd 851 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Health supervision visits (cont) 5 and 6 Year Visits, 655


developmental surveillance, 267. See also Development/ 7 and 8 Year Visits, 680
developmental surveillance 9 and 10 Year Visits, 706
disease detection activities, 260–262 in adolescence
disease prevention activities, 262 11 through 14 Year Visits, 738
evidence and rationale, 275–301 15 through 17 Year Visits, 770
employing evidence at visits, 264–265 18 through 21 Year Visits, 802
health promotion, 262–263 HIV. See also Sexually transmitted infections (STIs)
health supervision, 266–270 screening for, 288–289
histories. See Histories (patient and family) Holding newborns, 375–376
history component, 266–267 Home
immunizations at, 270. See also Immunizations adjustment to, 372–373
outline, 266b dental home. See also Oral health
parent-child interaction, 267. See also Parent-child importance of, 206–207
interaction/relationship responsibilities of, 206t
Periodicity Schedule, 275–277 environment, 47–48. See also Living situation
physical examinations at, 262. See also Physical examinations medical. See Medical home
previsit questionnaire, 8 safety. See Home safety
priorities for, 265–266 transition home
privacy of, 268b Newborn Visit guidance, 346–347
safety and injury prevention counseling in, 239–241 First Week Visit (3 to 5 Days) guidance, 370
screening/surveillance at, 260–262, 270. See also Screening/ Home safety
surveillance in infancy
developmental surveillance, 267. See also Development/ Prenatal Visit, 332
developmental surveillance Newborn Visit, 359
special health care needs, children with, 263–264 First Week Visit (3 to 5 Days), 381
systems review. See Systems review (Bright Futures Visits) 1 Month Visit, 408
timing of, 264 2 Month Visit, 432
Hearing loss, screening for, 286–288 4 Month Visit, 454–455
Heat-related illness/heatstroke prevention 6 Month Visit, 480
Prenatal Visit, 328–329 9 Month Visit, 498–499
Newborn Visit, 356 in early childhood
First Week Visit (3 to 5 Days), 379–380 12 Month Visit, 522–523
9 Month Visit, 497 15 Month Visit, 541
sickling with sickle cell trait, 197t 18 Month Visit, 561–562
Helmets, use of in middle childhood (5 and 6 Year Visits), 675–676
11 through 14 Year Visits, 763 dampness
15 through 17 Year Visits, 795–796 Prenatal Visit guidance, 311
18 through 21 Year Visits, 820 1 Month Visit guidance, 391–392
Histories (patient and family) mold
in infancy Prenatal Visit guidance, 311
Prenatal Visit, 307 1 Month Visit guidance, 391–392
Newborn Visit, 335–337 as a physical determinant of health, 28–30
First Week Visit (3 to 5 Days), 363 Home visitation program staff, 511–512
1 Month Visit, 385 Hospice care for children with special health care needs, 70
2 Month Visit, 411 Housing-related illnesses/injuries, 29–30
4 Month Visit, 435 evidence-based interventions to reduce, 30, 30b
6 Month Visit, 459 Human immunodeficiency virus. See also Sexually transmitted
9 Month Visit, 483 infections (STIs)
in early childhood screening for, 288–289
12 Month Visit, 505 Hunger, 169–170. See also Food security/insecurity
15 Month Visit, 527 newborn cues, 176, 375–376, 427
18 Month Visit, 545 Hygiene
2 Year Visit, 565 oral. See Oral health
2½ Year Visit, 587 personal. See Personal hygiene
3 Year Visit, 605 Hyperactivity/impulsivity
4 Year Visit, 627 in early childhood, 129t
in middle childhood in middle childhood, 133
attention deficits. See Attention deficits

852

22 INDEX - BF.indd 852 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

I burns, prevention of
IEPs. See Individualized Education Programs (IEPs) First Week Visit (3 to 5 Days), 381
Illness prevention 2 Month Visit, 432
Newborn Visit guidance, 349 6 Month Visit, 480
First Week Visit (3 to 5 Days) guidance, 374–375 9 Month Visit, 498–499
Immigrant families, 24, 42, 47, 131, 395, 470 burping newborns, 375–376
Immunizations calcium in, 183b
in infancy calming the baby
Prenatal Visit, 309 Newborn Visit guidance, 350
Newborn Visit, 340 First Week Visit (3 to 5 Days) guidance, 373–374
First Week Visit (3 to 5 Days), 366 4 Month Visit guidance, 443
1 Month Visit, 389 6 Month Visit guidance, 471
2 Month Visit, 415 self-calming, 443, 471
4 Month Visit, 439 capabilities of newborns, 348
6 Month Visit, 463 care of newborns
9 Month Visit, 487 Newborn Visit, 348–349
in early childhood Prenatal Visit, 320
12 Month Visit, 509 2 Month Visit, 418
15 Month Visit, 531 4 Month Visit, 442
18 Month Visit, 549 6 Month Visit, 467
2 Year Visit, 569 cord care, 348–349
2½ Year Visit, 591 early care, 84. See also Prenatal care
3 Year Visit, 609 skin care, 348–349
4 Year Visit, 631 car safety seats, use of
in middle childhood Newborn Visit, 355–356
5 and 6 Year Visits, 659 First Week Visit (3 to 5 Days), 378–379
7 and 8 Year Visits, 683 1 Month Visit, 406
9 and 10 Year Visits, 709 2 Month Visit, 430
in adolescence 4 Month Visit, 453
11 through 14 Year Visits, 742 6 Month Visit, 478–479
15 through 17 Year Visits, 774 9 Month Visit, 496–497
18 through 21 Year Visits, 805 choking, prevention of, 480
at Bright Futures Visits, 270 cognitive development/skills in, 81–83
parental refusal of, 50–51 9 Month Visit guidance, 490
Impulsivity. See Hyperactivity/impulsivity communication skills in, 81–83
Independence, 54 6 Month Visit, 468–469
in infancy (6 Month Visit), 470 6 Month Visit guidance, 491
in middle childhood (7 and 8 Year Visits), 689–690 complementary foods in, 177–179
Individualized Education Programs (IEPs), 691–692 cord care in, 348–349
Individuals with Disabilities Education Act, 71b, 80b critical congenital heart disease, 292
Individuation in early childhood, 100 cultural influences in, 84
15 Month Visit, 532 Prenatal Visit guidance, 317
Infancy daily routines and rituals in (4 Month Visit), 444
abusive head trauma in, 121–122 development/developmental surveillance in, 78
alcohol use/exposure in Prenatal Visit, 308
Prenatal Visit, 314–315 Newborn Visit, 337
Newborn Visit, 343–344 First Week Visit (3 to 5 Days), 363–364
1 Month Visit, 393–394 1 Month Visit, 386
6 Month Visit, 465 2 Month Visit, 412
attachment/attachment patterns in, 119–120, 119t 4 Month Visit, 436
1 Month Visit guidance, 398–400 6 Month Visit, 460
bed sharing during, 244–245 9 Month Visit, 484
behavioral guidance in, 89–90 cognitive development/skills, 81–83, 490
9 Month Visit guidance, 493–494 developmental domains, 81–84
bilirubin, 291 developmental highlights/milestones, 84–90
blood, 291 growth, nutrition for, 172–173
breastfeeding in. See Breastfeeding healthy development, promotion of, 79–90
sexual development and sexuality, 217–218

