This story is part three in a six-part series featuring Novant Health pediatricians helping parents navigate their child’s development and telling them what to look for at each stage, from birth to adulthood.

Children ages 4 and 5 often enjoy structure and routine and are beginning to really start to understand consequences, said Dr. Stephen Lods of Novant Health Pediatrics Lake Norman in Huntersville, North Carolina. For example, they generally know when they eat too much it may cause a tummy ache.

This developmental stage can be a welcome change for many parents on the heels of the “survival years” of the earlier stages of parenting. But Lods said it’s important for parents of preschoolers and kindergarteners to pay attention to habits their children are forming and the tone that they set as their kids go off to school.

“From a parenting standpoint, you just have to be calm and consistent,” Lods said. “Kids model behavior based on what they see, and if parents yell at them for doing something, they’re going to yell back. They’re social and starting to manage relationships and their personality is coming out and they’re developing individuality.”

Lods said there are three common topics parents of children ages 4 and 5 should raise when meeting with their pediatrician:

‘They shouldn’t set the menu’

“Your kid’s going to have some food choices, but they shouldn’t set the menu,” Lods said. “They don’t have to eat a whole plate of Brussels sprouts, but they need to at least have a willingness to try some healthy foods because their taste buds are going to change, and they may actually learn to like something that they didn’t early on.

“Most eating habits start at home and not every family is able to make dinner and sit down as a family every night, but it’s good to do what you can to encourage good eating habits for your child.”

Lods also recommends parents heed the American Academy of Pediatrics’ 5-2-1-0 program . That advises kids eat five servings of fruits or vegetables each day, limit recreational screen time to two hours or less and get an hour of physical activity. The zero encourages limiting sugar-sweetened drinks. “Kids need a good routine for each day,” he said.

Getting ready for school

“We do hearing/vision screens to make sure they’re ready for school in that way, and also there is some paperwork and vaccines to take care of to make sure your child is ready for kindergarten,” Lods said.

“Before kids go off to school, there’s a standard form in North Carolina , which we essentially fill out for parents, to try and get the kids ready for school. There’s usually booster shots that are given at the four-year visit. If kids haven’t gotten them at the four-year visit, they get them at the five-year visit. It’s just two shots and they combine a couple different ones in each one, but it’s typically required before they go to school unless there’s a religious or health-related exemption. The parent would also need to let the school know of any chronic illnesses and medicines that the child needs to take.”

Are there any safety tips to keep in mind?

“Car seats are an obvious one since the rules have changed a little bit over the years. Car seats are rear-facing until 2. My general guideline for 4- and 5-year-olds is I would leave them in a five-point harness car seat until they outgrow the weight limit for the seat (which should be listed on the seat) before moving them on to a booster seat,” Lods said.

“Then there are many other safety concerns that are good to discuss. Swimming is one of the things that kids aren’t learning like they used to. There are kids that grow up and don’t know how to swim and when they’re adults they fall off a boat and sink to the bottom. It’s good to teach them how to swim and float and go over water safety.”

Also, North Carolina law requires children under 16 to wear a helmet while riding bicycles. “It’s great to encourage these kinds of outdoor activities, too, because kids need physical activity as opposed to an excess of screen time.”

Lods said many parents could benefit from “Parenting the Strong-Willed Child” by Rex Forehand and Nicholas Long. He said the book can be a great resource for understanding the way children think and make decisions and that it will remain useful as the child ages.

Dr. Stephen Lods

Novant Health Pediatrics Lake Norman

10305 Hamptons Park Drive

Huntersville, NC 28078