5 Year Well Visit: Information for Parents & Caregivers

• Take time for yourself and to be with your partner.

• Stay connected to friends, your personal interests, and work.

• Have regular playtimes and mealtimes together as a family.

• Give your child hugs. Show your child how much you love them.

• Show your child how to handle anger well, have time alone, talk respectfully, and participate in activities.

• Stop hitting, biting, and fighting right away.

• Help your child deal with conflict.

• Help your child do things for themself.

• Model Good Behavior. Young children love to imitate their parents/caretakers.

• Don’t smoke or use e-cigarettes. Keep your home and car smoke-free.

• Don’t use alcohol or drugs.

• If you’re worried about a family member’s use of alcohol or drugs, let us know, or reach out to local or online resources that can help.

• If you are worried about your living or food situation, talk with us. Community agencies and programs such as WIC and SNAP can also provide information and assistance.

• Children at this age are imaginative, get along well with friends their own age, and have lots of energy.

• They can tell what’s real and what’s make-believe and are more likely to agree with rules and be more independent.

• They speak clearly and can tell a simple story using full sentences, and can say their name and address.

• Five-year-olds are able to dress and undress themselves, understand rules in a game, and brush their own teeth.

• They can copy a cross and print some letters or numbers. They can hop, swing and climb, and can use the toilet on their own.

• Some children still wet the bed at night.

• Use correct terms for all body parts and teach your child how to be safe with other adults.

• CDC’s Milestone Tracker is a useful app (iOS and Android and on the web) to read about stages of your child’s development, for ages 2 months to 5 years.  

• FREE behavioral and developmental assessments are available.

  • San Diego County residents through the First 5 Programs (888) 534-7785 or First5sandiego.org.

  • Southern Riverside residents through the Healthy Steps Programs (858) 966-8300 or  Healthysteps.org.

  • Riverside and San Bernardino Counties are also served by Inland Regional Center (909) 890-4763 or https://www.inlandrc.org/.

• Family routines create a sense of safety and security for your child.

• Teach your child what is right and what is wrong.

• Give your child chores to do and expect them to be done.

• The most powerful way to reinforce good behavior is attention.

• Listen to and treat your child with respect.

• Don’t spank, hit, slap, threaten, insult, humiliate or shame to correct your child’s behavior.

• Fear, pain or distress make learning harder for your child and do not help children feel loved, safe and respected in their family.

• Talk about choices in difficult situations, what are the good and bad options, and what might come next depending on how they decide to act.

• At 5 years of children have a better understanding of family rules.

• They can be expected to follow simple, age-appropriate rules.

• Encourage internalization of family rules by asking about them.  

  • If your child asks for more computer time when his time is already done, ask him:

    • “How much time do you get each day?”

    • “How much time have you had today?”

    • “When can you have more time?”  

• If your child expresses frustration or disagreement about the rule, acknowledge their feelings and offer empathy while staying committed to the rule.

  • I know you love your computer time, and it is hard… You’ll have more time tomorrow”.

• Model calm behavior for your child.

• Decide on some acceptable ways of expressing feelings in your family.

• Healthy ways to express your feelings can include walking around the room a few times or taking a deep breath.

• Create a “calming space” where anyone in the family can go to take a break and cope with big feelings.  

• Make the consequences as logical as possible.  

  • For example, if your child uses a toy in a way that is not allowed, the toy is removed for a period of time.

Mealtimes should be a pleasant time for the family.

• Eat together as a family.  

• Have your child help plan, prepare, set up and serve food.

• Have designated areas of eating.

• Don’t eat in the car, in front of the TV or while using electronic devices.

• Let your child decide how much to eat. If they eat less at a meal, they will make it up at another meal. Model healthy eating.

• Think “5210” Every Day!

  • 5 or more servings of fruits & vegetables

  • 2 hours or less recreational screen time

  • 1 hour or more of physical activity

  • 0 sugary drinks. Give more water & low-fat milk

Important Vitamins and Nutrients

• Calcium: Builds strong bones. Calcium is commonly found in dairy products, sardines, broccoli, kale, and enriched orange juice.