853

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Infancy (cont) formula feeding. See Formula feeding


diet and nutrition in, 172–182 grazing, 449–450
Newborn Visit guidance, 346 hunger cues, 176, 375–376, 427
Prenatal Visit guidance, 319 mealtime routines, 494–495
discipline in, 89–90 pesticide exposure. See Pesticide exposure
drooling in, 447 satiation cues, 375–376, 427
drowning, prevention of self-feeding, 494–495
2 Month Visit, 432 solid foods, 426, 450, 474–475, 494–495
6 Month Visit, 480 strategies, 375–376
9 Month Visit, 498–499 table food, introduction to, 494–495
early care in, 84. See also Prenatal care weaning, 495
early education in, 84 food security/insecurity in
eating/feeding problems in, 179–180 Prenatal Visit, 310–311
emergency preparedness/readiness in Newborn Visit, 341–342
First Week Visit (3 to 5 Days) guidance, 374 First Week Visit (3 to 5 Days), 367–368
1 Month Visit, 408 1 Month Visit, 390–391
emotional development in, 83–84 2 Month Visit, 416–417
energy (caloric) needs in, 173 4 Month Visit, 464–465
falls, prevention of formula feeding in. See Formula feeding
1 Month Visit, 408 fussiness in
2 Month Visit, 432 1 Month Visit, 398–400
6 Month Visit, 480 2 Month Visit, 424–425
9 Month Visit, 498–499 gastroesophageal reflux disease in, 179–180
family dynamic/relationships in growth, nutrition for, 172–173
Prenatal Visit, 308 handwashing guidance
1 Month Visit, 397 First Week Visit (3 to 5 Days) guidance, 374–375
4 Month Visit, 441 newborn health risks, 322
6 Month Visit, 466 health supervision visits in
9 Month Visit, 489 Prenatal Visit, 305–332
family support in, 58–59 Newborn Visit, 333–359
Prenatal Visit, 316–317 First Week Visit (3 to 5 Days), 361–381
Newborn Visit, 345 1 Month Visit, 383–408
First Week Visit (3 to 5 Days), 368–369 2 Month Visit, 409–432
1 Month Visit, 395 4 Month Visit, 433–455
2 Month Visit, 417 6 Month Visit, 457–480
4 Month Visit, 441 9 Month Visit, 481–499
6 Month Visit, 466 heat-related illness/heatstroke prevention in, 196
9 Month Visit, 489 Prenatal Visit, 328–329
mental health support for infant illness, 122–123 Newborn Visit, 356
firearm safety in First Week Visit (3 to 5 Days), 379–380
Prenatal Visit, 331 9 Month Visit, 497
9 Month Visit, 498 histories (patient and family)
fluids in, 476 Prenatal Visit, 307
cup drinking, 494–495 Newborn Visit, 335–337
fluoride in (6 Month Visit), 472 First Week Visit (3 to 5 Days), 363
food/feeding in 1 Month Visit, 385
First Week Visit (3 to 5 Days), 375–378 2 Month Visit, 411
1 Month Visit, 402–405 4 Month Visit, 435
2 Month Visit, 426–429 6 Month Visit, 459
4 Month Visit, 449–452 9 Month Visit, 483
6 Month Visit, 473–477 holding newborns, 375–376
9 Month Visit, 494–495 home safety in
allergies/sensitivities, 179 Prenatal Visit, 332
breastfeeding. See Breastfeeding Newborn Visit, 359
complementary foods, 177–179 First Week Visit (3 to 5 Days), 381
cup drinking, 494–495 1 Month Visit, 408
delaying solid foods, 426, 450 2 Month Visit, 432
eating/feeding problems, 179–180 4 Month Visit, 454–455
feeding environment, 180 6 Month Visit, 480
financial resources for feeding, 326 9 Month Visit, 498–499
854

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

illness prevention in bottle in bed, avoidance of, 448, 472


Newborn Visit guidance, 349 drooling, 447
First Week Visit (3 to 5 Days) guidance, 374–375 maternal oral health, 447
Newborn Visit guidance, 349 oral hygiene, 448
immunizations in teething, 447
Prenatal Visit, 309 outings in
Newborn Visit, 340 First Week Visit (3 to 5 Days) guidance, 374–375
First Week Visit (3 to 5 Days), 366 newborn health risks, 322
1 Month Visit, 389 overweight, infants with, 152–153, 162
2 Month Visit, 415 parent-child interaction/relationship in
4 Month Visit, 439 Prenatal Visit, 308
6 Month Visit, 463 Newborn Visit, 338, 345
9 Month Visit, 487 First Week Visit (3 to 5 Days), 364
independence in (6 Month Visit), 470 1 Month Visit, 387
intimate partner violence in 2 Month Visit, 413, 421–422
Prenatal Visit, 313–314 4 Month Visit, 437, 443–444
Newborn Visit, 342–343 6 Month Visit, 461, 468–469
1 Month Visit, 393 9 Month Visit, 485
9 Month Visit, 488–489 pesticide exposure in
lead poisoning in 1 Month Visit guidance, 392
Prenatal Visit, 311–313 6 Month Visit guidance, 475–476
4 Month Visit, 440 pets/pet safety in
lifelong health promotion in, 35 Prenatal Visit, 331
linguistic skills in, 81–83 Newborn Visit, 358–359
literacy skills in, 83b physical activity in, 194t, 199
6 Month Visit, 468–469 physical examinations in, 271
living situation in Newborn Visit, 339–340
Prenatal Visit, 310–311 First Week Visit (3 to 5 Days), 365
Newborn Visit, 341–342 1 Month Visit, 388
First Week Visit (3 to 5 Days), 367–368 2 Month Visit, 414
1 Month Visit, 390–391 4 Month Visit, 438
2 Month Visit, 416–417 6 Month Visit, 462
4 Month Visit, 464–465 9 Month Visit, 486
low-birth-weight babies, 22 play/playtime in
maltreatment and neglect in, 120–122 1 Month Visit, 401
maternal/parental depression in 2 Month Visit, 424
Prenatal Visit, 318 4 Month Visit, 445–446
1 Month Visit, 396–397 poisoning, prevention of
2 Month Visit, 419–420 6 Month Visit, 480
6 Month Visit, 466 9 Month Visit, 498–499
media use/exposure in radon exposure in, 392
1 Month Visit, 401 regurgitation in, 179–180
2 Month Visit, 423 room sharing during, 244–245
4 Month Visit, 445 safety and injury prevention in, 242–245
6 Month Visit, 469 Prenatal Visit, 332
9 Month Visit, 492 Newborn Visit, 359
social media, 231 First Week Visit (3 to 5 Days), 381
medications in 1 Month Visit, 408
Prenatal Visit, 324 2 Month Visit, 432
4 Month Visit, 451 screening/surveillance in
mental health promotion in, 118–123 Prenatal Visit, 308, 309
mineral supplements in, 173–174 Newborn Visit, 340
motor skills in First Week Visit (3 to 5 Days), 366
fine motor skills, 81 1 Month Visit, 389
gross motor skills, 81 2 Month Visit, 415
nutritional health in, 172–182 4 Month Visit, 439
Prenatal Visit guidance, 319 6 Month Visit, 463
Newborn Visit guidance, 346 9 Month Visit, 487
oral health in, 208–210 bilirubin, 291
4 Month Visit guidance, 447–448 blood, 291
6 Month Visit guidance, 472 critical congenital heart disease, 292 855

