Bright Futures eNews – March 2017

March 2017
Dear Colleague,
We are pleased to announce the March 2017 installment of Bright Futures eNews.
If you are new to Bright Futures, watch this 2-minute About Bright Futures video to get started using the Bright Futures recommendations in your health promotion and disease prevention practices and with programs and families in your community.
Consider using the video in presentations about Bright Futures. Share the link with colleagues in various settings in which Bright Futures is being used (eg, clinics, home visiting, child care, school-based health centers, public health settings, etc.).
Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition
Bright Futures Guidelines, 4th Edition is Released!
Do not miss the completely revised and updated 4th Edition of the Bright Futures Guidelines ! It is an essential resource that provides updated background and recommendations for pediatric health promotion and health supervision for 31 age-based visits – from infancy through adolescence. With Bright Futures, you can accomplish the following 4 tasks in 18 minutes — disease detection, disease prevention, health promotion, and anticipatory guidance! The result: more efficient visits, stronger partnerships with children and families, and greater knowledge of changes in family, communities, and society that affect a child’s health.
The Bright Futures Guidelines, 4th Edition builds upon previous editions with new and updated content that reflects the latest research. It includes 3 new health promotion themes (Promoting Lifelong Health for Families and Communities, Promoting Health for Children and Youth With Special Health Care Needs, Promoting the Healthy and Safe Use of Social Media), updated Milestones of Development and Developmental Surveillance questions, and new clinical content about the latest age-specific recommendations. Throughout, the Guidelines weave in recognition of social determinants of health (risks and protective factors) and an increased focus on lifelong physical and mental health.

As established in the 3rd Edition, the first priority for each health supervision visit is to address the needs and concerns of the child/adolescent and family, and the therapeutic relationship is key to implementation. Click here for a preview and for more infomation!

The Bright Futures Tool and Resource Kit is undergoing revision and is anticipated to be released in January 2018.

Introductory Webinars: Bright Futures Guidelines, 4th Edition
Make sure to sign up for the latest Bright Futures Webinars beginning in April 2017! Learn about the revised and updated Bright Futures Guidelines, 4th Edition from the editors themselves. We will be hosting two separate 45-minute Webinars for health care professionals and public health professionals. Of course, everyone is welcome to attend either! They will be recorded and posted on the Bright Futures Web site for anyone that cannot participate in the live events.
The editors will review the new and updated components such as 3 new health promotion themes, updated Milestones of Development and Developmental Surveillance questions, updates to several adolescent visit screening recommendations, and more. They will discuss how to efficiently and effectively integrate these new components into your practice setting and will answer your questions about the Bright Futures Guidelines, 4th Edition.
Bright Futures Guidelines, 4th Edition – Introduction (for Health Care Professionals)
Wednesday, April 19 
1:00 PM ET/12:00 PM CT
Click here to register.

