Your Child's Checkup: 5 Years

What to Expect During This Visit

Your doctor and/or nurse will probably:

1. Check your child's weight and height, calculate body mass index (BMI), and plot the measurements on growth charts.

2. Check your child's blood pressure, vision, and hearing using standard testing equipment.

3. Ask questions, address concerns, and offer advice about your child's:

Eating. Schedule three meals and one or two nutritious snacks a day. If you have a picky eater, keep offering a variety of healthy foods for your child to choose from. Kids should be encouraged to give new foods a try, but don't force them to eat.

Bathroom habits. By now, your child should be able to go to the bathroom alone. Constipation may become a problem because some children are embarrassed to use the bathroom at school. Remind your child to take regular bathroom breaks and not to "hold it." Talk to your doctor if you have concerns about your child's bathroom habits.

Sleeping. Kids this age generally sleep about 10–11 hours each night. Most 5-year-olds no longer nap during the day. To help your child get enough sleep, you might need to set an earlier bedtime.

Development. By 5 years, it's common for many children to:

• know their address and phone number
• tell stories using full sentences
• recognize and print some letters
• draw a person with head, body, arms, and legs
• skip
• walk down stairs, alternating feet
• count their fingers
• dress by themselves

4. Do a physical exam with your child undressed while you are present. This will include listening to the heart and lungs, observing motor skills, and talking with your child to assess language skills.

5. Update immunizations. Immunizations can protect kids from serious childhood illnesses, so it's important that your child get them on time. Immunization schedules can vary from office to office, so talk to your doctor about what to expect.

6. Order tests. Your doctor may assess your child's risk for anemia, lead, and tuberculosis and order tests, if needed.

Looking Ahead

Here are some things to keep in mind until your child's next checkup at 6 years:

Eating

1. Serve your child a well-balanced diet that includes lean protein, whole grains, fruits, vegetables, and low-fat dairy products.
2. Kids this age should get 2.5 cups (600 ml) of low-fat milk or fortified milk alternative (or other low-fat dairy products) daily.
3. Limit juice to no more than 4 ounces (120 ml) a day. Avoid high-sugar and high-fat foods and drinks.
4. Make time to eat together as a family. Turn off the TV and put away devices.

Routine Care

1. Allow plenty of time for physical activity and free play every day. Do it as a family.
2. Limit screen time (TV shows, DVDs, smartphones, video games, tablets, and computers) to no more than 1 to 2 hours a day of quality children's programming. Keep TVs and devices out of your child's bedroom.
3. Have your child brush teeth twice a day with a pea-sized amount of fluoride toothpaste. Schedule regular dental checkups as recommended by your child's dentist.
4. To help prepare your child for kindergarten:
   • Practice counting and singing the ABCs.
   • Encourage drawing, coloring, and recognizing and writing letters.
   • Keep consistent daily routines and times for meals, snacks, playing, reading, cleaning up, waking up, and going to bed.
   • Allow your child to take some responsibility for self-care, including going to the bathroom, washing hands, brushing teeth, and getting dressed. Offer reminders and help when needed.
   • Teach your child your home address and phone number.
   • Read to your child every day.

Safety

1. Teach your child the skills needed to cross the street independently (looking both ways, listening for traffic), but continue to help your child cross the street until age 10 or older.
2. Make sure your child always wears a helmet when riding a bicycle (even one with training wheels). Do not allow your child to ride in the street.
3. Make sure playground surfaces are soft enough to absorb the shock of falls.
4. Always supervise your child around water, and consider enrolling your child in a swimming class.
5. Apply sunscreen of SPF 30 or higher at least 15 minutes before your child goes outside to play and reapply about every 2 hours.
6. Protect your child from secondhand smoke, which increases the risk of heart and lung disease. Secondhand vapors from e-cigarettes is also harmful.
7. Keep your child in a belt-positioning booster seat in the backseat until he or she is 4 feet 9 inches (150 cm) tall. Kids reach this height usually between 8 and 12 years old.
8. Teach your child what to do in case of an emergency, including how to dial 911.
9. Protect your child from gun injuries by not keeping a gun in the home. If you do have a gun, keep it unloaded and locked away. Ammunition should be locked up separately. Make sure kids cannot access the keys.
10. Discuss appropriate touch. Explain that certain parts of the body are private and no one should see or touch them. Tell your child to come to you if someone asks to look at or touch his or her private parts, is asked to look at or touch someone else's, or is asked to keep a secret from you.
11. Talk to your doctor if you're concerned about your living situation. Do you have the things that you need to take care of your child? Do you have enough food, a safe place to live, and health insurance? Your doctor can tell you about community resources or refer you to a social worker.

These checkup sheets are consistent with the American Academy of Pediatrics (AAP)/Bright Futures guidelines.