22 INDEX - BF.indd 855 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Infancy (cont) Injuries. See also specific injury


self-regulation skills in, 87–88 intentional injury, 235–236
separation anxiety in, 84 prevention of. See Safety and injury prevention
sexual development and sexuality in, 217–218 unintentional injury, 235
sibling adjustment/relationships in Inter-conceptional guidance, 56
Newborn Visit, 347 Internet use
First Week Visit (3 to 5 Days), 370–371 7 and 8 Year Visits, 686–687
2 Month Visit, 420 9 and 10 Year Visits, 713
skin care in, 348–349 cyberbullying. See Bullying/cyberbullying
sleep behaviors, patterns, and safety, 88, 88t, 89t safety and injury prevention and, 241–242
Prenatal Visit, 329–330 social media. See Social media use/exposure
Newborn Visit, 357–358 Interpersonal violence. See Bullying/cyberbullying; Fighting
First Week Visit (3 to 5 Days), 380–381 Intimate partner violence
1 Month Visit, 398, 407 in infancy
2 Month Visit, 423, 431 Prenatal Visit, 313–314
4 Month Visit, 454 Newborn Visit, 342–343
6 Month Visit, 470, 479 1 Month Visit, 393
9 Month Visit, 490 9 Month Visit, 488–489
bottle in bed, avoidance of, 448, 472 in early childhood
infant putting self to sleep, 470 2 Year Visit, 570–571
sudden infant death and, 79, 243–245 4 Year Visit, 634
social connections/skills in, 83–84 National Domestic Violence Hotline, 28
social media and, 231 as a social determinant of health, 25, 28
special health care needs, children with, 70–72 Iron intake, 188b
healthy development of, 80–81
nutrition for, 181–182 J
spitting up in, 179–180 Juice
substance use/exposure in in infancy, 476
Prenatal Visit, 314–315 in early childhood, 557, 619, 639
Newborn Visit, 343–344
1 Month Visit, 393–394 L
6 Month Visit, 465 Lactose intolerance, 169
sudden infant death, 79, 243–245 Language
reducing, 243, 244b, 398 delay, screening for, 284
sun exposure/protection in development. See Language development
First Week Visit (3 to 5 Days), 374–375 fluency with. See Language development
6 Month Visit, 480 understanding. See Language development
supplements in, 173–174 Language development. See also Linguistic skills
4 Month Visit guidance, 451 in early childhood, 91–93
supplies for newborns, 348–349 3 Year Visit, 617
teaching infants, 89–90 4 Year Visit, 636
teething in, 447 simple phrases, use of, 553
temperature taking in, 374 simple words, use of, 553, 595
tobacco use/exposure in Lead poisoning
Prenatal Visit, 316 Prenatal Visit, 311–313
Newborn Visit, 342 4 Month Visit, 440
First Week Visit (3 to 5 Days), 368 as a biological determinant of health, 21
1 Month Visit guidance, 391 screening for, 289–290
6 Month Visit, 465 Learning deficits/disabilities
vitamin D in, 183b in middle childhood, 133
vitamin supplements in, 173–174 in adolescence, 139
weaning in, 495 special health care needs for children with. See Special health
weight in care needs, children with
healthy weight, 162 Learning/learning experiences
low-birth-weight babies, 22 in infancy, interactive learning, 491
overweight, infants with, 152–153, 162 in early childhood
weight gain, 375–376 4 Year Visit, 638
programs. See Early childhood programs

856

22 INDEX - BF.indd 856 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

structured learning M
preschool. See Preschool Maltreatment and neglect
readiness for, 638 in infancy, 120–122
school. See School in middle childhood
Lesbian, youth who identify as, 224–225 5 and 6 Year Visits, 675
Life course framework, 18–20 7 and 8 Year Visits, 700–701
in Bright Futures, 21–30 sexual abuse. See Sexual abuse
early adverse experiences Marijuana, 75, 141, 314, 343
focus on the effects of, 19–20 Marital separations, impact of, 28
moderating factors, use of, 20 Maternal alcohol use. See Alcohol use/exposure
epigenetics and, 19, 22f Maternal health, 346
health care professionals, implications for, 30–35 Maternal nutrition, 346
lifelong health promotion. See Lifelong health Maternal oral health, 447
medical home, implications for the, 30–35 Maternal/parental depression, 52
physical determinants, 28–30 Prenatal Visit, 318
social determinants. See Social determinants of health 1 Month Visit, 396–397
Lifelong health 2 Month Visit, 419–420
definitions related to, 15b 6 Month Visit, 466
life course framework. See Life course framework as a biological determinant of health, 22
promoting, 15–17, 34f chronic, 318
in infancy, 35 perinatal, 318
in early childhood, 35 screening for, 52–53, 283
in middle childhood, 35 Maternal substance use. See Substance use/exposure
in adolescence, 35 Maternal tobacco use. See Tobacco use/exposure
Linguistic skills M-CHAT-R/F. See Modified Checklist for Autism in Toddlers
in infancy, 81–83 Revised, with Follow-up
in early childhood, 91–93 Media use/exposure
18 Month Visit, 553–555 in infancy
2 Year Visit, 577 1 Month Visit, 401
2½ Year Visit, 594 2 Month Visit, 423
in middle childhood, 104 4 Month Visit, 445
in adolescence, 108 6 Month Visit, 469
language delay, screening for, 284 9 Month Visit, 492
Literacy skills. See also Reading/reading skills social media, 231
in infancy, 83b in early childhood
6 Month Visit, 468–469 12 Month Visit, 515
in early childhood, 98–99 2 Year Visit, 576
Living situation 2½ Year Visit, 596
in infancy 4 Year Visit, 642–643
Prenatal Visit, 310–311 social media, 231
Newborn Visit, 341–342 in middle childhood
First Week Visit (3 to 5 Days), 367–368 7 and 8 Year Visits, 695–696
1 Month Visit, 390–391 social media, 232–233
2 Month Visit, 416–417 familial influences on, 55
4 Month Visit, 464–465 social. See Social media use/exposure
in early childhood Medical home
12 Month Visit, 510 Prenatal Visit guidance, 321
2 Year Visit, 571 1 Month Visit guidance, 401
3 Year Visit, 610–611 after-hours support, 401
4 Year Visit, 632–633 life course framework implications for, 30–35
in adolescence Medications
11 through 14 Year Visits, 745 in infancy
15 through 17 Year Visits, 777 Prenatal Visit, 324
18 through 21 Year Visits, 807 4 Month Visit, 451
Local community resources, 32, 33b in adolescence (18 through 21 Year Visits), 818
over-the-counter
4 Month Visit guidance, 451
Prenatal Visit guidance, 324
Menstruation, 718–719

