Well Child Care 5 Years

Nutrition

Your child may enjoy helping to choose and prepare the family meals with supervision. Children watch what their parents eat, so set a good example. This will help teach good food habits. Mealtime should be a pleasant time for the family. Avoid junk foods and soda pop. Televisions should never be on during mealtime. Your child should eat 5 or more servings of fruits/vegetables a day. Limit candy, soda, and high-fat snacks. Your child should have at least 2 cups of low-fat milk or other dairy products each day.  Lower fat content in milk and other dairy products is almost always a good idea. Lowering the fat content of milk DOES NOT change any of the nutritional value of the milk.  Most families should be using nonfat or 1% milk. Your doctor will advise you if you should be using milk with a higher fat content.  Please continue your Vitamin D supplement if directed to do so.

Development

Children at this age are imaginative, get along well with friends their own age, and have lots of energy. Be sure to praise children lavishly when they share things with each other.
Bed Wetting
Many children still wet the bed at night.  This is usually normal.  In order to help your child learn to stay dry during the night try the following:
·         Make sure your child does not consume caffeine after 4:00 PM (Coke, Pepsi, Mountain Dew, etc; tea, coffee).
·         The last thing your child should do before getting into bed is a relaxed and complete emptying of his or her bladder.
·         Monitor how often your child wets the bed.  If the frequency of wet nights is increasing, please call us.
School-age kids require 10-11 hours per night.
Five-year-olds usually are able to dress and undress themselves, understand rules in a game, and brush their own teeth. For behaviors that you would like to encourage in your child, try to catch your child being good. That is, tell your child how proud you are when he does things that help you or others. Five-year-olds should be doing simple chores such as setting the table on a daily basis.

Behavior Control

Find ways to reduce dangerous or hurtful behaviors. Also teach your child to apologize. Sending a child to time out in a quiet, boring corner without anything to do for 5 minutes should follow. Time outs can help teach important rules of getting along with others. Do not send a child to his room. A bedroom should always be a desirable location for your child. Ask your healthcare provider if you need help with your child’s behavior.

Reading and Electronic Media

It is important to set rules about television watching. Limit electronic media (TV, DVDs, or computer) time to 1 or 2 hours per day of high quality children’s programming. Participate with your child and discuss the content with them. Do not allow children to watch shows with violence or sexual behaviors. Find other activities besides watching TV that you can do with your child. Reading, hobbies, and physical activities are good choices.  Remember – do not put a television in your child’s bedroom.

Dental Care

·         Brushing teeth regularly after meals and before bedtime is important. Think up a game and make brushing fun.
·         Make an appointment for your child to see the dentist every 6 months.
·         Fluoride supplementation is important to make teeth stronger and prevent decay.  If the water in your community is fluoridated you will not require an additional supplement.  If there is no fluoride in the water your doctor will recommend a fluoride supplement for your child.  Since your child is receiving fluoride in either the water or by supplement please do not use toothpaste that contains fluoride.

Safety Tips

Accidents are the number-one cause of serious injury and death in children. Keep your child away from knives, power tools, or mowers.

All parents, caregivers and babysitters should be certified in CPR every two years.  Your local hospital may have a class available.

Fires and Burns
·         Practice a fire escape plan every 3 months.  First,  set off your smoke detectors.  Everyone in the house should walk outside and go to the same meeting place every time.  Now that your child is 5 years old, he or she can be encouraged to calmly leave the house independently.  Make sure the meeting place is at least 20 adult paces from your home so that your children are not standing in smoke.
·         Check smoke detectors and replace the batteries as needed.
·         Keep a fire extinguisher in or near the kitchen.
·         Teach your child to never play with matches or lighters.
·         Teach your child emergency phone numbers and to leave the house if fire breaks out.
·         Turn your water heater down to 120°F (50°C).
Falls
·         Never allow your child to climb on chairs, ladders, or cabinets.
·         Do not allow your child to play on stairways.
·         Make sure windows are closed or have screens that cannot be pushed out.
Car Safety
Your child should use a forward facing car seat as long as possible, up to the highest weight and height allowed by the manufacturer.   Your child must ride in the back seat.
All children whose weight or height has outgrown the forward-facing limit for their car seat should use a booster seat until they are 4 feet 9 inches tall and are at least 8 years old. 
·         NEVER buy any motorized vehicles for your child to drive.
Pedestrian and Bicycle Safety
·         Always supervise street crossing. Your child may start to look in both directions but don’t depend on her ability to cross a street alone.
·         All family members should use a bicycle helmet, even when riding a tricycle.
·         Do not allow your child to ride a bicycle near traffic.
·         Purchase a bicycle that fits your child well. Don’t buy a bicycle that is too big for your child. Bikes that are too big are associated with a great risk of accidents.
Water Safety
·         ALWAYS watch your child around swimming pools.
·         Consider enrolling your child in swimming lessons.
Poisoning
Teach your child to take medicines only with supervision.
Teach your child to never eat unknown pills or substances.
Keep the POISON CONTROL number (1-800-222-1222) on all phones.
Strangers
·         Discuss safety outside the home with your child.
·         Teach your child her address and phone number and how to contact you at work.
·         Teach your child never to go anywhere with a stranger.
·         Teach your child that no adult should tell a child to keep secrets from parents, no adult should show interest in private parts, and no adult should ask a child for help with private parts.
Smoking
·         Children who live in a house where someone smokes have more respiratory infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.
·         If you smoke, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.

Immunizations

The virus that causes influenza (which is also called the flu) changes every year.  Children over 6 months of age should receive an annual flu vaccine starting in late September.  Many offices offer both tradition flu shots as well as Flumist (which is a painless squirt in the nose without any needles