• Food habits now influence eating habits in later life.
  • Teach your child about the food pyramid and offer foods that are lower in salt and sugar.
  • Use good food portions, encourage drinking water over juice, sports drinks and soda.
  • Limit your child to one treat a day.
  • Your goal is 4 servings of calcium-rich foods each day.
  • Encourage consumption of fresh vegetables, poultry, fish and trimmed lean meats.
  • Children do not need daily juice. Despite what our parents taught us juice has no nutritional value. The vitamin C provided in juice is not necessary to fight infection and consuming sweet drinks, even 100 percent natural contributes to obesity.
  • Discourage processed meats, chips, candy and soft drinks. Limit fast foods and discourage eating in front of the television.
  • Lunch box strategy: tuna fish, PBJ, chicken and turkey, raw veggies, soup, whole grain breads, fresh or dried fruits, nonfat milk and water. The best fast foods are pizza, roast chicken, salad, and fruits.
  • A multivitamin is recommended for all children and adults. The goal is to take Vitamin D 400 IU and calcium 800 mg each day. Most generic multivitamins contain these.
  • The goal is 30 minutes of exercise daily.


  1. Children are encouraged to stay in 5 point harness car seats until 6 years old. After that, booster seats should be used until the child reaches 4 feet 9 inches. For most kids that will be around 11 years old.
  2. Use helmets with bicycles, scooters, roller skating and skiing. Use elbow, wrist and knee pads where appropriate.
  3. Don’t take your child’s “common sense” for granted. Lock up all medications and household poisons including cleaners, paint thinners, and drain cleaners. Do not store these products in containers that resemble food containers.
  4. Guns in the home are a danger to the family. If guns are kept, store the gun and ammunition locked up and in separate locations.
  5. Teach your child his name, address and phone number. Discuss stranger safety.
  6. Discuss water safety. Knowing how to “swim” does not ensure the child’s safety in water at this age.
  7. Call the Poison Control Center if you suspect your child ate a poison: 800-222-1222. Do not administer syrup of ipecac until speaking with the Poison Control Center first.


  • Learn to deal with the rush of our community to push and accelerate our children’s curriculum and activities. Remember to make time to play with your child and show affection.
  • Continue to encourage household chores and expand the child’s role in the household. Teach your child the difference between activities that we do for ourselves (making one’s own bed, picking up after self) and chores that we do because we are part of a larger family community (bringing in the mail, taking out the trash, watering plants).
  • Masturbation is quite common as part of self-discovery and learning to associate genital stimulation with pleasant sensations. Masturbation is normal if it is private and not highly preferred over most other activities. Avoid shaming your child for masturbating. Rather inform him/her that it is a private act and that no one else should touch their private parts.

SCREEN TIME: Screen Time is any time spent in front of T.V., computer, tablets, or smart phones.

  • Television time and kind of programs watched should be carefully monitored. Violence on TV is linked to aggressive behavior.
  • There is a relationship between the amount of TV watched and a child’s weight. Limit TV to 1 hour daily.
  • Watch shows with your child and use them to stimulate topics of conversation. Discourage programs that are linked with toy sales.
  • Keep TV sets out of bedrooms.


Discipline at this age is challenging. We recommend that parents reprimand children for bad behavior in private, providing appropriate and clearly stated limits and consequences if rules are broken. Nagging and idle threats by parents are ineffective. Follow through with stated consequences when rules are broken. Social isolation (time out) remains an effective consequence for many children. The positive effects of praise are often more powerful behavior modifiers than negative reinforcement (such comments as “I really like it when you let your friends play with your toys,” or “thank you for waiting quietly while your father and I talked”).


Today we will complete vaccine series as needed. We will do a vision and hearing screen. If risk factors are present, we will do a PPD (Tuberculosis test), lead test, or cholesterol screen.


Setting Limits: How to Raise Responsible, Independent Children by Providing Clear Boundaries.
Robert MacKenzie.

NEXT VISIT: Your child’s next routine visit is at 6 years of age.

NEED SCHOOL FORMS? Don’t forget to drop off your health forms at the front desk or submit them after your check-up here.

*Edited by Dr. Emily Atwood on 5/6/21