857

22 INDEX - BF.indd 857 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Mental health, 115–116 calcium in, 186


in infancy 5 and 6 Year Visits, 669–670
Prenatal Visit guidance, 318 7 and 8 Year Visits, 694–695
promotion of, 118–123 dietary reference intakes, 183b
in early childhood, promotion of, 123–130 cognitive development/skills in, 104
in middle childhood, promotion of, 130–136 communication skills in, 104
in adolescence community safety in, 246–247
11 through 14 Year Visits, 756–757 conduct disturbances in, 134
15 through 17 Year Visits, 788–789 connectedness in, 131–132
promotion of mental health, 136–145 social connections/skills, 104, 105t
anxiety disorders. See Anxiety disorders development/developmental surveillance in, 78–79
attachment. See Attachment/attachment patterns 5 and 6 Year Visits, 656
challenges/problems 7 and 8 Year Visits, 681
in infancy, 120–122 9 and 10 Year Visits, 707
in early childhood, 124–129 cognitive development/skills, 104
in middle childhood, 132–136 developmental domains, 103–104, 105t
in adolescence, 138 developmental highlights/milestones, 106
abuse. See Family violence; Intimate partner violence; growth, nutrition for, 185–186
Maltreatment and neglect; Sexual healthy development, promotion of, 102–106
abuse puberty/pubertal development, 690, 718–721
anger management. See Anger management sexual development and sexuality, 219–221
anxiety disorders. See Anxiety disorders diet and nutrition in, 185–187
conduct disturbances. See Behavioral concerns/problems 5 and 6 Year Visits, 668–670
mood disorders. See Mood disorders/regulation 7 and 8 Year Visits, 694–695
prevalence of, 116 9 and 10 Year Visits, 723–724
referrals for, 116–118 oral health promotion, 212
screening for, 116–118 saturated fat, 723–724
special health care needs, children with, 118 eating disorders in (9 and 10 Year Visits), 723–724
tantrums. See Tantrums eating habits in, 186–187
trends in, 116 7 and 8 Year Visits, 694–695
emotional development/well-being. See Emotional 9 and 10 Year Visits, 723–724
development/well-being e-cigarette use/exposure in
family facing infant illness, support for, 122–123 5 and 6 Year Visits, 661–662
mood disorders. See Mood disorders/regulation 7 and 8 Year Visits, 686
promotion of, 115–145 9 and 10 Year Visits, 712
separation anxiety. See Separation anxiety emotional development/well-being in, 104, 105t
suicide, 140, 250 5 and 6 Year Visits, 662
tantrums. See Tantrums 7 and 8 Year Visits, 687
MI. See Motivational interviewing (MI) to prevent obesity 9 and 10 Year Visits, 714
Middle childhood empathy in (5 and 6 Year Visits), 664–665
after-school activities/care/programs in family dynamic/relationships in
5 and 6 Year Visits, 667 5 and 6 Year Visits, 663
7 and 8 Year Visits, 691–692 7 and 8 Year Visits, 688
9 and 10 Year Visits, 725–726 9 and 10 Year Visits, 715
alcohol use/exposure in family rules and routines in
5 and 6 Year Visits, 661–662 5 and 6 Year Visits, 664–665
7 and 8 Year Visits, 686 7 and 8 Year Visits, 689–690
9 and 10 Year Visits, 712 family support in, 59–60
anger management in family violence in
5 and 6 Year Visits, 665 5 and 6 Year Visits, 660–661
9 and 10 Year Visits, 716–717 7 and 8 Year Visits, 684–685
anxiety disorders in, 134 9 and 10 Year Visits, 710–711
attachment patterns in, 131–132 fighting in
attention-deficit/hyperactivity disorder in, 133 7 and 8 Year Visits, 684–685
brushing teeth in, 212 9 and 10 Year Visits, 710–711
5 and 6 Year Visits, 668 firearm safety in
7 and 8 Year Visits, 693 5 and 6 Year Visits, 676
9 and 10 Year Visits, 722–723 7 and 8 Year Visits, 701
bullying in, 134–135, 247–248 9 and 10 Year Visits, 730
7 and 8 Year Visits, 684–685 fire safety in (5 and 6 Year Visits), 675–676
858 9 and 10 Year Visits, 710–711

22 INDEX - BF.indd 858 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

flossing in parent-child interaction/relationship in


5 and 6 Year Visits, 668 5 and 6 Year Visits, 657
7 and 8 Year Visits, 693 7 and 8 Year Visits, 682
9 and 10 Year Visits, 722–723 9 and 10 Year Visits, 708
fluoride in, 212 parent-teacher communications in, 667
5 and 6 Year Visits, 668 patience in, 665
7 and 8 Year Visits, 693 personal hygiene in, 718–719
9 and 10 Year Visits, 722–723 physical activity in, 194t, 200–201, 248
food security/insecurity in 5 and 6 Year Visits, 670–671
5 and 6 Year Visits, 661 7 and 8 Year Visits, 695–696
7 and 8 Year Visits, 685 9 and 10 Year Visits, 725–726
9 and 10 Year Visits, 711 age-appropriate activities, 201t
friends/peers in physical examinations in, 271
5 and 6 Year Visits, 666 5 and 6 Year Visits, 657
7 and 8 Year Visits, 688 7 and 8 Year Visits, 682
9 and 10 Year Visits, 729 9 and 10 Year Visits, 708
growth, nutrition for, 185–186 play in, 248
health supervision visits in puberty/pubertal development in
5 and 6 Year Visits, 651–676 7 and 8 Year Visits, 690
7 and 8 Year Visits, 677–701 9 and 10 Year Visits, 718–721
9 and 10 Year Visits, 703–730 respect for others in, 664–665
histories (patient and family) safety and injury prevention in, 246–248
5 and 6 Year Visits, 655 school attendance in
7 and 8 Year Visits, 680 5 and 6 Year Visits, 666
9 and 10 Year Visits, 706 7 and 8 Year Visits, 691–692
home safety in (5 and 6 Year Visits), 675–676 9 and 10 Year Visits, 720–721
immunizations in school in
5 and 6 Year Visits, 659 parent-teacher communications, 667
7 and 8 Year Visits, 683 pubertal transitions in, 720–721
9 and 10 Year Visits, 709 school food, 669–670
independence in (7 and 8 Year Visits), 689–690 school readiness, 666
Internet use in special education services, 691–692
7 and 8 Year Visits, 686–687 school performance in
9 and 10 Year Visits, 713 7 and 8 Year Visits, 691–692
learning deficits/disabilities in, 133 9 and 10 Year Visits, 720–721
lifelong health promotion in, 35 school problems in
linguistic skills in, 104 7 and 8 Year Visits, 691–692
maltreatment and neglect in 9 and 10 Year Visits, 720–721
5 and 6 Year Visits, 675 school progress in
7 and 8 Year Visits, 700–701 7 and 8 Year Visits, 691–692
media use/exposure in 9 and 10 Year Visits, 720–721
7 and 8 Year Visits, 695–696 school safety, 246–247
social media, 232–233 screening/surveillance in
menstruation in, 718–719 5 and 6 Year Visits, 658
mental health promotion in, 130–136 7 and 8 Year Visits, 683
mood disorders/regulation in, 133–134 9 and 10 Year Visits, 709
moral development in, 106 seat belts, use of
motor skills in 5 and 6 Year Visits, 672–673
fine motor skills, 103 7 and 8 Year Visits, 697
gross motor skills, 103 9 and 10 Year Visits, 727
neighborhood and community safety/violence in self-esteem in
5 and 6 Year Visits, 660–661 5 and 6 Year Visits, 662
7 and 8 Year Visits, 684–685 7 and 8 Year Visits, 687
9 and 10 Year Visits, 710–711 9 and 10 Year Visits, 714
oral health in, 212–213 self-regulation in, 689–690
5 and 6 Year Visits, 668 setting reasonable limits in, 716–717
7 and 8 Year Visits, 693 sexual abuse in, 136
9 and 10 Year Visits, 722–723 sexual development and sexuality in, 219–221
outdoor safety in (5 and 6 Year Visits), 673 puberty/pubertal development, 690, 718–721
overweight and obesity, children with, 163–164 sexual safety in, 718–719
859