• Vitamin D: Helps keep bones strong and supports many bodily functions. Most children’s multivitamins will contain the recommended 600 IU per day.  Vitamin D is found in milk, yogurt, cheese, salmon, tuna, mushrooms, egg yolk, and fortified cereals.

• Iron: Helps keep blood and growth and development healthy. Iron is found in eggs, chicken, leafy greens, red meat, beans, and fortified grains like breads and cereals.

Food Assistance

• 2-1-1 is an organization that helps families connect with food assistance programs such as CalFresh, local and regional food banks, emergency food services, Women Infant Children (WIC) program and more. Contact them at 211sandiego.org/resources/food-assistance/ OR dial 2-1-1 from any phone.

• Some families may qualify for assistance in purchasing food for children up to age 5. For more information on the WIC program, please ask your doctor or contact WIC directly

• WIC San Diego http://sandiegowic.org/ 1-800-500-6411

• WIC Riverside https://www.ruhealth.org/wic 1-800-472-2321

• Read daily to your child.  

• Use books to talk together. Ask your child questions about the story or pictures.

• Let them “tell” the story.

• Limit daily screen time to less than 2 hours total.

• Turn off screens at least 1 hour before bedtime to help with better sleep.

• Limit or reduce media exposure (including playing with electronic toys).

• Give high-quality programming and always avoid violent content.

• Good alternatives to TV are reading, hobbies and physical activities.

• Do not have electronic media in your child’s bedroom- this includes a TV, DVD player, video game, computer, and cell phone. Young children love to imitate their parents/caretakers.

• Waituntil8th (https://www.waituntil8th.org/digital-training): details a growing movement centered around delaying permission of personal smartphone use for a child until 8th grade. This movement has a strong backing by child psychologists and parents nationwide. Please speak to your child's doctor about why this may be important for your child.

• Consider making a family media plan. It helps you make rules for media use and balance screen time with other activities, including exercise.

Help your child get ready for school.

• Talk to your child about school.

• Read books with your child about starting school.

• Take your child to see the school and meet the teacher.

• Create bedtime routines so they get 10 to 11 hours of sleep.

• Offer them a healthy breakfast every morning.

• Attend back-to-school night, parent-teacher events, and as many other school events as possible.

• Talk with your child and child’s teacher about bullies.

• Talk with your child’s teacher if you think your child might need extra help or tutoring.

• Make sure your child goes to a safe place after school.

• If your child has disabilities or special health care needs, be active in the Individualized Education Program process.

• Praise your child for doing things well at school.

• Set a routine and make a quiet place for doing homework.

• Children younger than 6 years need 3 hours of activity every day.

• Supervise all outdoor play, especially near streets and driveways.

• Help your child build lifelong habits for staying active, enjoying recreation, and learning healthy ways to compete.

• Support trying different activities instead of focusing on just one sport.

• Create opportunities for daily play.

• Praise your child for being active.

• Sleep is important to your child’s overall health, especially for his immune health,behaviors, focusing, and mental health.

• Your child needs about 10-13 hours (including naps) in a 24 hour period.

• Keep regular bedtimes as much as possible including on weekends and holidays.

• Bedtime routines should be consistent and easy to follow.

• Keep the sleep area safe and conducive to sleep, avoiding clutter, keeping lights dim and free from electronic media (especially no television in the bedroom).

• Avoid any screen time within 60 minutes of bedtime.

• Brush your child’s teeth twice per day with a soft bristled toothbrush and a small amount of fluoridated toothpaste.

• Flossing every day is recommended

• If your child sucks their thumb, ask their doctor or dentist for advice on how to help them stop.

• Schedule regular visits with your child’s dentist.

• Limit how much sweet and sugary foods and drinks your child gets.

• Your child’s permanent (“adult”) teeth might have already started coming in. These teeth have grooves on them that make them more likely to get cavities

• Fluoride helps protect teeth from developing cavities.

• The American Academy of Pediatrics recommends applying fluoride varnish to kids' teeth every 3-6 months, starting when they get their first tooth until they are 5 years old. Fluoride Varnish Information.

• To find eligible Medi-Cal dental clinics near you: Call 1-800-322-6384 or visit Medi-Cal Dental

Strangers

• Teach your child the first and last names of family members.