Bright Futures Guidelines, 4th Edition – Introduction (for Public Health Professionals)
Wednesday, May 24 
1:00 PM ET/12:00 PM CT
Click here to register.
Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) 
Bright Futures/AAP Periodicity Schedule is Updated!
Each child and family is unique; therefore, the Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (known as the Periodicity Schedule) are designed for the care of infants, children, and adolescents who are receiving competent parenting, have no manifestations of any important health problems, and are growing and developing in satisfactory fashion. Additional visits may become necessary if circumstances suggest variations from normal. Developmental, psychosocial, and chronic disease issues for children and adolescents may require frequent counseling and treatment visits separate from preventive care visits.
The Bright Futures/AAP Periodicity Schedule is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence. These recommendations represent a consensus by the AAP and Bright Futures. The AAP continues to emphasize the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care. Refer to the specific guidance by age as listed in the Bright Futures Guidelines, 4th Edition.  For implementation and coding information for each visit on the Periodicity Schedule, please see the Bright Futures and Preventive Medicine Coding fact sheet. For more background, click here to review the related Bright Futures Guidelines, 4th Edition’s Evidence and Rationale chapter.
AAP Practice Transformation  is your one-stop resource for transforming your practice and career to meet the challenges of the new healthcare environment. Access the latest strategies, resources, and tools to make your practice thrive in the rapidly changing healthcare delivery and payment systems. Find practical guidance for all stages of your career. Be ready to face the future of pediatric practice.
Bright Futures Implementation
NEW State Implementation Stories!
Find out how your colleagues in other states are implementing the Bright Futures Guidelines by visiting the States & Communities section of the Bright Futures Web site. We have added 10 new and 5 updated implementation stories about states that are successfully implementing the Bright Futures recommendations. The new stories were developed as a part of the Alliance for Innovation on Maternal and Child Health project in which the AAP is participating. The stories were created by interviewing AAP chapter leaders and public health representatives. The stories demonstrate a wide variety of implementation examples including incorporating the Bright Futures/AAP Periodicity Schedule into Medicaid agencies, using Bright Futures measures in quality improvement projects, training multidisciplinary practitioners that provide services to families and children, and many other examples illustrating the value of flexibility of the Bright Futures content. Be sure to check-out the Bright Futures Web site for tips on implementing Bright Futures recommendations in your state, community, and practice.
Do you have a story to tell about how you’ve implemented Bright Future in your practice?
Please contact us so we can feature your implementation story on our Web site or in a future edition of the Bright Futures eNews.
Web site Contact Us:
Reminder: Please link directly to the Bright Futures/AAP Periodicity Schedule on your Web site to ensure you are accessing the most up-to-date version. Please check your current link and update accordingly.
Be sure to visit the Bright Futures Web site to access Bright Futures materials and other resources.
Inclusion in this publication does not imply an endorsement by the American Academy of Pediatrics. The AAP is not responsible for the content of these resources. Web site addresses are as current as possible but may change at any time. The American Academy of Pediatrics Bright Futures National Center eNews is funded through a cooperative agreement (grant number: U04MC07853) with the Health Resources and Services Administration, Maternal and Child Health Bureau.

Contact for more information.

American Academy of Pediatrics 141 Northwest Point Blvd., Elk Grove Village, IL 60007-1098


GOP health-care plan: Don’t gut Medicaid

As a primary-care pediatrician, I greatly appreciated Bob Young’s summary of the GOP health-care plan.

There is little surprise their proposed plans include eliminating Medicaid expansion and the individual mandate. However, the House bill also proposes radical decreases to Medicaid funding.

Medicaid is an American legislative success story. It came into law with bipartisan support, and 95 percent of kids nationwide have health insurance coverage largely thanks to Medicaid. In Washington state, one out of every two kids is insured by Medicaid. In my own practice, a sizable percentage of kids are insured through Medicaid.

I am certain that the electorate did not intend for the federal government to gut Medicaid, taking us far backward in providing medical coverage for Washington children.

Rupin Thakkar, M.D., Seattle

What’s the Latest with the Flu for Clinicians – March 2017

American Academy of Pediatrics
What’s the Latest with the Flu for Clinicians
March 2017


Current Flu Situation

As of March 7, flu activity was still elevated in the United States and expected to continue for several weeks. The season so far has been moderate. The majority of states reported widespread influenza activity at this time. With 40 pediatric deaths from influenza reported so far this flu season, even one preventable death is too many. Flu-related deaths in children younger than 18 years old should be reported through the Influenza-Associated Pediatric Mortality Surveillance System. The number of flu-associated deaths among children reported during this 2016-2017 flu season will be updated each week and can be found at

It is important to continue to recommend influenza vaccination. Children 6 months through 8

years of age need 2 doses if they have received fewer than 2 doses of any trivalent or quadrivalent influenza vaccine before July 1, 2016. The interval between the 2 doses should be at least 4 weeks. This age cohort requires only 1 dose if these children have previously received 2 or more total doses of any trivalent or quadrivalent influenza vaccine before July 1, 2016. The 2 previous doses do not need to have been received during the same influenza season or in consecutive influenza seasons. See the American Academy of Pediatrics (AAP) policy, “Recommendations for Prevention and Control of Influenza in Children, 2016–2017”, for more information.