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Middle childhood (cont) Mood disorders/regulation


snacks in in middle childhood, 133–134
5 and 6 Year Visits, 668 in adolescence
7 and 8 Year Visits, 693 11 through 14 Year Visits, 756–757
9 and 10 Year Visits, 722–724 15 through 17 Year Visits, 788–789
social connections/skills in, 104, 105t 18 through 21 Year Visits, 815–816
social media use in, 232–233 anger management. See Anger management
special education services in, 691–692 anxiety disorders. See Anxiety disorders
special health care needs, children with, 73–74 separation anxiety. See Separation anxiety
healthy development of, 103 Moral development, 106
nutrition for, 187 Motivational interviewing (MI) to prevent obesity, 155
spiritual development in, 106 Motor skills
sports in, 248 in infancy
substance use/exposure in, 135–136 fine motor skills, 81
5 and 6 Year Visits, 661–662 gross motor skills, 81
7 and 8 Year Visits, 686 in early childhood
9 and 10 Year Visits, 712 3 Year Visit, 620
sugar-sweetened beverages in fine motor skills, 91
5 and 6 Year Visits, 668 gross motor skills, 91, 284
7 and 8 Year Visits, 693 screening for, 284
9 and 10 Year Visits, 722–723 in middle childhood
sun exposure/protection in fine motor skills, 103
5 and 6 Year Visits, 674–675 gross motor skills, 103
7 and 8 Year Visits, 699 in adolescence
9 and 10 Year Visits, 729 fine motor skills, 108
temperament in gross motor skills, 108
7 and 8 Year Visits, 689–690 Mouth
9 and 10 Year Visits, 716–717 oral health. See Oral health
tobacco use/exposure in traumatic injury to, 214
5 and 6 Year Visits, 661–662
7 and 8 Year Visits, 686 N
9 and 10 Year Visits, 712 Naptime, 514–515
vitamin D in, 186 National Domestic Violence Hotline, 28
5 and 6 Year Visits, 669–670 National Down Syndrome Society, 72
7 and 8 Year Visits, 694–695 National Health and Nutrition Examination Survey (NHANES),
dietary reference intakes, 183b 152
water safety in Neglect. See Maltreatment and neglect
5 and 6 Year Visits, 674 Neighborhood and community safety/violence, 246–247
7 and 8 Year Visits, 698–699 in early childhood (4 Year Visit), 635
9 and 10 Year Visits, 728 in middle childhood
weight in 5 and 6 Year Visits, 660–661
5 and 6 Year Visits, 669–670 7 and 8 Year Visits, 684–685
7 and 8 Year Visits, 694–695 9 and 10 Year Visits, 710–711
9 and 10 Year Visits, 723–724 as a physical determinant of health, 29
healthy weight, 163–164 protective factors for, 26b
overweight and obesity, children with, 163–164 Neisseria gonorrhea. See also Sexually transmitted infections
whole-grain consumption in, 669–670 (STIs)
Milk screening for, 296, 297
in early childhood, 557, 618, 639 Newborns. See Infancy
lactose intolerance, 169 NHANES. See National Health and Nutrition Examination
Mineral supplements in infancy, 173–174 Survey (NHANES)
Mobility development, 490 Night walking, 535
Models of care for adolescence, 110, 110t Nutrition. See Diet and nutrition
Modified Checklist for Autism in Toddlers Revised, with Follow-up
(M-CHAT/R-F), 78 O
Mold in home Obesity. See Overweight and obesity
Prenatal Visit guidance, 311 Omega-3 fatty acids, 172
1 Month Visit guidance, 391–392

860

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Oral health, 205–206 preventing, 153–155, 156t–157t


in infancy, 208–210 screening for, 158–159
4 Month Visit guidance, 447–448 severe obesity, 153
6 Month Visit guidance, 472 special health care needs, children with, 153
bottle in bed, avoidance of, 448, 472 treating, 159–161
drooling, 447 weight change targets, 162t
maternal oral health, 447
oral hygiene, 448 P
teething, 447 Pacifiers
in early childhood, 210–212 and oral health, 206b, 209, 210, 211, 398, 447, 472, 519
12 Month Visit, 514–515, 519 self-consoling with, 399, 425
15 Month Visit, 538–539 sleeping with, 243, 244b, 398, 431
caries, reduction of, 538–539 sudden infant deaths, prevention of, 243, 244b, 398
dental hygiene, 519 Palliative care for children with special health care needs, 70
first dental checkup, 519 Parent-child conflicts
in middle childhood, 212–213 discipline. See Behavior management; Discipline
5 and 6 Year Visits, 668 15 Month Visit, 536
7 and 8 Year Visits, 693 Parent-child interaction/relationship
9 and 10 Year Visits, 722–723 in infancy
in adolescence, 213–214 Prenatal Visit, 308
11 through 14 Year Visits, 750 Newborn Visit, 338, 345
15 through 17 Year Visits, 782–783 First Week Visit (3 to 5 Days), 364
18 through 21 Year Visits, 811 1 Month Visit, 387
brushing teeth, 214 2 Month Visit, 413, 421–422
brushing teeth. See Brushing teeth 4 Month Visit, 437, 443–444
dental checkups 6 Month Visit, 461, 468–469
12 Month Visit, 519 9 Month Visit, 485
7 and 8 Year Visits, 693 in early childhood
9 and 10 Year Visits, 722–723 12 Month Visit, 507
dental home 15 Month Visit, 529, 536
importance of, 206–207 18 Month Visit, 547
responsibilities of, 206t 2 Year Visit, 567
fluoride. See Fluoride 2½ Year Visit, 589
promotion of, 205–214 3 Year Visit, 607
resources, 206b 4 Year Visit, 629
risk assessments in middle childhood
in infancy, 209–210, 210f 5 and 6 Year Visits, 657
in early childhood, 211 7 and 8 Year Visits, 682
screening, 293–294 9 and 10 Year Visits, 708
special health care needs, children with, 208 in adolescence
toothpaste guidance, 208, 208f 11 through 14 Year Visits, 740
Oral hygiene. See Oral health 15 through 17 Year Visits, 772
Orthodontics, 214 18 through 21 Year Visits, 803
Outdoor safety conflicts. See Parent-child conflicts
in early childhood Parents
2 Year Visit, 582 activities outside the family, 592
4 Year Visit, 645 adolescent parents, 43–44
in middle childhood (5 and 6 Year Visits), 673 alcohol use. See Alcohol use/exposure
Outings conflicts with. See Parent-child conflicts
First Week Visit (3 to 5 Days) guidance, 374–375 depression in, 52–53
newborn health risks, 322 emergency preparedness/readiness for, 236b, 374
Overweight and obesity father’s role, 43
in infancy, 152–153, 162 immunizations, refusal of, 50–51
in early childhood, 152–153, 163 interaction/relationship with infant/child. See Parent-child
in middle childhood, 163–164 interaction/relationship
in adolescence, 153, 164 obesity prevention, role in, 154
assessment of, 158–159 promoting positive behaviors in children, 53–55
health care professional’s role, 155, 156t same-sex parents, 44
interpreting BMI, 269t seat belts, use of, 540, 559
prevalence of, 152–153 substance use. See Substance use/exposure
861

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Parents (cont) injury prevention during, 198, 198b


