6 YEAR OLD

Proactive in your child’s care.

Empowering families for over 50 years.

Please take the time to read through this material. We provide this information because

we see value in educating our patients.

Mansfield Office454 Chauncy StreetMansfield, MA 02048

(508) 339-9944

Westwood Office541 High Street

Westwood, MA 02090(781) 326-7700

www.wmpeds.com

6 Year Visit: Immunizations

Your child is due to receive the following immunizations at this visit:

NONE

We strongly recommend that all patients 6 months of age and older

receive an annual Influenza (flu) vaccine.

Please review the enclosed Vaccine Information Sheets (VISs) prior to

your visit for more information.

For our complete immunization schedule:

wmpeds.com/topic/immunization-schedule

Mansfield Office454 Chauncy StreetMansfield, MA 02048

(508) 339-9944

Westwood Office541 High Street

Westwood, MA 02090(781) 326-7700

www.wmpeds.com

VIDEOS

Let us help you be proactive and educated

in your child’s care!These following videos are just a few that we feel may help you and

your child at this specific age. Please view our website at

www.wmpeds.com for these and many more.

6 Year

Abdominal Pain

Ankle and Finger Injuries

Cuts and Lacerations: ‘To Stitch, or Not to Stitch?’

Sore Throats: ‘How to Perform a Strep Test’

Mansfield Office454 Chauncy StreetMansfield, MA 02048

(508) 339-9944

Westwood Office541 High Street

Westwood, MA 02090(781) 326-7700

www.wmpeds.com

Prevent Unnecessary ER VisitsIf you don’t need to call 911 – Please call us before you go to the ER!

Each year hundreds of ER visits and expensive co-pays for WMPEDS patients might be avoided with phone

consultation and office or home based treatment.

Save your family the trop and the cost.

Call us first, before you got to the ER.

LACERATIONS: Many cuts can be closed in our office without stitches using special glue for the skin

called “dermabond.”

CALL US FIRST -- to help assess your child’s laceration.

BELLY PAIN: Serious causes of abdominal pain exist but are rare. Many children with pain are in fact

constipated… even with a daily BM.

CALL US FIRST -- to discuss your child’s symptoms.

CROUP: A barking cough can often be calmed with steam, cold freezer or night air or a dose of

Orapred according to the “nighttime croup plan”.

CALL US FIRST -- to help decide which treatment your child needs.

FINGER, WRIST & ANKLE INJURIES: Lots of sprains and strains can be treated with RICE (Rest, Ice,

Compression and Elevation).

CALL US FIRST –- to help assess your child’s injury.

BUMPED HEADS: The majority of concussions do not need imaging and heal spontaneously over time

with physical and cognitive rest.CALL US FIRST -– to review your child’s symptoms.

FEVER: Fever helps the body fight infection and is rarely harmful. Refer to the “fever fear” manual for

evaluation and treatment guidelines.

CALL US FIRST -– to discuss when to schedule a visit.

EAR & THROAT PAIN: Both ear and throat pain is often soothed with ibuprofen. Most ear infections

resolve without antibiotics and home strep tests can help determine if your child needs an office visit.

CALL US FIRST -– to help assess your child’s pain.

Worried about waking up a doctor at night?

Don’t be! Nurse triage service is available 24/7 to discuss your child’s symptoms, to page a doctor when needed and

to help decide whether a trip to the ER is needed. We are happy to take your phone call.

Please visit www.wmpeds.com for educational videos and more information.

Mansfield Office454 Chauncy StreetMansfield, MA 02048

(508) 339-9944

Westwood Office541 High Street

Westwood, MA 02090(781) 326-7700

www.wmpeds.com

Caring for Your School-Age Child

Description

This comprehensive health reference and a complete guideto the complex developmental issues of the middle years

includes more than 100 illustrations and offers up-to-date

information on:

Charting your child's physical, emotional, social, and

intellectual growth

Dealing with the gender-specific issues facing boys and girls as theyapproach adolescence

Recognizing your child's important emotional and social issues, includingmaking friends, school behavior, sex education, self-esteem, and

attention deficit disorder

Maintaining discipline and authority while forging a respectful

relationship with your child

Handling divorce, stepfamilies, adoption, sibling rivalry, and dual-working-parent households

Combating procrastination, laziness, aggressiveness or shyness, and bed-wetting

Understanding your child's inborn temperament--and how it affects thechild-parent relationship

Treating childhood injuries and ailments--a comprehensive health guide

And much more

Caring for Your School-Age Child is an essential childcare resource for all parentswho want to provide the very best care for their children!