The Centers for Disease Control and Prevention (CDC) released a new Morbidity and Mortality Weekly Report (MMWR) titled, “Update: Influenza Activity — United States, October 2, 2016–February 4, 2017.” The report summarizes U.S. influenza activity for the dates listed.


More Influenza Illness Suggests Need for More Rapid Antiviral Treatment

Children clinically presumed to have influenza should be considered for early antiviral treatment, when indicated, independent of laboratory confirmation or receipt of influenza vaccine. This crucial approach can help minimize morbidity and mortality, particularly in young children, and those who are hospitalized or who have underlying co-morbidities. Antiviral treatment should be started as soon as possible after influenza illness onset and should not be delayed while waiting for a confirmatory test result because early therapy provides the best outcomes.

Treating high risk children or children who are very sick with flu with antiviral drugs is very important. It can mean the difference between having a milder illness instead of a very serious one that could result in a hospital stay. See the AAP policy or visit the CDC Antiviral Drugs Web page for information about how antiviral medications can be used to prevent or treat influenza when influenza activity is present in the community. A summary of antiviral recommendations for clinicians is available on the CDC Web page Influenza Antiviral Medications: Summary for Clinicians.

CDC Webinar: 2016-2017 Influenza Season Activity and Recommendations for Clinicians

On February 16, 2017, the CDC Clinician Outreach and Communication Activity (COCA) hosted a webinar titled “2016-2017 Influenza Season Activity and Recommendations for Clinicians.” During this webinar, clinicians learned about 2016-2017 influenza activity to date and heard an overview of CDC recommendations for health care providers including influenza vaccination and the use of antiviral medications for the treatment of influenza. An archived version of the webinar, a transcript, and presentation materials are available online.


Ready Wrigley Preparedness for Flu Season

The AAP worked with the CDC to develop and endorse a new Ready Wrigley Activity Booklet on influenza. Each book aims to build capacity in children’s preparedness by inspiring youth readiness and promoting individual resilience. The books are designed for children 2 to 8 years of age. The Ready Wrigley Activity Book series is produced by the CDC Children’s Preparedness Unit and CDC communication specialists.


Additional Information

For more information, see the AAP Red Book Online Influenza Resource page and CDC FluView. All AAP “What’s the Latest with the Flu” messages are archived. Members of the AAP also have access to Flu Vaccine Recommendations and Key Speaking Points.

Top 10 resolutions at ALF reflect concerns over immigrant children

Resolutions to protect the children and families of immigrants marked the top three resolutions selected by AAP leaders at the Annual Leadership Forum (ALF) last weekend.

The resolutions called for access to legal representation for families seeking safe haven, protections for children of migrants, and response to the executive order limiting immigration and entry.

Other top 10 resolutions addressed improving mental health access for children, advocating to national leaders to stand against hate crimes and other discriminatory behavior across the country, wider availability of epinephrine supplies in schools, and evidence-based firearm policy and research.

Following are the top 10 resolutions:

  • Building Access to Legal Representation for Children, Adolescents, and Families Seeking Safe Haven
  • Protect Children of Migrants
  • Response to Executive Order Limiting Immigration and Entry
  • Improving Mental Health Access for Children
  • Advocate for Epinephrine Supply in Schools to Serve Entire School Population
  • Not One More Child Should Die in a Dental Chair: Remembering Caleb
  • Endorsing Evidence-Based Firearm Policy and Policy-Informed Research
  • Calling for Statement from National Leaders Against Hate and Discrimination
  • Medication Return and Safe Disposal
  • Assisting Chapters with Membership Recruitment and Retention

“I was happy to see so many of these align with the current work of the Board and with the Strategic Plan,” said AAP CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP.