as teachers, 468 7 and 8 Year Visits, 698
tobacco use. See Tobacco use/exposure 9 and 10 Year Visits, 728
well-being of, 51–53 nutritional health for, 196–198
2 Year Visit, 573 Prenatal Visit guidance, 319
work-life balance, 613 pre-participation evaluations, 198
Parents’ Evaluation of Developmental Status (PEDStest), 261 promotion of, 193–202
Parent-teacher communications in middle childhood, 667 sickle cell trait, management of, 196, 196b
Patience in middle childhood, 665 special health care needs, children with, 195–196
Pedestrian safety in early childhood, 622 and sports, 196–198. See also Sports
PEDStest. See Parents’ Evaluation of Developmental Status Physical determinants of health, 28–30
(PEDStest) Physical examinations, 262, 267–269
Peers. See Friends/peers in infancy, 271
Performance-enhancing substances, 190 Newborn Visit, 339–340
Periodicity Schedule, 275–277 First Week Visit (3 to 5 Days), 365
Periodontal conditions, 214 1 Month Visit, 388
Personal hygiene 2 Month Visit, 414
in early childhood 4 Month Visit, 438
2 Year Visit, 580 6 Month Visit, 462
in middle childhood 9 Month Visit, 486
9 and 10 Year Visits, 718–719 in early childhood, 271
Pesticide exposure 12 Month Visit, 508
1 Month Visit guidance, 392 15 Month Visit, 530
6 Month Visit guidance, 475–476 18 Month Visit, 548
Pets/pet safety 2 Year Visit, 568
in infancy 2½ Year Visit, 590
Prenatal Visit, 331 3 Year Visit, 608
Newborn Visit, 358–359 4 Year Visit, 630
in early childhood calming technique, 272b
12 Month Visit, 522 in middle childhood, 271
3 Year Visit, 623 5 and 6 Year Visits, 657
4 Year Visit, 646 7 and 8 Year Visits, 682
Physical activity 9 and 10 Year Visits, 708
in infancy, 194t, 199 in adolescence, 271–273
in early childhood, 194t, 199–200 11 through 14 Year Visits, 740–741
18 Month Visit, 554–555 15 through 17 Year Visits, 772–773
2 Year Visit, 575 18 through 21 Year Visits, 804
3 Year Visit, 620 school-based health clinics, 273
4 Year Visit, 643 Play/playtime
in middle childhood, 194t, 200–201, 248 in infancy
5 and 6 Year Visits, 670–671 1 Month Visit, 401
7 and 8 Year Visits, 695–696 2 Month Visit, 424
9 and 10 Year Visits, 725–726 4 Month Visit, 445–446
age-appropriate activities, 201t in early childhood, 99–100
in adolescence, 194t, 201–202 18 Month Visit, 553–555
11 through 14 Year Visits, 753–755 2 Year Visit, 575, 576
15 through 17 Year Visits, 786–787 2½ Year Visit, 595
18 through 21 Year Visits, 813–814 3 Year Visit, 603–624, 614
after-school activities. See After-school activities/care/ 4 Year Visit, 643
programs in middle childhood, 248
familial influences on, 55 playgroups, readiness for, 597–598
guidance, 194t Poisoning, prevention of
heat-related illness, 196, 197t. See also Heat-related illness/ in infancy
heatstroke 6 Month Visit, 480
inactivity 9 Month Visit, 498–499
in early childhood, 620 in early childhood
growing problem of, 195 12 Month Visit, 522–523
from media viewing. See Media use/exposure 15 Month Visit, 541
18 Month Visit, 560
lead poisoning. See Lead poisoning
862

22 INDEX - BF.indd 862 1/25/17 1:42 PM


Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Postpartum checkups S
1 Month Visit guidance, 396 Safety and injury prevention
2 Month Visit guidance, 419 in the prenatal period, 242
Preconception care, 56 in infancy, 242–245
nutritional health, 171–172 Prenatal Visit, 332
Prenatal Visit guidance, 319 Newborn Visit, 359
Pregnancy First Week Visit (3 to 5 Days), 381
Prenatal Visit, 305–332 1 Month Visit, 408
in adolescence, 222 2 Month Visit, 432
11 through 14 Year Visits, 759–760 in early childhood, 245–246
15 through 17 Year Visits, 791–792 in middle childhood, 246–248
18 through 21 Year Visits, 817 in adolescence, 248–252
rates of pregnancy, 222 abuse. See Family violence; Intimate partner violence;
adjustment to, 313 Maltreatment and neglect;
alcohol use in, 314–315 Sexual abuse
assistance after discharge, 346–347 burns, prevention of. See Burns, prevention of
biological determinants of health during, 21–23 car safety seats. See Car safety seats
inter-conceptional guidance, 56 child development and, 236–237
maternal depression, 283 community safety. See Neighborhood and community
Prenatal Visit guidance, 318 safety/violence
postpartum checkups Connected Kids: Safe, Strong, Secure, 241
1 Month Visit guidance, 396 counseling in health supervision visits, 239–241
2 Month Visit guidance, 419 drowning, prevention of. See Drowning, prevention of
preconception care. See Preconception care emergency preparedness suggestions for parents, 236b
prenatal care. See Prenatal care falls, prevention of. See Falls, prevention of
reducing complications in, 57–58 families and culture in, 237–238
substance use/misuse in, 314–315 firearm safety. See Firearm safety
tobacco use in, 316 fire safety. See Fire safety
Prenatal care, 56–57 health care professional’s role, 242
Prenatal Visit guidance, 320 heat-related illness. See Heat-related illness/heatstroke
nutritional health, 171–172 prevention
safety and injury prevention, 242 home safety. See Home safety
social media use and, 231 intentional injury, 235–236
Prenatal Visit, 305–332 Internet use and, 241–242
Preschool maltreatment. See Maltreatment and neglect
4 Year Visit, 638 outdoor safety. See Outdoor safety
as a social determinant of health, 23 pedestrian safety in early childhood, 622
Prescription medications. See Medications pet safety. See Pets/pet safety
Privacy of health supervision visits, 268b during physical activity. See Physical activity
Puberty/pubertal development as a physical determinant of health, 28–30
7 and 8 Year Visits, 690 promotion of, 235–252
9 and 10 Year Visits, 718–721 safe sleep. See Sleep behaviors, patterns, and safety
school safety, 246–247
Q sexual. See Sexual safety
Quality of care, using Bright Futures to improve, 9 sexual abuse. See Sexual abuse
social media, use of, 229–233, 241–242. See also Social media
R use/exposure
Radon exposure, 392 special health care needs, children with, 238–239
Reading/reading skills. See also Literacy skills during sports. See Sports
18 Month Visit, 553–555 sun exposure. See Sun exposure/protection
2 Year Visit, 578 texting and, 241–242
2½ Year Visit, 594 unintentional injury, 235
3 Year Visit, 616 water safety. See Water safety
linguistic skills. See Linguistic skills Same-sex parents, families with, 44
Regurgitation in infancy, 179–180 Saturated fats, 723–724
Respect for others, 664–665
Role modeling and social media, 231

863

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

School in early childhood


in middle childhood 12 Month Visit, 509
attendance. See School attendance 18 Month Visit, 549
parent-teacher communications, 667 2 Year Visit, 569
pubertal transitions in, 720–721 2½ Year Visit, 590
school food, 669–670 3 Year Visit, 609
school performance. See School performance 4 Year Visit, 631
school problems. See School problems in middle childhood
school progress. See School progress 5 and 6 Year Visits, 658
school readiness, 666 7 and 8 Year Visits, 683
school safety, 246–247 9 and 10 Year Visits, 709
special education services, 691–692 in adolescence
in adolescence 11 through 14 Year Visits, 741–742
11 through 14 Year Visits, 748–749 15 through 17 Year Visits, 773–774
15 through 17 Year Visits, 780–781 18 through 21 Year Visits, 804–805
18 through 21 Year Visits, 809 substance use/misuse, 141–144
adaptation to, 691–692 for alcohol use, 298
after school. See After-school activities/care/programs for anemia, 278–279
Individualized Education Programs (IEPs), 691–692 for autism spectrum disorder, 280
performance in. See School performance for blood pressure, 281
School attendance for cervical dysplasia, 282
5 and 6 Year Visits, 666 for depression
7 and 8 Year Visits, 691–692 adolescent depression, 283
9 and 10 Year Visits, 720–721 maternal/parental depression, 52–53, 283
School-based health clinics, 273 of development. See Development/developmental
School food surveillance
in middle childhood, 669–670 disease detection, 260–261
obesity prevention, 157t for dyslipidemia, 285
School performance at health supervision visits, 260–262, 270
7 and 8 Year Visits, 691–692 developmental surveillance, 267. See also Development/
9 and 10 Year Visits, 720–721 developmental surveillance
School problems for hearing loss, 286–288
7 and 8 Year Visits, 691–692 for human immunodeficiency virus, 288–289
9 and 10 Year Visits, 720–721 for language delay, 284
School progress for lead poisoning, 289–290. See also Lead poisoning
7 and 8 Year Visits, 691–692 for mental health problems, 116–118
9 and 10 Year Visits, 720–721 for oral health, 293–294
School readiness for overweight and obesity, 158–159
in early childhood, 101–102, 102b for scoliosis, 295
in middle childhood, 666 for sexually transmitted infections, 288–289, 295–297
School safety, 246–247 for speech delay, 284
Scoliosis, screening for, 295 for substance use/misuse, 298
Screening/surveillance in adolescence, 141–144
in infancy for tobacco use, 298
Prenatal Visit, 308, 309 tools, 8
Newborn Visit, 340 for tuberculosis, 299
First Week Visit (3 to 5 Days), 366 for vision problems, 300–301
1 Month Visit, 389 SCT. See Sickling/sickle cell trait (SCT)
2 Month Visit, 415 Seat belts
4 Month Visit, 439 middle childhood, use in
6 Month Visit, 463 5 and 6 Year Visits, 672–673
9 Month Visit, 487 7 and 8 Year Visits, 697
bilirubin, 291 9 and 10 Year Visits, 727
blood, 291 adolescence, use in
critical congenital heart disease, 292 11 through 14 Year Visits, 763
development, screening for. See Development/ 15 through 17 Year Visits, 795–796
developmental surveillance 18 through 21 Year Visits, 820
car booster seats, use with, 644, 674, 697
parental use of, 540, 559