5 EAT MORE SERVINGS OF FRUIT AND VEGGIES Strive for 5 (or more) servings each day

A serving = 1 fruit or ½ cup of vegetablesVegetables are “free” foods and can be eaten whenever!

2 CUT DOWN ON TV AND SCREEN TIME Limit total screen time to under 2 hours dailyIncludes TV, video games, iPads, iPods and iPhonesKeep TVs and Internet out of the bedroom!

1 INCREASE YOUR PHYSICAL ACTIVITY TIME Get at least 1 hour of daily physical activity

Get up and play!

0 SKIP THE SUGARY DRINKS OR WHOLE MILKKeep soda, juice, and sports drinks minimalDrink 1% or skim milk instead of whole milkDrink more water!

cmch

Center on Media and Child Health at Children’s Hospital Boston

Visit the Center on Media and Child Health

Types of Media

TV & Movies Music

Video Games Print Media

Cell Phones

*More media types coming soon includinginternet and advertising

Media and Your Child

Infants & Toddlers Preteens

Preschoolers Teens

School Age Children

www.cmch.tv/mentors_parents/

cmch

Center on Media and Child Health at Children’s Hospital Boston

Center on Media and Child Health at www.cmch.tvto learn more about:

Types of Media

Print Media

*More media types coming soon including

Concerns about Media

Violence Fear

Overweight Sexual Behavior

Body Image

*More concerns coming soon including riskbehaviors and attention

Media and Your Child

Preteens

Teens

CMCH Tips for Media Use

Time Limits

Co-viewing

Media Literacy

Homework

www.cmch.tv/mentors_parents/

Center on Media and Child Health at Children’s Hospital Boston

www.cmch.tv

Concerns about Media

Fear

Sexual Behavior

*More concerns coming soon including riskbehaviors and attention

CMCH Tips for Media Use

Media Ratings

VCRs & DVRs

Modeling

2011

10

2

3

5

8

9

7

6

4

1 switch to fat-free or low-fat (1%) milk They have the same amount of calcium and other essential nutrients as whole milk, but fewer calories and less saturated fat.

make half your grains whole grains To eat more whole grains, substitute a whole-grain product for a refined product—such as eating whole-wheat bread instead of white bread or brown rice instead of white rice.

foods to eat less often Cut back on foods high in solid fats, added sugars, and salt. They include cakes, cookies, ice cream, candies, sweetened drinks, pizza, and fatty meats like ribs, sausages, bacon, and hot dogs. Use these foods as occasional treats, not everyday foods.

compare sodium in foods Use the Nutrition Facts label to choose lower sodium versions of foods like soup, bread, and frozen meals. Select canned foods labeled“low sodium,” ”reduced sodium,” or “no salt added.”

drink water instead of sugary drinks Cut calories by drinking water or unsweetened beverages. Soda, energy drinks, and sports drinks are a major source of added sugar, and calories, in American diets.

balance calories Find out how many calories YOU need for a day as a first step in managing your weight. Go to www.ChooseMyPlate.gov to find your calorie level. Being physically active also helps you balance calories.

enjoy your food, but eat less Take the time to fully enjoy your food as you eat it. Eating too fast or when your attention is elsewhere may lead to eating toomany calories. Pay attention to hunger and fullness cues before, during, and after meals. Use them to recognize when to eat and when you’ve had enough.

avoid oversized portions Use a smaller plate, bowl, and glass. Portion out foods before you eat. When eating out, choose a smaller size option, share a dish, or take home part of your meal.

foods to eat more often Eat more vegetables, fruits, whole grains, and fat-free or 1% milk and dairy products. These foods have the nutrients you need for health—including potassium, calcium, vitamin D, and fiber. Make them thebasis for meals and snacks.

make half your plate fruits and vegetables Choose red, orange, and dark-green vegetables like tomatoes, sweet potatoes, and broccoli, along with other vegetables for your meals. Add fruit to meals as part of main or side dishes or as dessert.

choose MyPlate10 tips to a great plate

Making food choices for a healthy lifestyle can be as simple as using these 10 Tips. Use the ideas in this list to balance your calories, to choose foods to eat more often, and to cut back on foods to eat less often.

