Your Child At 5 Years Old

Your five year old continues to grow and mature.  He or she can jump, tie shoes, print his or her first name, ask what the meaning is, follow rules of games, and enjoy helping in household tasks.  A five year old can also tell a story and begin to understand right from wrong and fair and unfair.

Depending on the time of year your child reaches five, you will be thinking about kindergarten.  All of the public school districts hold kindergarten readiness evaluations in springtime.  These evaluations can be helpful in making your decision of when to start kindergarten.  This evaluation will also screen for speech, hearing or vision problems.  This is an age when nearsightedness may begin.  Be on the alert for failing distance vision or squinting.

Continue to answer questions about sex frankly.  Answer only the question your child asks you.  When discussing the sex organs, treat them just as another organ in the body.  Continue to instruct caution with strangers.

Don’t forget to continue regular dental check-ups.

Caring for Your 5 Year Old

As in the past, continue to monitor your child’s diet and encourage good dietary habits. (By the way, practice what we preach.)  If there are heart attacks or strokes in family members under age fifty or you are a parent with cholesterol above 250, we may need to check cholesterol in your child. In addition, continue to keep safety in mind. 

• Talk to your child about strangers and safety while crossing the street or walking in parking lots.
• Teach your child what to do in case of fire.  Have a family plan and practice with a home fire drill.
• Lock up tools, guns, matches and poisonous chemicals.
• Use an approved booster car seat.
• When riding bikes, require the use of a helmet 100% of the time.
• If your child has an interest in roller blades, remember to use a helmet, wrist guards, and knee and elbow pads.
• Use sunscreen SPF 15 or 30 and insect repellant when outdoors.

Immunizations:

The immunizations your child may receive at this age have been discussed.  By now you have read the information about them that we have supplied you.  Most children do not have a reaction to these immunizations.  If there is a reaction, most likely it is a slight fever or fussiness.  You may give your child Tylenol or other acetaminophen products for these symptoms.  If you feel the Tylenol has not helped or you are concerned about other symptoms let us know.  If your child’s temperature exceeds 102 degrees F. orally, let us know.

Your Next Appointment:

Your child’s next physical appointment will be at 6 years.  
  

Sore Throat (Pharyngitis)

Definition

• The child complains of a sore throat.
• In children too young to talk, a sore throat may be suspected if they refuse to eat or begin to cry during feeding.
• When examined with a light, the throat is bright red.

Cause
Most sore throats are caused by viruses and are part of a cold.  About 10% of sore throats are due to the strep bacteria.  A throat culture or rapid strep test is the only way to distinguish strep pharyngitis form viral pharyngitis.  Without treatment, a strep throat can have some rare but serious complications.  Tonsillitis (temporary swelling and redness of the tonsils) is usually present with any throat infection, viral or bacterial.  The presence of tonsillitis does not have any special meaning. Children who sleep with their mouths open often wake in the morning with a dry mouth and sore throat.  It clears within an hour of having something to drink.  Use a humidifier to help prevent this problem.  Children with postnasal drip from draining sinuses often have a sore throat from frequent throat clearing.

Expected Courses
Sore throats with viral illnesses usually last 3 or 4 days.  Strep throat responds well to penicillin.  After taking the medication for 24 hours, your child is no longer contagious and can return to day care or school if the fever is gone and he or she is feeling better.

Home Care

• Local Pain Relief - Children over 8 years of age can gargle with warm salt water (1/4 teaspoon of salt per glass).  Children over 4 years of age can suck on hard candy (butterscotch seems to be a soothing flavor) or lollipops as often as necessary.  Children over age 1 can sip warm chicken broth or warm apple juice. 
• Soft Diet- Swollen tonsils can make some foods hard to swallow.  Provide your child with a soft diet for a few days if he or she prefers it.
• Fever -Acetaminophen or ibuprofen may be given for a few days if your child has a fever over 102ºF (39ºC) or a great deal of throat discomfort. 

Common Mistakes in Treating Sore Throat

• Avoid expensive throat sprays or throat lozenges.  Not only are they no more effective than hard candy, but they also may contain an ingredient (benzocaine) that may cause a drug reaction.
• Avoid using leftover antibiotics from siblings or friends.  These should be thrown out because they deteriorate faster than other drugs.  They have no effect on viruses, and they can cause harm.  They also make it difficult to find out what is wrong if your child becomes sicker.
• Rapid Strep Tests are helpful only when their results are positive.  If they are negative, a throat culture should be performed to pick up the 20% of strep infections that the rapid tests miss.    Avoid rapid strep tests performed in shopping malls or at home because they tend to be inaccurate.

Call our Office Immediately if:

• Your child is drooling, spitting, or having great difficulty in swallowing.
• Breathing becomes difficult.
• Your child is acting very sick.
• Your child’s neck is stiff. 

Call our Office During Regular Hours:

• If your child has had a sore throat for more than 24 hours, make an appointment to determine whether a throat culture is necessary.
• If the sore throat is very mild and the main symptom is croup, hoarseness, or a cough, a throat culture may not be needed.  Throat cultures are recommended for all other sore throats because of a resurgence of acute rheumatic fever that began in 1987.  Rheumatic fever is a complication of strep infections that can lead to permanent damage to the valves of the heart.
• If a fever lasts more than 3 days.
• If you have other questions or concerns.

Instructions for Pediatric Patients, 2nd edition, 1999 by WB Saunders Company.  Written by Barton Schmitt, M.D., pediatrician.