The top resolutions were voted on by 76% of the 199 eligible voting members present.

Leading up to the ALF, AAP members were able to comment on the resolutions online.

Look to the May issue of AAP News for additional coverage of the 2017 ALF.

AAP Statement Opposing Separation of Mothers and Children at the Border

“The American Academy of Pediatrics (AAP) opposes the Department of Homeland Security (DHS) proposal reported in the media that would separate immigrant mothers from their children when they arrive at the U.S. border.

“Pediatricians work to keep families together in times of strife because we know that in any time of anxiety and stress, children need to be with their parents, family members and caregivers. Children are not just little adults and they need loved ones to comfort and reassure them.

“Federal authorities must exercise caution to ensure that the emotional and physical stress children experience as they seek refuge in the United States is not exacerbated by the additional trauma of being separated from their siblings, parents or other relatives and caregivers. Proposals to separate children from their families as a tool of law enforcement to deter immigration are harsh and counterproductive. We urge policymakers to always be mindful that these are vulnerable, scared children.

“The American Academy of Pediatrics is ready to assist federal officials in crafting immigration procedures that protect children.”

by: Fernando Stein, MD, FAAP, President and

Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics

​Ruling by Appellate Court means physicians can counsel parents about firearm safety without fear of sanctions and loss of license

American Academy of Pediatrics Applauds Ruling to Uphold a Physician’s Right to Counsel on Firearm Safety


​Ruling by Appellate Court means physicians can counsel parents about firearm safety without fear of sanctions and loss of license

ELK GROVE VILLAGE, IL (Feb. 16, 2017) – The American Academy of Pediatrics welcomes today’s decision by the 11th Circuit Court of Appeals to uphold a lower court ruling against Florida’s “physician gag law,” which would have stopped physicians from counseling families on how to keep children safe around firearms.

The ruling means important conversations may continue unfettered between physicians and families about protecting children from unintentional injury and death, and it protects the physician’s First Amendment right to counsel patients.

The court upheld the June 2012 decision of U.S. District Judge Marcia G. Cooke of the Southern District of Florida-Miami, who issued a ruling permanently enjoining the 2011 Florida law restricting physician speech on firearms counseling from going into effect.

“We are delighted that the constitution has been defended, particularly when it comes to the First Amendment.,” said Fernando Stein, MD, FAAP, president of the American Academy of Pediatrics. “Pediatricians routinely counsel families about firearm safety just as they offer guidance on seat belt use, helmets and parental tobacco use to reduce the risk of injury to children where they live and play. These are all topics that families should feel very comfortable talking about with their pediatrician.”

The law would have prohibited a simple conversation in the physician’s office that can save lives. Research has shown that when physicians offer guidance on gun locks and safe storage, appropriate to a child’s specific age and development, it is more likely that families will take those necessary steps.

“We are pleased with the 11th Circuit’s common-sense decision, which allows physicians the right to counsel families on firearms ownership and storage,” said Madeline Joseph, MD, FACEP, FAAP, president of the Florida chapter of the AAP. “This ruling will allow physicians to offer sound medical advice to families without fear of state interference or penalties.”

The Florida Privacy of Firearm Owners Act, which was signed by Florida Gov. Rick Scott in June 2011, violates the free speech rights of doctors and patients. It bans physicians from asking their patients routine questions and having a discussion about firearm safety and subjects physicians accused of violating the statute to harsh penalties usually reserved for egregious professional misconduct.

Soon after passage, the law was challenged in court by the Florida chapters of the AAP, the American Academy of Family Physicians and the American College of Physicians, as well as by six individual physicians. The lawsuit, Wollschlaeger v. Governor of Florida, argued physicians’ First Amendment right to free speech and patients’ First Amendment right to hear the physician’s speech were violated. A U.S. District Court judge agreed with the physicians’ lawsuit and issued a permanent injunction, which was appealed by the state of Florida.