DG TipSheet No. 1 June 2011 Center for Nutrition USDA is an equal opportunity Policy and Promotion provider and employer. Go to www.ChooseMyPlate.gov for more information.

10 tips

Nutrition Education Series

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Enjoy your

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food choices.

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food, but eat less.

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meals—and choose foods with lowernumbers.

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ChooseMyPlate.gov1 includes much of theconsumer and professional informationformerly found on MyPyramid.gov.

Also on the web Sample Menus for a Week

Food Group Based Recipes

Historical Development of FoodGuidance

Nutrition Communicators Network forPartners – Application Forms

All print-ready content

Did you know that injuries are the greatest threat to the life and health of your child? Injuries are the leading cause of death of school-aged children. Yet you can prevent most major injuries!

At age 6, your child will become more independent. He or she will be able to do more things that are dangerous. Your child will try to prove that he or she is grown up. But children still aren’t good at judging sound, distance, or the speed of a moving car at this age. Your child can learn a few simple things to do for protection, but you must still be in charge of his or her safety.

Fire SafetyMake an escape plan in case of fire in your home. Your fire department can tell you how. Teach your child what to do when the smoke alarm rings. Practice what you and your child would do if you had a fire.

Do not smoke in your home. Many home fires are caused by a lit cigarette that has not been put out completely.

Install smoke alarms in your house and test the batteries every month to make sure they work. Change the batteries once a year.

Firearm HazardsChildren in homes where guns are present are in more danger of being shot by themselves, their friends, or family members than of being injured by an intruder. It is best to keep all guns out of the home. Handguns are especially dangerous. If you choose to keep a gun, keep it unloaded and in a locked place separate from ammunition. Ask if the homes where your child visits or is cared for have guns and how they are stored.

Bike SafetyProtect your child from bad head injuries or even death. Make sure your child wears a helmet every time they ride a bike. Never let your child ride in the street. Your child is too young to ride in the street safely!

Street SafetyNever let your child play near the street. Your child may dart out into traffic without thinking. The park or playground is the best place to play. Begin to teach your child safe street habits. Teach your child to stop at the curb, then look to the left, to the right, and back to the left again. Teach your child never to cross the street without a grown-up.

6Ye

ars

6 YEARSSafety for Your Child

(over)

And Remember Car SafetyYour child must now use a booster seat in the car. Always check to be sure that he or she is correctlyrestrained in the booster seat before you start the car. Your child should use a booster seat until the lap belt can be worn low and flat on the hips and the shoulder belt can be worn across the shoulder rather than the face or neck (usually at about 80 pounds and 4 feet 9 inches tall). The safest place for all children, even through school age, is in the back seat of the car. Set a good example. Make sure you and other adults buckle up, too!

SAFETY IN A KID’S WORLDDear Parent: Your child is old enough to learn how to prevent injuries. The game below is designed to help your child think about safety. Read the messages with your child and talk about them together. Then take this safety sheet home and post it where everyone can see it.

It takes time to form a safety habit. Remind each other what it says. Make safety a big part of your lives.

Bike SafetyAlways wear a

when you ride your

Get the HelmetHabit!

Directions: Find yourway through this maze.Connect the helmet withthe bicycle.

Revised-0801HE0064-B

3-53/rep0505TIPP®—The Injury Prevention Program © 1994 American Academy of Pediatrics

The information in this publication should not be used as a substitute for the medical care andadvice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on the individual facts and circumstances.

From Your Doctor

1

Being physically active is one of the most important steps to being healthy. Families play an important role in helping youth learn to be active and stay active throughout their lives.

How Does Physical Activity Help?Builds strong bones and muscles.1

Decreases the likelihood of developing obesity and risk factors for diseases like type 2 diabetes and heart disease.1

May reduce anxiety and depression and promote positive mental health.1

How Much Physical Activity Do Youth Need?

How Physically Active Are Youth?Among 9th–12th grade students, only 11% of girls and 24% of boys said they were physically active at least 60 minutes per day.3Among 9–13 year olds, only 39% said they participated in organized physical activity.4

In 2007, only 30% of 9th–12th grade students said they attended physical education classes every day.5

In 1969, 41% of students walked or biked to school. By 2001, only 13% of students walked or biked to school.6

Among 9th–12th grade students, 35% reported watching 3 or more hours of television per day.5

Is My Child’s Aerobic Activity Moderate or Vigorous?When your child does moderate-intensity activity, his heart will beat faster than normal and he will breathe harder than normal. On a scale of 0 to 10, where sitting is a 0 and 10 is the highest level of effort possible, moderate-intensity activity is a 5 or 6.