• 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.

• Use correct terms for all body parts as your child becomes interested in how boys and girls differ.

• Teach your child that no adult should tell a child to keep secrets from parents.

• No adult should show interest in private parts.

• No adult should ask a child for help with private parts.

• If you feel unsafe in your home or have been hurt by someone, let us know. Hotlines and community agencies can also provide confidential help.

Car Safety

• Continue to use a car safety seat.

• Everyone should buckle up with both lap and shoulder belt on every trip.

• Children should remain in a forward-facing car safety seat up to that seats weight and length limits.  

• Children should use a belt-positioning booster seat typically until 8 years old and 4 feet 9 inches (144.8 cm) tall.

• Never put your child in the front seat if your car has an airbag.

• All children should ride in the back seat until age 13 years. Never hold a child on your lap while riding in the car.

Fires and Burn

• Check your smoke detector to make sure it is working.

• Keep a fire extinguisher in or near the kitchen.

• Practice a fire escape plan.

• Keep all electrical appliances out of the bathroom or out of reach, especially hair straightening and curling irons.

• Turn your water heater down to 120°F (50°C).

Falls

• Make sure windows are closed or have screens that cannot be pushed out.

• Do not allow your child to climb on ladders, chairs, or cabinets.

• Lock doors to dangerous areas like the basement or garage.

• Make sure drawers, all furniture, televisions and lamps are anchored to the wall when possible and can't fall over.

Pedestrian and Bicycle Safety

• Always supervise street crossing. Your child may start to look in both directions .

• Teach him to always stop at the curb and never cross the street without a grown up.

• Your child and all family members should use a bicycle helmet, even when riding a tricycle.

• Purchase a bicycle that fits your child well. Don't buy a bicycle that is too big for your child.

• Your child’s first bicycle should have coaster brakes, hand brakes may be too difficult to use correctly at this age.

Water Safety and Sun Protection

• Watch your child constantly when they are around the bathtub, jacuzzi, pool or any other body of water outside the house.

• Supervise your child around any water (pool, lake, stream or ocean).  

• Even if your child knows how to swim, NEVER let him swim alone.

• Teach your child never to dive in the water unless an adult has checked the depth of the water.

• Be sure the swimming pool in your home, apartment complex or community has a surrounding fence and self closing and self latching gate.

• Protect your child from the sun with clothing, a hat, other covering, and sunscreen of 15 SPF or higher.  

Poisonings

• Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away.

• Pay special attention to laundry pods and dishwasher pods- these are brightly colored and very dangerous if ingested.

• Never present medications/vitamins as “candy” to young children.

• Keep the poison center number on all phones 1-800-222-1222 or 9-1-1.

• Even small amounts of lead can hurt your child's health and brain development.

• Take away toys and jewelry that could have lead.

• Look up recalls on a website called Consumer Product Safety Commission.

Firearm Safety

• Remove guns from the home.

• If you do have a gun, store it unloaded and in a locked cabinet.

• Store ammunition in a separate location.

• Immunizations protect your child against serious, life-threatening diseases.

• The vaccines recommended for school entry are:

  • DTaP (Diphtheria, Tetanus, acellular Pertussis)

  • IPV (Inactivated Polio Vaccine)

  • MMR (Measles Mumps Rubella)

  • Varicella (Chickenpox)

• It is safe for your child to be given all recommended vaccines according to the schedule published by the American Academy of Pediatrics.

• Vaccines are safe and effective, and proven to save lives.

• If you have concerns about vaccines, please talk to your child’s primary healthcare provider for accurate information.

• Learn more about recommended immunizations from the American Academy of Pediatrics.

• Common side effects from vaccines

  • Fever - can be treated with acetaminophen or ibuprofen.

  • Soreness - can be treated with ibuprofen or cool compress.

  • Swelling at injection site - can be treated with cool compress.

• For more details, visit the Immunizations section on Health Hub.

Your child’s next visit should be at 6 years of age.  

We will talk about:

• Taking care of your child, your family, and yourself

• Creating family routines

• Behavior and Discipline

• Preparing for school

• Keeping your child’s teeth healthy, eating healthy foods, and staying active

• Keeping your child safe at home, outside, and in the car