Medical Care and Your 4- to 5-Year-Old

The Well-Child Visit

Regular well-child exams are an important part of keeping kids healthy and up to date on immunizations against many serious childhood diseases.

Checkups also are a chance for you and the doctor to talk about developmental and safety issues, and for you to get answers to any questions about your child's overall health.

What to Expect at the Doctor's Office

At yearly exams, your child will be weighed and measured, and these results will be plotted on growth charts for weight, height, and body mass index (BMI). Using these charts, doctors can see how kids are growing compared with other kids the same age and gender. The doctor will take a medical and family history and do a physical exam.

During checkups, your child's blood pressure, vision, and hearing will be checked. Your child may be screened for anemia, lead poisoning, tuberculosis, or high cholesterol.

Immunizations given might include:

• fifth diphtheria, tetanus, and pertussis (DTaP) vaccine
• second measles, mumps, and rubella (MMR) vaccine
• fourth inactivated poliovirus vaccine (IPV)
• second chickenpox (varicella) vaccine

The flu vaccine, given before flu season each year, also is recommended. Other vaccines might be needed if the doctor determines that your child is at risk for conditions like meningococcal or pneumococcal disease.

The doctor will check for crossed eyes and any vision and hearing problems, and also check the teeth for tooth decay, abnormal tooth development, malocclusion (abnormal bite), dental injuries, or other problems. In addition to the doctor's dental evaluation, your child should be making regular visits to the dentist.

The doctor also will check on behavioral and social development, asking questions to see if your child's everyday behavior is age appropriate, how well your child does in social situations, and how well he or she communicates.

Developmental Milestones

Developmental milestones for 4-year-olds include being able to:

• help with household tasks
• play cooperatively with other kids
• understand the concept of gender
• identify colors

Developmental milestones for 5-year-olds include being able to:

• dress independently and tie shoes
• know their address and phone number
• draw a person with head, body, arms, and legs
• print some letters

Child safety is another topic discussed at well-child visits. The doctor will talk about the importance of using car seats, closely watching kids around swimming pools, preventing poisoning, not smoking around kids, and using sunscreen. In homes with guns, weapons and ammunition should be stored separately and kept locked at all times.

When Should I Call the Doctor?

Some symptoms can be signs of an infection, chronic medical condition (such as asthma), or other medical problem. Call your doctor if your child has any of these:

• changes in weight or eating habits
• changes in behavior or sleep patterns
• a failure to grow in height as expected
• a fever and looks sick
• lasting vomiting or diarrhea
• trouble keeping liquids down
• signs of a skin infection or long-lasting rash
• a lasting cough, wheezing, or other breathing problems
• localized pain, such as from an ear infection

Common Medical Problems

Problems often found in this age group include bedwetting and sleep disturbances, such as nightmares. Kids also might have growing pains in their calves at night.

Your doctor can offer guidance to help you manage these issues.