864

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Self-esteem SIDS. See Sudden infant death syndrome (SIDS)


5 and 6 Year Visits, 662 Singing
7 and 8 Year Visits, 687 18 Month Visit, 553
9 and 10 Year Visits, 714 3 Year Visit, 616
Self-regulation engagement in, 553
in infancy, 87–88 Sleep behaviors, patterns, and safety
in early childhood, 94 in infancy, 88, 88t, 89t
in middle childhood, 689–690 Prenatal Visit, 329–330
Separation anxiety Newborn Visit, 357–358
in infancy, 84 First Week Visit (3 to 5 Days), 380–381
in early childhood, 100 1 Month Visit, 398, 407
15 Month Visit, 533 2 Month Visit, 423, 431
18 Month Visit, 550–551 4 Month Visit, 454
Sex, definition of, 219b 6 Month Visit, 470, 479
Sexual abuse 9 Month Visit, 490
in early childhood, 129 bottle in bed, avoidance of, 448, 472
in middle childhood, 136 infant putting self to sleep, 470
in adolescence, 140 sudden infant death, 79, 243–245
Sexual development and sexuality in early childhood, 94
in infancy, 217–218 9 Month Visit, 490
in early childhood, 218–219 12 Month Visit, 514–515
in middle childhood, 219–221 15 Month Visit, 535
puberty/pubertal development, 690, 718–721 bedtime struggles, 126t
in adolescence, 221–225 in adolescence
11 through 14 Year Visits, 757–758 11 through 14 Year Visits, 753–755
15 through 17 Year Visits, 789–790 15 through 17 Year Visits, 786–787
18 through 21 Year Visits, 816 18 through 21 Year Visits, 813–814
circumcision, 322 bottle in bed, avoidance of
definitions related to, 219b in infancy, 448, 472
ejaculation, 718–719 in early childhood, 535
menstruation, 718–719 night walking, 535
promotion of, 217–225 sleep schedule
Sexual intercourse in adolescence, 221–222 9 Month Visit, 490
Sexuality. See Sexual development and sexuality 15 Month Visit, 535
Sexually transmitted infections (STIs) social media use and, 230
in adolescence, 222 sudden infant death, 79, 243–245
11 through 14 Year Visits, 759–760 reducing, 243, 244b, 398
15 through 17 Year Visits, 791–792 Smoking. See Tobacco use/exposure
18 through 21 Year Visits, 817 Snacks
screening for, 288–289, 295–297 5 and 6 Year Visits, 668
Sexual orientation, 224–225 7 and 8 Year Visits, 693
Sexual safety 9 and 10 Year Visits, 722–724
in middle childhood, 718–719 Social connections/skills. See also Friends/peers
contraception, 222 in infancy, 83–84
STIs. See Sexually transmitted infections (STIs) in early childhood, 93, 95
Shared decision-making, 31–32 12 Month Visit, 511–512
Shared plan of care (SPoC), 66, 67f 4 Year Visit, 637
Sibling adjustment/relationships difficulty in forming friendships, 128t
in infancy in middle childhood, 104, 105t
Newborn Visit, 347 in adolescence, 108–109
First Week Visit (3 to 5 Days), 370–371 Social determinants of health, 23
2 Month Visit, 420 definition of, 15b
in early childhood, 615 health supervision visits, 262–263
Siblings risk factors in, 25, 27f, 28, 31
addition of, 552 strengths and protective factors in, 23–25, 31
relationships with. See Sibling adjustment/relationships Socialization. See Social connections/skills
Sickling/sickle cell trait (SCT), 196
athletic settings, managing in, 196, 196b
heat-related illness, signs of, 197t

865

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Social media use/exposure Sports


in the prenatal period, 231 in middle childhood, 248
in infancy, 231 in adolescence, 250–252
in early childhood, 231 cheerleading, 252
in middle childhood, 232–233 concussions from, 251
in adolescence, 233 heat-related illness, 196
cyberbullying. See Bullying/cyberbullying injury prevention during, 198
displacement of social interactions by, 230 7 and 8 Year Visits, 698
distraction of, 230 9 and 10 Year Visits, 728
family plan for, 232b performance-enhancing substances, 190
healthy/safe use, promotion of, 229–233, 241–242 and physical activity, 196–198
information quality, 230 sickle cell trait, management of, 196, 196b
role modeling and, 231 sickling, 196
sleep behaviors/patterns and, 230 Spousal separations, impact of, 28
Special education services in middle childhood, 691–692 STIs. See Sexually transmitted infections (STIs)
Special health care needs, children with, 65–66 Stress
in infancy, 70–72 in adolescence. See Coping with stress in adolescence
healthy development, 80–81 as a biological determinant of health, 22
nutritional health, 181–182 consequences of, 27f
in early childhood, 72–73 family changes and, 51–52
healthy development, 90 precipitants of, 27f
nutritional health, 185 as a social determinant of health, 25, 27f
in middle childhood, 73–74 Substance use/exposure, 56
healthy development, 103 in infancy
nutritional health, 187 Prenatal Visit, 314–315
in adolescence, 74–75 Newborn Visit, 343–344
healthy development, 106–107 1 Month Visit, 393–394
nutritional health, 190 6 Month Visit, 465
physical activity, 195–196 in early childhood
adult care, transitioning to, 75 12 Month Visit, 511
brushing teeth, 208 2 Year Visit, 572
care coordination for, 66–69 3 Year Visit, 611
coordination eco-map, 66–69, 69f 4 Year Visit, 633
development in middle childhood, 135–136
in infancy, 80–81 5 and 6 Year Visits, 661–662
in early childhood, 90 7 and 8 Year Visits, 686
in middle childhood, 103 9 and 10 Year Visits, 712
in adolescence, 106–107 in adolescence, 141–145
family support for, 47 11 through 14 Year Visits, 745–746, 760–761, 764–765
family-centered team approach, 68t 15 through 17 Year Visits, 777–778, 792–793
flossing, 208 18 through 21 Year Visits, 808, 818
health promotion for, 65–75 car safety
health supervision visits, 263–264 driving under the influence, 820
hospice care, 70 riding in vehicles (11 through 14 Year Visits), 764–765
mental health problems, 118 driving under the influence, 820
nutritional health during pregnancy, 314–315
in infancy, 181–182 screening for, 298
in early childhood, 185 in adolescence, 141–144
in middle childhood, 187 Youth Risk Behavior Surveillance System, 141, 142b
in adolescence, 190 Sudden infant death syndrome (SIDS), 243–245. See also sudden
oral health for, 208 unexpected infant death (SUID)
overweight and obesity, children with, 153 reducing, 243, 244b, 398
palliative care, 70 Sudden unexpected infant death, 53, 79, 243–244. See also Sudden
physical activity for, 195–196 infant death syndrome (SIDS)
safety and injury prevention, 238–239 Sugar intake
shared plan of care for, 66, 67f 7 and 8 Year Visits, 694–695
Speech delay, screening for, 284 9 and 10 Year Visits, 723–724
Spiritual development, 106 beverages. See Sugar-sweetened beverages
Spitting up in infancy, 179–180
SPoC. See Shared plan of care (SPoC)
866

