The 2024 Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) has been approved by the American Academy of Pediatrics (AAP). Each child and family is unique; therefore, these recommendations are designed for the care of children who are receiving nurturing 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 more frequent counseling and treatment visits separate from preventive care visits. Additional visits also may become necessary if circumstances suggest concerns. 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
To ensure that health care professionals have the most current recommendations, the Periodicity Schedule is not published in Pediatrics but is posted on the American Academy of Pediatrics Web site (www.aap.org/periodicityschedule). This webpage includes the most recent version of the Periodicity Schedule and the full set of footnotes. The Periodicity Schedule is reviewed and revised annually to reflect current evidence and recommendations.
The following is a description of the changes made to the Periodicity Schedule since it was last published in April 2023. The only updates to the Bright Futures Periodicity Schedule include additions to existing footnotes, which updates information but does not change the clinical recommendations.
3 to 5 Day Visit (Footnote 4)
This footnote reflects the updated AAP “Policy Statement: Breastfeeding and the Use of Human Milk”, published June 2022.
Footnote 4 has been updated to read, “Newborns should have an evaluation within 3 to 5 days of birth and within 48 to 72 hours after discharge from the hospital to include evaluation for feeding and jaundice. Breastfeeding newborns should receive formal breastfeeding evaluation, and their mothers should receive encouragement and instruction, as recommended in “Policy Statement: Breastfeeding and the Use of Human Milk” (https://doi.org/10.1542/peds.2022-057988). Newborns discharged less than 48 hours after delivery must be examined within 48 hours of discharge, per “Hospital Stay for Healthy Term Newborn Infants”. (https://doi.org/10.1542/peds.2015-0699).”
BMI (Footnote 5)
This footnote reflects the AAP “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” published January 2023.
Footnote 5 has been updated to read, “Screen per ‘Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity’” (https://doi.org/10.1542/peds.2022-060640).
Behavioral, Social, and Emotional Screening (Footnote 14)
This footnote reflects the USPSTF “Anxiety in Children and Adolescents: Screening” recommendations, published October 2022.
Footnote 14 has been updated to read, “Screen for behavioral and social-emotional problems per “Promoting Optimal Development: Screening for Behavioral and Emotional Problems” (https://doi.org/10.1542/peds.2014-3716), “Mental Health Competencies for Pediatric Practice” (https://doi.org/10.1542/peds.2019-2757), “Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders” (https://pubmed.ncbi.nlm.nih.gov/32439401), “Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women’s Preventive Services Initiative” (https://pubmed.ncbi.nlm.nih.gov/32510990), and “Anxiety in Children and Adolescents: Screening” (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-anxiety-children-adolescents). The screening should be family centered and may include asking about caregiver emotional and mental health concerns and social determinants of health, racism, poverty, and relational health. See “Poverty and Child Health in the United States” (https://doi.org/10.1542/peds.2016-0339),” The Impact of Racism on Child and Adolescent Health” (https://doi.org/10.1542/peds.2019-1765), and “Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health” (https://doi.org/10.1542/peds.2021-052582).”
Tobacco, Alcohol, or Drug Use Assessment (Footnote 15)
This footnote reflects the Centers for Disease Control and National Institute of Drug Abuse guidance related to recommending and prescribing Naloxone.
Footnote 15 has been updated to read, “A recommended tool to assess use of alcohol, tobacco and nicotine, marijuana, and other substances, including opioids is available at http://crafft.org. If there is a concern for substance or opioid use, providers should consider recommending or prescribing Naloxone (see https://www.cdc.gov/ore/search/pages/2018-evidence-based-strategies.html and https://nida.nih.gov/publications/drugfacts/naloxone).”
Newborn Bilirubin Screening (Footnote 21)
This footnote reflects the AAP “Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation,” published August 2022.
Footnote 21 has been updated to read, “Confirm initial screening was accomplished, verify results, and follow up, as appropriate. See Clinical Practice Guideline Revision: ‘Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation’ (https://doi.org/10.1542/peds.2022-058859).”
Oral Health (Footnote 35 and Footnote 36)
These footnotes reflect the updated AAP clinical report, “Maintaining and Improving the Oral Health of Young Children,” published December 2022.
Footnote 35 has been updated to read, “Assess whether the child has a dental home. If no dental home is identified, perform a risk assessment (https://www.aap.org/en/patient-care/oral-health/oral-health-practice-tools/) and refer to a dental home. Recommend brushing with fluoride toothpaste in the proper dosage for age. See ‘Maintaining and Improving the Oral Health of Young Children’ (https://doi.org/10.1542/peds.2022-060417).”
Footnote 36 has been updated to read, “Perform a risk assessment (https://www.aap.org/en/patient-care/oral-health/oral-health-practice-tools/). See ‘Maintaining and Improving the Oral Health of Young Children’ (https://doi.org/10.1542/peds.2022-060417).”
Committee on Practice and Ambulatory Medicine, 2023–2024
Jesse M. Hackell, MD, FAAP, Chairperson
Yvette M. Almendarez, MD, FAAP
Patricia E. Cantrell, MD, FAAP
Carolyn Cleary, MD, FAAP
Elizabeth Hawse, MD, FAAP
Lisa M. Kafer, MD, FAAP
Seth D. Kaplan, MD, FAAP – Section on Administration and Practice Management Liaison
Tomitra Latimer, MD, FAAP
Alisa Skatrud, MPA – Family Liaison
Robert H. Wiskind, MD, FAAP
Committee on Practice and Ambulatory Medicine, 2022–2023
Jesse M. Hackell, MD, FAAP, Chairperson
Yvette M. Almendarez, MD, FAAP
Abeba Berhane, MD, FAAP
Patricia Cantrell, MD, FAAP
Lisa M. Kafer, MD, FAAP
Tomitra Latimer, MD, FAAP
Katherine S. Schafer, DO, FAAP – Section on Administration and Practice Management Liaison
Alisa Skatrud, MPA - Family Liaison
Robin Warner, MD, FAAP
Robert H. Wiskind, MD, FAAP
Staff
Lauren Barone, MPH
Maureen Cooney, MPH
Mackenzie Magnus, MBA, MPH
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.
Comments