Middle Childhood Well-Child Visits (ages 5-10y)

We will look at the middle years of childhood, those from 5-10 years of age, as a group rather than individually. It is still very important that your child come to see the Pediatrician once per year during this time. What can you expect at these visit with the Pediatrician?

Vitals – Heart rate and respiratory rate will be counted, temperature and blood pressure are taken.

Growth measurements – Height, weight, and BMI (Body Mass Index) continue to be measured and plotted on growth curves for age and gender.  The BMI is s a person’s weight in kilograms (kg) divided by the square of height in meters. Higher BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the health of an individual by itself. It is another marker we use to help determine the health of your child. 

Vision and Hearing – Most offices will check your child’s vision and/or hearing at these visits, unless you are certain they have been screened at school within the last year. Any abnormalities noted, including poor eyesight, hearing loss, etc, will result in a referral to a vision or hearing specialist for further, more detailed evaluations. 

Development –

• Social: They progressively demonstrate social and emotional self-regulation during this time, including forming relationships with peers and adults, ability to understand and follow rules, form problem solving skills, and develop compassion and empathy. 
• Speech & Language: They should be easily understood by strangers. 
• Gross (large) motor: They develop increasingly complex movements, from skipping and hopping on one foot to learning to play a sport or ride a bicycle. 
• Fine motor: They learn to write letters first, and then words and sentences. They are able to complete increasingly complex small tasks such as puzzles and building with legos. 

Questions from the Pediatrician – your child’s doctor will ask questions about nutrition and meals, sleeping, screen time, interactions with family members and peers. 

Nutrition – Continue to offer your growing child a variety of fruits, vegetables, proteins, dairy, fats, and carbohydrates. Promote family meal times with snacks in between. Allow your child to decide how much to eat at once.  Avoid fruit juices or other sweetened beverages, but always have water available to drink. 

Healthy Teeth – brushing your child’s teeth twice daily should be an important part of the daily routine. Your child should be seen by the dentist every 6 months for check ups and cleanings. 

Exam – your child will have a head-to-toe exam at every well-child visit. 

Vaccinations – The CDC recommended vaccination schedule recommends booster vaccinations for DTaP (Diphtheria, Tetanus, and acellular Pertussis), Polio, MMR (Measles, Mumps, Rubella), and Varicella (Chicken Pox) at age 4-5y. If they were not given at age 4, they will be given at the 5 year visit prior to entrance into Kindergarten. Depending on the time of year, your child’s doctor may recommend the Influenza vaccine as well.  Your Pediatrician will discuss these in detail with you at your visit. There are no further recommended vaccines for children aged 6-10y.

Questions from you – you will likely have questions about proper nutrition, sleep habits, behavior, and schooling. Bring your questions to the visit and never hesitate to ask your child’s Pediatrician about your concerns.

School – Starting at age 5-6 years of age children enter into Kindergarten. Once in school regularly, ensure your child is ready to learn by setting a reasonable bedtime and a consistent morning routine that includes a nutritious breakfast. Talk with your child about school daily. Difficulty with behaviors and learning disabilities are often brought to light during this time. Work with your child’s school to develop a plan for optimal learning if this is needed. 

Safety information – part of every well-child visit is discussion of safety that is appropriate for age. For middle childhood, this includes:

• car safety – follow recommendations for booster seats and transitions to regular car seats based on your child’s age and height/weight. Your child should continue to sit in the back seat. Never leave your child in the car alone. 
• water safety – young children should never be left alone in the water, even if it is only a few inches or only for a short amount of time. Drowning occurs quickly. Teach your child to swim but do not assume this will prevent drowning accidents.
• street safety – teach your child to cross the street safely, including using crosswalks, watching for cars, only crossing with an adult. 
• bike safety – ensure your child has a well-fitting helmet to use with bicycles, scooters, skateboards, hover boards, etc. 
• sun exposure – avoid direct exposure during the middle of the day as much as possible. Use hats and long sleeves. Use sunscreen with a high SPF. 
• firearms – remove all firearms from the home, if possible. Otherwise, ensure they are locked in a safe and stored unloaded. 

Well-child visit should occur yearly.

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