Other medical organizations have also challenged the law. In November 2012, an amicus brief supporting the district court ruling to enjoin the law was signed by the American Academy of Pediatrics, the American Medical Association, the American Academy of Family Physicians, the American Academy of Child and Adolescent Psychiatry, the American Academy of Orthopaedic Surgeons, the American College of Surgeons, the American College of Preventive Medicine, the American College of Obstetrics and Gynecology, and the American Psychiatric Association.

The U.S. Court of Appeals for the 11th Circuit heard oral arguments in the case in July of 2013. Since the Florida legislation passed in 2011, at least 14 other states have introduced similar bills, but none have passed.

Springer Publishing Company is pleased to announce the publication of Medications & Mothers’ Milk 2017

mothers-milkThe Essential Reference for Professionals Working with Breastfeeding Mothers

Medications and Mothers’ Milk is the worldwide-bestselling drug reference on the use of medications in breastfeeding mothers, providing you the most current, complete, and evidence-based information.

Extensively updated throughout, the 17th Edition includes hundreds of new drugs, diseases, vaccines, and syndromes. The appendices provide information on radioactive drugs and tests, and over-the-counter drugs.

Written by world-renowned Clinical Pharmacologist, Dr. Thomas Hale, and assisted by Dr. Hilary Rowe, this drug reference provides everything that is known about the transfer of various medications into human milk, the use of radiopharmaceuticals, the use of chemotherapeutic agents, and vaccines in breastfeeding mothers.


  • Updated throughout with new data on 1,115 drugs, syndromes, vaccines, and herbals.
  • Contains new tables to compare the suitability of psychiatric medications and pain medication.
  • Includes many new radiocontrast agents and other diagnostic procedures.

We would like to work with your association to promote this book to your members.  We can offer your association discounting on quantities that are purchased for sale to your members.

Buy Now >>

350 groups sign letter to President Trump in support of vaccines

More than 350 medical, professional and advocacy organizations signed on to a letter drafted by the Academy to President Donald Trump expressing “unequivocal support” for the safety of vaccines.

The 28-page letter cites and abstracts more than 40 studies on vaccine safety and effectiveness. Co-signers of the Feb. 7 letter represent every AAP chapter along with state and national medical, research and advocacy groups, including the American Medical Association, the March of Dimes and Autism Speaks.

“Vaccines protect the health of children and adults and save lives,” the letter states. “They prevent life-threatening diseases, including forms of cancer. Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.”

As the new administration takes shape, the Academy and others wanted to be on the record early to demonstrate strong support for vaccines and the recommended immunization schedule.

The letter points out that despite successes, outbreaks of vaccine-preventable diseases still occur. “As a nation, we should redouble our efforts to make needed investments in patient and family education about the importance of vaccines … to increase the rate of vaccination among all populations,” the letter concludes. “Put simply: Vaccines are safe. Vaccines are effective. Vaccines save lives.”

Mandatory Lead Screening for 1 and 2-year-olds on Medicaid in Alaska

A letter from Dr. Alex Malter, Alaska’s esteemed Medicaid Medical Director, on mandatory lead screening for 1 and 2-year-olds on Medicaid in Alaska: “The Department of Health and Social Services is updating its regulations to clarify that lead screening is required for all children enrolled in Medicaid at 12 and 24 months of age. The attached letter from the Division of Healthcare Services provides more detail about the requirement, and provides a contact phone number if you would like more information.”


New Chapter Champion for Newborn Hearing

Congratulations to Jennifer Scoble, MD who will serve as the Alaska’s AAP Chapter Champion for newborn hearing.  Dr. Scoble feels strongly in this program and writes, “The early detection and intervention of hearing loss is important to me because I have a personal background and professional interest in neurodevelopment, particularly as it pertains to the NICU graduate, but including all children.  We have an opportunity to make a big difference in the lives of children with hearing loss by detecting it early and intervening as soon as possible.”