Well Child Care at 11 and 12 Years

Nutrition

Nutrition is very important for children at this age. They are growing rapidly and growing more independent.

The best way to get your children to eat well is to be a role model and to get them involved in meal planning. Pre-teens tend to have too much fat, cholesterol, salt and sugar in their diets. Make sure that you purchase and enjoy plenty of fruits, vegetables and calcium-rich foods. Iron-rich foods (especially meats, nuts, soy and iron-enriched cereals) are important, especially for menstruating girls. Children often gain too much weight from overeating high-calorie snacks and fast foods, drinking too much soda and juice, and not getting enough exercise. Your healthcare provider should check your child's weight at least once per year.

Ask your child for their thoughts on the best way to prepare foods, how they perceive their body, and the amount of activity they need for good health. Have open-ended conversations about the habits that lead to gaining too much weight such as not enough exercise, skipping meals, drinking too many soft drinks, or eating a lot of fast food. Ask your child about when they eat, overeat, or crave certain foods. If your pre-teen is eating when not hungry, encourage them to do something else such as exercising, reading, or working on a project to stop thinking about food.

Development

Most girls and some boys are well into the rapid physical growth of adolescence. Ask your healthcare provider if you have specific questions about your child's physical and emotional changes as he or she matures.

School achievement is very important at this age. Pre-teens should take responsibility for completing their homework and achieving goals. Each child has different skills and limitations, however. Stay involved with your child's schoolwork, and be a cheerleader, rewarding efforts and achievements with praise.

Pre-teens have many questions about sex and need the facts. They need to learn about menstrual periods, erections, wet dreams, sexual intercourse, and relationships. Many families and many doctors begin to talk to 11 and 12 year olds about sex before girls get their first menstrual period or boys get their first wet dream, so they will know that these events are normal. If you are not comfortable talking with your child, ask your healthcare provider for help.

It is also important to teach your child that sex should involve human feelings, such as commitment, belonging, self-esteem, and love. They need your advice.

Behavior Control

Parents play an important role in the life of a pre-teen. Despite the attention given to popular culture heroes, role-modeling by parents is very important. Involvement by adults of both genders is best.

At this age, peer pressure can be hard to resist. Watch for signs of change in your child's normal behavior, particularly behaviors that go against the family's value system. To help prevent problems, try to get to know your child's friends and their parents. Children who are most successful at resisting negative peer pressure are those with a strong self concept who have the confidence to say "No." Talk with your child about drugs, alcohol, and tobacco. Discuss with your pre-teen how to make good choices in the company of friends. Use your praise and attention when they do the right thing. Catch them being good.

Reading and Electronic Media

Pre-teens can get bored with simple characters or predictable stories. They are capable of more complex thought and are able to put themselves in another's place. They can appreciate books that highlight different points of view. Reading can inspire courage, compassion, and commitment. Talk with your child at every opportunity about the books your child is reading, and what they think about what they read.

Encourage your child to participate in family games and outdoor activities. Limit "screen" time (TV, electronic games, computers) to no more than 1 to 2 hours per day. Watch some programs with your pre-teen and discuss the program. Television, electronic games, and computers in your child's bedroom are strongly discouraged. Television in the bedroom is associated with increases in body weight. To reinforce this, fairness is advisable. No one in the home should have these items in the bedroom.

Dental Care

Except for the 3rd molars (wisdom teeth), most pre-teens have all their permanent teeth. Emphasize regular toothbrushing. Make sure your child sees the dentist regularly.

Safety Tips

Accidents are the number one cause of deaths in children. Children like to take risks at this age but are not well prepared to judge the degree of those risks. Therefore, children still need supervision. Parents should model safe choices.

Car Safety

• Always wear safety belts.

Bicycle Safety

• Make sure your child always uses a bicycle helmet. You can set a good example by always wearing a helmet.
• Teach your child about riding a bicycle on busy streets.
• Purchase a bicycle that fits your child well. Don't buy a bicycle that is too big for your child. Bikes that are too big are associated with a great risk of accidents.
• Don’t allow your child to ride an all-terrain vehicle (ATV).

Strangers

• Discuss safety outside the home with your child.
• Make sure your child knows her address and phone number and her parents' place(s) of work.
• Teach your child never to go anywhere with a stranger.

Smoking

Most smokers started smoking as teens. Children at this age may be trying to find a way to fit in with a group of friends, or think it is a fun activity at parties. They may be curious about what it is like. They may think it will help them relax. They may do it as a way to rebel against parents. Pre-teens and teens are often not concerned with health problems later in life. It may be more helpful to emphasize the negatives that your child can see and feel now:

• Cigarettes do not smell good. The smell will get into your child's clothes, room, hair, and breath.
• Smokers should smoke outside (even when it is cold) away from other people. Smokers cannot participate in certain events because they smoke.
• Cigarettes cost a lot of money. An average smoker spends at least $1600 to $2000 a year on cigarettes. Your child can probably think of many other things to spend his or her money on.
• If you smoke, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.

Immunizations

These immunizations are recommended at 11 or 12 years of age:

• Tdap vaccine (tetanus, diphtheria, and pertussis for 11 years of age and up, single dose)
• meningococcal conjugate vaccine (single dose)
• HPV (human papillomavirus vaccine) is recommended for females aged 11 to 12. This vaccine protects against sexually transmitted warts and cervical cancer. The vaccine is given in a three dose series. Ask your healthcare provider for more information about HPV vaccine and the diseases against which it protects.
• An annual influenza shot is recommended for children up until 18 years of age.

Next Visit

The American Academy of Pediatrics recommends that your child have a routine checkup every year through adolescence. Be sure to bring your child's shot records to every annual visit.