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Sugar-sweetened beverages in adolescence


5 and 6 Year Visits, 668 11 through 14 Year Visits, 739
7 and 8 Year Visits, 693 15 through 17 Year Visits, 771
9 and 10 Year Visits, 722–723 18 through 21 Year Visits, 803
Suicide, 140, 250
SUID. See Sudden unexpected infant death (SUID) T
Sun exposure/protection Talking
in infancy 18 Month Visit, 553
First Week Visit (3 to 5 Days), 374–375 3 Year Visit, 616
6 Month Visit, 480 engagement in, 553
in early childhood speech delay, screening for, 284
12 Month Visit, 522 Tantrums. See also Behavioral concerns/problems; Temperament
18 Month Visit, 560 in infancy
2½ Year Visit, 601 12 Month Visit, 513
4 Year Visit, 646 15 Month Visit, 536
in middle childhood in early childhood
5 and 6 Year Visits, 674–675 excessive, 127t
7 and 8 Year Visits, 699 Teaching children. See also Early education; Learning/learning
9 and 10 Year Visits, 729 experiences; Preschool; School
in adolescence in infancy, 89–90
15 through 17 Year Visits, 796–797 in early childhood, 95–98
18 through 21 Year Visits, 820–821 Teeth. See Brushing teeth; Oral health
Supplements Teething, 447
in infancy, 173–174 Television viewing, 55. See also Media use/exposure
4 Month Visit guidance, 451 Temperament
vitamin. See Vitamin supplements in early childhood, 93
Survey of Well-being of Young Children (SWYC), 261 2 Year Visit, 575
Swaddling, 244b in middle childhood
in infancy 7 and 8 Year Visits, 689–690
Prenatal Visit, 329–330, 350 9 and 10 Year Visits, 716–717
Newborn Visit, 357–358 tantrums. See Tantrums
First Week Visit (3 to 5 Days), 380–381 Temperature taking in infancy, 374
1 Month Visit, 398–399, 400 Texting, 241–242
2 Month Visit, 424 Tobacco use/exposure, 56
4 Month Visit, 443 in infancy
SWYC. See Survey of Well-being of Young Children (SWYC) Prenatal Visit, 316
Syphilis. See also Sexually transmitted infections (STIs) Newborn Visit, 342
screening for, 296, 297 First Week Visit (3 to 5 Days), 368
Systems review (Bright Futures Visits), 267 1 Month Visit guidance, 391
in infancy 6 Month Visit, 465
Newborn Visit, 338 in early childhood
First Week Visit (3 to 5 Days), 364 12 Month Visit, 511
1 Month Visit, 387 2 Year Visit, 572
2 Month Visit, 413 3 Year Visit, 611
4 Month Visit, 437 4 Year Visit, 633
6 Month Visit, 461 in middle childhood
9 Month Visit, 485 5 and 6 Year Visits, 661–662
in early childhood 7 and 8 Year Visits, 686
12 Month Visit, 507 9 and 10 Year Visits, 712
15 Month Visit, 529 in adolescence
18 Month Visit, 547 11 through 14 Year Visits, 745–746, 760–761
2 Year Visit, 567 15 through 17 Year Visits, 777–778, 792–793
2½ Year Visit, 589 18 through 21 Year Visits, 808, 818
3 Year Visit, 607 as a biological determinant of health, 21
4 Year Visit, 629 e-cigarettes. See E-cigarette use/exposure
in middle childhood screening for, 298
5 and 6 Year Visits, 656
7 and 8 Year Visits, 681
9 and 10 Year Visits, 707

867

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Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents

Toilet training, 95 W
18 Month Visit, 551 Waking behaviors/patterns. See Sleep behaviors, patterns, and
2 Year Visit, 579 safety
readiness, signs of, 551 Water in early childhood, 557, 618, 639
resistance to, 126t Water safety. See also Drowning, prevention of
Toothbrushes in early childhood
6 Month Visit guidance, 472 12 Month Visit, 521
brushing teeth. See Brushing teeth 2½ Year Visit, 600
Toothpaste 3 Year Visit, 623
fluoridated, 207, 209, 211, 212, 214 4 Year Visit, 645
guidance, 208, 208f in middle childhood
Transgender, youth who identify as, 219b, 224–225 5 and 6 Year Visits, 674
Transition home 7 and 8 Year Visits, 698–699
Newborn Visit guidance, 346–347 9 and 10 Year Visits, 728
First Week Visit (3 to 5 Days) guidance, 370 Weaning infants, 495
Traumatic injury Weight
abusive head trauma in infancy, 121–122 in infancy
acoustic trauma. See Acoustic trauma healthy weight, 162
to mouth, 214 low-birth-weight babies, 22
Tuberculosis, screening for, 299 overweight, infants with, 152–153, 162
weight gain, 375–376
U in early childhood
Underweight, children with, 151 healthy weight, 163
interpreting BMI, 269t overweight and obesity, children with, 152–153, 163
low-birth-weight babies, 22 in middle childhood
5 and 6 Year Visits, 669–670
V 7 and 8 Year Visits, 694–695
Vegetables 9 and 10 Year Visits, 723–724
in middle childhood, 669–670 healthy weight, 163–164
pesticides in. See Pesticide exposure overweight and obesity, children with, 163–164
Violence. See also Maltreatment and neglect in adolescence
in adolescence, 249–250. See also Bullying; Fighting healthy weight, 164
in the community. See Neighborhood and community overweight and obesity, adolescents with, 153, 164
safety/violence as a biological determinant of health, 22
domestic. See Family violence; Intimate partner violence body mass index, 151, 152t
interpersonal. See Bullying/cyberbullying; Fighting interpreting, 269t
sexual abuse. See Sexual abuse weight-change targets based on, 161, 162t
Vision problems, screening for, 300–301 cultural attitudes about, 169
Vitamin D definitions and terminology, 151
in infancy, 183b healthy weight, promotion of, 151–164
in early childhood, 183b low-birth-weight babies, 22
in middle childhood, 186 overweight, children with. See Overweight and obesity
5 and 6 Year Visits, 669–670 underweight, children with, 151
7 and 8 Year Visits, 694–695 interpreting BMI, 269t
dietary reference intakes, 183b low-birth-weight babies, 22
in adolescence, 183b Whole-grain consumption, 669–670
dietary reference intakes, 183b Windows, prevention of falls from, 622
Vitamin supplements Work-life balance, 613
in infancy, 173–174
vitamin D. See Vitamin D Y
Youth Risk Behavior Surveillance System, 141, 142b

868

22 INDEX - BF.indd 868 1/25/17 1:42 PM

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