Examples of moderate-intensity activities include brisk walking, hiking, rollerblading, skateboarding, bicycle riding, baseball and softball.

2

When your child does vigorous-intensity activity, her heart will beat much faster than normal and she will breathe much harder than normal. On a scale of 0 to 10, vigorous-intensity activity is a 7 or 8.

games that involve running.

What Kinds of Activities Are Appropriate for My Child?It is important for youth to participate in activities that are safe and good for their growth and development. Younger children like to move between short bursts of activity followed by short periods of rest. Adolescents do more structured and longer activities than younger children. For example:

For aerobic physical activity, younger children like to run, jump, or play tag for short periods of time and then take a break. Adolescents can run for longer periods of time.For muscle strengthening activity, younger children enjoy active play such as gymnastics, playing on a jungle gym or climbing a tree. Adolescents may start a structured weight-lifting program.

What Can Families Do To Get and Keep Their Children Active?Youth learn a lot about physical activity from their families. Family members who enjoy physical activity can help children enjoy physical activity. Caregivers play a very important role in determining youth participation in physical activities—how much, how often, and what type of physical activity. Caregivers can also help youth balance non-active time periods (watching TV, using the computer, or talking on the phone) and physical activity.

Lead an active lifestyle yourself.Make family time physical activity time.

Build physical activity into your family’s daily routine. Take a walk after dinner together or do housework or yard work together.

courts to be active.Attend family nights or other physical activity events at your child’s school or local community centers.Be active whenever possible. Walk or ride bikes to school or the bus stop instead of riding in a car. Parents of young children can enjoy the walk or bike ride, too.Include physical activity breaks in events such as long car trips, vacations, or visits to relatives or friends. Bring along beach balls, kites, jump ropes, or other items that can be used for active play.

Instead of watching television or playing video games, encourage your children to be active with their friends by playing tag, basketball, or by riding bikes.Give your children toys that encourage physical activity like balls, kites, and jump ropes.Make special events physical activity events, such as activity-based birthday parties or other group celebrations.Encourage your children to join a sports team or try a new physical activity.

Help youth participate in team or individual sports, as well as in noncompetitive activities such as bicycling, hiking, jogging, and swimming.Be positive about the physical activities your children engage in and encourage their interest in new activities.Help children be physically active by taking them to and from activities and events or

Encourage children to talk about how physical activity makes them feel and how much fun they have when they are active.

3

Where Can I Find Additional Information About Youth Physical Activity?U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services; 2008. Available at: http://www.health.gov/paguidelines.Centers for Disease Control and Prevention. Healthy Youth! Physical Activity. Available at: http://www.cdc.gov/HealthyYouth/physicalactivity/.Centers for Disease Control and Prevention. Making Physical Activity a Part of a Child’s Life. Available at: http://www.cdc.gov/physicalactivity/everyone/getactive/children.html.Alliance for a Healthier Generation. Good Health Starts at Home. Available at: http://www.healthiergeneration.org/uploadedFiles/For_Parents/ParentResourceBook.pdf.National Association for Sport and Physical Education. Teacher Toolbox, Physical Activity Calendars. Available at: http://iweb.aahperd.org/naspe/template.cfm?template=teachers_toolbox.html

VACCINE INFORMATION STATEMENT

Influenza VaccineWhat You Need to Know

(Flu Vaccine, Inactivated)

2013-2014

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis

Hojas de información sobre vacunas están disponibles en español y en muchos otros idiomas. Visite www.immunize.org/vis

1 Why get vaccinated?Influenza (“flu”) is a contagious disease that spreads around the United States every winter, usually between October and May. Flu is caused by the influenza virus, and can be spread by coughing, sneezing, and close contact.Anyone can get flu, but the risk of getting flu is highest among children. Symptoms come on suddenly and may last several days. They can include:• fever/chills• sore throat• muscle aches• fatigue• cough• headache• runny or stuffy noseFlu can make some people much sicker than others. These people include young children, people 65 and older, pregnant women, and people with certain health conditions—such as heart, lung or kidney disease, or a weakened immune system. Flu vaccine is especially important for these people, and anyone in close contact with them.Flu can also lead to pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. Each year thousands of people in the United States die from flu, and many more are hospitalized. Flu vaccine is the best protection we have from flu and its complications. Flu vaccine also helps prevent spreading flu from person to person.

