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In the middle childhood years, your child will become more independent and peer relationships will become especially important. Be patient as your child may tend to think they no longer need adult care and supervision.

  • Your job as a parent is to offer healthy foods and allow your child a chance to choose them. Offer three healthy meals and 1- 2 snacks per day. Set a good example for your child. Eat together as a family if possible. Limit fast foods, junk foods, and sweets. Let your child help you shop and do simple meal preparation.
  • Limit milk to 16 – 24 ounces per day of lower fat milk (skim or 1% unless they are underweight). If your child is dairy intolerant or refuses to drink milk, offer other calcium rich substitutes (yogurt, cheese, calcium supplemented juices, soy milk, rice milk, etc.). The goal for this age is 1000 mg day of calcium. Encourage plenty of water and limit juice to less than 4 ounces per day.
  • Don’t get into power struggles with picky eaters. It is better to calmly keep offering a variety of healthy foods. A multivitamin and/or calcium supplement may be given to especially picky eaters.

It is important for children this age to have a regular bedtime routine. The average 9 –
10 year old sleeps 9 – 10 hours per day. Consult with us if your child is having trouble going to sleep or staying asleep.
Consult with us if your child is still bedwetting after age 8.

  • Motor skills and coordination are steadily improving at this age. We encourage regular physical activity with a goal of being active at least two hours a day. This is a wonderful age to play sports and we encourage children of this age to play a variety of sports.
  • Peer relationships and acceptance become increasingly more important for this age. Discuss peer pressure with your child and how to handle it. Children who feel good about themselves are more able to resist negative peer pressure and make better choices for themselves. Be on the lookout for bullying. Consult with us if your child seems to have problems making friends.
  • Signs of puberty may begin to appear. Prepare your child for these body changes. Answer your child’s questions about sex in a simple honest manner. If you are uncomfortable with this topic we can address it at their checkup. Discuss getting a first period (menses) with your daughter.


  • Many children ages 9 – 11 still need to be in a booster seat. Review the website for guidelines on when your child no longer needs a booster seat. Children 12 and under should be in the back seat. Be a good role model and buckle yourself in.
  • Use a bicycle helmet and protective gear for bicycling and roller blading. Teach the “rules of the road” when on foot or on bicycle. Use appropriate protective equipment for sports – mouth guards, cups, protective eye gear, etc.
  • In the summer months remember sun and mosquito protection.
  • Consider enrolling your child in swim classes if they are not comfortable swimmers. Review how and where to dive safely.
  • Never allow your child to play with fireworks, firecrackers or sparklers. Develop a fire escape plan for your home and practice it with your child.
  • If you have a gun, make sure guns and ammunition are kept locked in separate places. Discuss the dangers of guns with your child. Consider asking the parents of your child’s friends about gun safety in their houses.
  • Teach your children about stranger danger and privacy. Review with them how to call 911 if there is an emergency.

A Few Other Things

  • Brush teeth twice a day using a soft toothbrush and fluoridated toothpaste. See a dentist every six months. Flossing should now be done every day.
  • We recommend limiting TV and computer usage to less than 2 hours a day. Monitor what types of shows and games your child is watching and playing. Do not allow violent video games. Keep computers in public places so you can supervise what your child is accessing. Monitor social media use.
  • Encourage daily reading, at least twenty minutes a day. Continue to read out loud together.
  • Having your child do simple household chores is a great way to encourage independence and responsibility. Set clear rules and expectations and stick to them. Help your child to set his/her own goals and encourage him/her to think about skills and abilities he/she would like to have.

Immunizations and Blood Testing
At the 11-year checkup we recommend a Tetanus and Pertussis booster, Tdap and a Meningitis vaccine. We recommend an Influenza vaccine, generally given as a nasal spray at this age, in the winter months. We will check your child’s blood for cholesterol levels between 9 and 11. Let us know if there is a significant family history of high cholesterol.

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