The 2019 Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) have been approved by the American Academy of Pediatrics (AAP) and represent a consensus of AAP and the Bright Futures Periodicity Schedule Workgroup. Each child and family is unique; therefore, these recommendations are designed for the care of children who are receiving competent parenting, have no manifestations of any important health problems, and are growing and developing in a satisfactory fashion. Developmental, psychosocial, and chronic disease issues for children and adolescents may require frequent counseling and treatment visits separate from preventive care visits. Additional visits also may become necessary if circumstances suggest variations from the normal.

The AAP continues to emphasize the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care.1 

The Periodicity Schedule will not be published in Pediatrics. Readers are referred to the AAP Web site ( for the most recent version of the Periodicity Schedule and the full set of footnotes. This process will ensure that health care professionals have the most current recommendations. The Periodicity Schedule will be reviewed and revised annually to reflect current recommendations.

Following are the changes made to the Periodicity Schedule since it was last published in April 2017.

Footnote 6 has been updated to read, “Screening should occur per ‘Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents’ ( Blood pressure measurement in infants and children with specific risk conditions should be performed at visits before age 3 years.”

Footnote 24 has been updated to read, “Perform risk assessment or screening, as appropriate, per recommendations in the current edition of the AAP Pediatric Nutrition: Policy of the American Academy of Pediatrics (Iron chapter).”

Footnote 25 has been updated to read, “For children at risk of lead exposure, see ‘Prevention of Childhood Lead Toxicity’ ( and ‘Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention’ (”

FUNDING: No external funding.

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

Policy statements from the American Academy of Pediatrics benefit from expertise and resources of liaisons and internal (AAP) and external reviewers. However, policy statements from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent.

The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.


American Academy of Pediatrics

, eds.
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents
. 4th ed.
Elk Grove Village, IL
American Academy of Pediatrics

Julia E. Richerson, MD, FAAP, Chairperson

Joseph J. Abularrage, MD, MPH, MPhil, FAAP

Yvette M. Almendarez, MD, FAAP

Alexy D. Arauz Boudreau, MD, FAAP

Patricia E. Cantrell, MD, FAAP

Jesse M. Hackell, MD, FAAP

Amy P. Hardin, MD, FAAP

Scot B. Moore, MD, FAAP

Robin Warner, MD, FAAP

Dana Bright, MSW

Alexy D. Arauz Boudreau, MD, FAAP

Joseph F. Hagan Jr, MD, FAAP

Alex R. Kemper, MD, FAAP, Bright Futures Evidence Expert

Kelley E. Meade, MD, FAAP

Judith S. Shaw, EdD, MPH, RN, FAAP

Jane B. Bassewitz, MA

Kathryn M. Janies

Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.