Anticipatory guidance 5-year-old well-child visit

Growth & Development: Growth from now until puberty varies for every child. Typically, your child will grow an average of 2.4 to 2.8 inches per year and gain 6.5 to 7.5 pounds per year, often in spurts (“growth spurts”) (Garzon et al., 2025). Developmentally your five-year-old should be able to tell stories in multiple sentences, answer basic questions about themselves, tie knots, get dressed independently, and hold a pencil correctly. Socially your child will be developing friendships and may want to spend more time outside of home. They should be able to get along with other children and follow directions (American Academy of Pediatrics, 2023).

Nutrition: Today we discussed your child’s growth percentage in comparison to others of the same age. A healthy five-year-old should be eating three meals a day with snacks as needed. Meals and snacks should have a variety from all of the food groups (fruits, vegetables, grains, protein foods, and dairy or fortified soy alternatives), and go-to drinks should be low-fat or fat-free milk and water (U. S. Department of Agriculture, 2022). Avoid offering sugary foods and drinks such as candy and soda as snacks and avoid the use of foods as rewards (Pries et al., 2019).

Sleep: Your child should get 10-13 hours of sleep per day including bedtime sleep and naps. About 30% of children still nap at this age but you may notice they start getting shorter or they stop altogether (Suni & Vyas, 2024). If your child has trouble falling asleep make sure their bedroom environment is peaceful, quiet, and comfortable (Suni & Vyas, 2024). Limit electronics and TV an hour before bed, establish a bedtime routine, and ensure your child is being active during the day (Garzon et al., 2025).

Safety: Start teaching your child emergency information (their full name, parents/caregivers full name, home address, contact number, 911 and when to use) (Garzon et al, 2025).  Important safety points for your child include water safety (life jackets, swimming lessons, and constant supervision around ANY bodies of water), street safety (looking both ways before crossing, only crossing with an adult), car seat safety (at five years old your child should still be in a 5- point harness, look at your car seats height and weight limitations), and personal safety (stranger danger, inappropriate touching from others, being comfortable telling you when someone makes them feel unsafe or in danger), keeping firearms unloaded, locked, and stored away from ammunition (American Academy of Pediatrics, 2023a). If your child begins playing any sports or using anything with wheels make sure they are using the correct protective equipment (pads, helmet, mouth guard, etc.) (Garzon et al, 2025).

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