2 Inactivated flu vaccineThere are two types of influenza vaccine: You are getting an inactivated flu vaccine, which does not contain any live influenza virus. It is given by injection with a needle, and often called the “flu shot.”A different, live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement.

Flu vaccine is recommended every year. Children 6 months through 8 years of age should get two doses the first year they get vaccinated.Flu viruses are always changing. Each year’s flu vaccine is made to protect from viruses that are most likely to cause disease that year. While flu vaccine cannot prevent all cases of flu, it is our best defense against the disease. Inactivated flu vaccine protects against 3 or 4 different influenza viruses.It takes about 2 weeks for protection to develop after the vaccination, and protection lasts several months to a year.Some illnesses that are not caused by influenza virus are often mistaken for flu. Flu vaccine will not prevent these illnesses. It can only prevent influenza.A “high-dose” flu vaccine is available for people 65 years of age and older. The person giving you the vaccine can tell you more about it.Some inactivated flu vaccine contains a very small amount of a mercury-based preservative called thimerosal. Studies have shown that thimerosal in vaccines is not harmful, but flu vaccines that do not contain a preservative are available.

3 Some people should not get this vaccine

Tell the person who gives you the vaccine:• If you have any severe (life-threatening) allergies. If

you ever had a life-threatening allergic reaction after a dose of flu vaccine, or have a severe allergy to any part of this vaccine, you may be advised not to get a dose. Most, but not all, types of flu vaccine contain a small amount of egg.

• If you ever had Guillain-Barré Syndrome (a severeparalyzing illness, also called GBS). Some peoplewith a history of GBS should not get this vaccine. Thisshould be discussed with your doctor.

• If you are not feeling well. They might suggestwaiting until you feel better. But you should comeback.

4 Risks of a vaccine reactionWith a vaccine, like any medicine, there is a chance of side effects. These are usually mild and go away on their own.Serious side effects are also possible, but are very rare. Inactivated flu vaccine does not contain live flu virus, so getting flu from this vaccine is not possible. Brief fainting spells and related symptoms (such as jerking movements) can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries caused by falls. Tell your doctor if you feel dizzy or light-headed, or have vision changes or ringing in the ears.Mild problems following inactivated flu vaccine: • soreness, redness, or swelling where the shot was

given • hoarseness; sore, red or itchy eyes; cough• fever• aches• headache• itching• fatigueIf these problems occur, they usually begin soon after the shot and last 1 or 2 days. Moderate problems following inactivated flu vaccine:• Young children who get inactivated flu vaccine and

pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure.

Severe problems following inactivated flu vaccine:• A severe allergic reaction could occur after any

vaccine (estimated less than 1 in a million doses). • There is a small possibility that inactivated flu vaccine

could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.

The safety of vaccines is always being monitored. For more information, visit: www.cdc.gov/vaccinesafety/

5 What if there is a serious reaction?

What should I look for?• Look for anything that concerns you, such as signs of

a severe allergic reaction, very high fever, or behavior changes.

Signs of a severe allergic reaction can include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness. These would start a few minutes to a few hours after the vaccination.

What should I do?• If you think it is a severe allergic reaction or other

emergency that can’t wait, call 9-1-1 or get the person to the nearest hospital. Otherwise, call your doctor.

• Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your doctor might file this report, or you can do it yourself through the VAERS web site at www.vaers.hhs.gov, or by calling 1-800-822-7967.

VAERS is only for reporting reactions. They do not give medical advice.

6 The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program (VICP) is a federal program that was created to compensate people who may have been injured by certain vaccines.Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382 or visiting the VICP website at www.hrsa.gov/vaccinecompensation.

7 How can I learn more?• Ask your doctor.• Call your local or state health department.• Contact the Centers for Disease Control and

Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) or - Visit CDC’s website at www.cdc.gov/flu

Vaccine Information Statement (Interim) Inactivated Influenza Vaccine

42 U.S.C. § 300aa-26

07/26/2013Office Use Only