6-11 years guidance
Introduction
Your child is in the grades chool years, which may range from age 6-11 or so. Children grow and change a lot during this time, and there are many things you can do to help guide your child during this process. You can find general advice for this below. If you have questions about how any of this should apply to your child, please check with your child's healthcare team.
Helpful websites
Sleep
From around age 6-12 years children need 9-12 hours of sleep each day, which should not include any naps. It is important to have a consistent bed time and wake up time; letting your child "sleep in" on the weekends can make it much harder for your child to sleep well during the week. Having a consistent bedtime routine is helpful, and you can see advice for addressing several sleep problems below. Read through the "Helpful articles" for more detailed information.
Bedtime routine
Children respond well to routines. The point of the routine is to show your child it is time to sleep and help them calm down so they can sleep well. Click on the button below for tips about a bedtime routine.
- keep the lights low with no screens on an hour before bed
- tell your child that it is time to get ready for bed - do not ask them if they want to get ready for bed
- have a consistent start and end time, usually totaling <1 hour
- give a warm bath or shower and change into pajamas
- if needed, offer a snack with some protein (foods with protein include meat, eggs, cheese, peanut butter) so your child is not too hungry overnight
- either brush your child's teeth or have them brush their own teeth - after this they should not drink anything other than water
- perform a calming activity (such as reading a book or coloring)
- use a consistent phrase and method to say goodnight
For some of these steps you can offer your child choices. By letting them choose which snack to eat, which book to read, or which activity to do, they will feel more in control. This can help them go to sleep more easily.
Sleep problems
There are many different reasons children may have trouble sleeping well. You can click on any of the cards below to learn about specific issues:
Wakes often
Gets up early
Stays up late
Nightmares
Night terrors
Snoring
Sleep walking
Bed-sharing
Noise/climate
Bedwetting
Nutrition
People often say "You are what you eat." It is important to help your child eat and drink healthily so they:
- consume enough energy for appropriate growth
- take in enough nutrients for good health
- adopt good eating habits to promote a positive mindset regarding eating
You can read through specific advice below.
Helpful websites and articles
Liquids
Click on the cards below to learn about milk, water, juice, and how to provide these drinks to your child.
Milk?
Water?
Juice?
How to give?
Foods
Children should eat all the food groups and a variety of textures and flavors. The food groups include fruits, vegetables, grains, protein-foods, dairy, and oils. Click on the cards below to learn more about all of these, how to provide them in healthier or less healthy ways, and how much you should offer per day.
Fruits
Vegetables
Grains
Protein foods
Dairy
Oils
Adjusting eating based on your child's weight
Many families believe their child is underweight or overweight and want to help them with this. If you feel this way, it is great you want to help your child! You should first discuss this with your child's healthcare team, both to see if this is something that you actually do need to worry about and to look for any potential causes that should be treated. Then, whether your child is underweight, a healthy weight, or overweight, click on the appropriate button below to learn more.
- If your child does not seem to eat very much then it is even more important that they mostly eat the more nutritious foods to help ensure they get all the nutrients their body needs.
- To gain more weight your child needs to consume more calories, so you have to find ways to give them more calories.
- You can add more calories to what they eat and drink by adding peanut butter, olive oil, or cheese to their foods. Read through this blog post for several other examples of how to add or modify foods to include more calories.
- You can consider making "weight gaining" shakes for your child to drink. This should not replace the food they eat, rather they should drink this after eating. You can try many different recipes with your child. For example, mix whole milk, oatmeal, peanut butter, and a banana together, put it in a blender, and see what this tastes like. Let your child help make these, find a recipe they like, and use this to add additional calories.
- If you try these tips and feel you are still not making progress, follow-up with your child's healthcare team for further advice.
- If your child is a healthy body weight then you should continue mostly offering the more nutritious food options discussed above.
- If your child wants bigger portions or seconds, you can generally let them have these. Children will eat more some days than others, and letting them follow their own hunger and fullness cues while eating mostly nutritious food options promotes healthy eating habits and is unlikely to cause too much weight gain.
- When someone is overweight this implies they are consuming more calories than their body needs. The main goal is to give your child the nutrients they need for good health without giving them too many calories.
- You should not try to rigorously count or track calories at this age.
- Thus, instead of worrying about exactly how many calories your child is consuming, focus on improving the eating habits to naturally decrease the amount of calories your child wants to consume. The next several points describe how to do this.
- You should mostly offer the more nutritious food options discussed above. This will help your child get the needed nutrients and these foods are more filling than snack and junk food options (such as chips, cookies, and cake).
- Usually foods that are less processed (such as fruits, vegetables, and whole grains) are more filling for the same number of calories than foods that are highly processed (such as most junk and snack food options).
- When the food is more filling this is good because your child will need to eat less of it to be satisfied.
- In addition to the more nutritious food options, you should offer food with some protein (such as meat, nut products, or eggs) and fiber (such as fruits or vegetables) at each meal and snack as these are more filling.
- Teach your child to eat to the point of no longer feeling hungry, not to the point of feeling full. If you feel full after eating that means you probably ate more than was needed.
- Try having your child wait 20 minutes between first and second servings of food.
- This is because it takes time for your brain to process the signals from the food you eat to actually feel full.
- Thus, have your child wait 20 minutes after a first serving before having seconds, and ask them if they are as hungry after the 20 minutes as they were right after they finished the meal.
- If they are not as hungry, that means they may need a smaller second serving, or none at all, to be satisfied.
- Teach your child the difference between "hunger" and "appetite" and that we want to eat for our hunger, not our appetite.
- Hunger is the need for food, where you are willing to eat pretty much any food because you need more energy.
- Appetite is the desire for certain types of food, such as a craving for something sweet.
- As an example, if you feel full after dinner and do not want any more of your meal, but you still have room for dessert, you are no longer hungry, rather your appetite is making you want the dessert.
- If your child brings food to school, they may also be eating additional food at school without you realizing this. You can ask your child directly if this is happening and then consider if this is contributing to too much weight gain.
- Many children will sneak food overnight or get food from other people without you realizing it. You can ask your child directly if this is happening and then consider if this is contributing to too much weight gain.
- If these tips are not helpful enough, ask your child's healthcare team for further advice.
Promoting healthy eating habits
When feeding your child it is just as important to consider how you provide the food in addition to what and how much you actually provide. Children respond well to structure and routines; click on the button below for meal structure advice.
- Try to offer 3 meals and 2-3 snacks per day while generally keeping meal and snack time consistent. This includes any eating occasions at school.
- Mostly offer the more nutritious food options listed above. Your child will likely have more access to the junk or snack food at school and social gatherings; try to stick to healthier options in the home where you have more influence over what your child eats.
- During meals, sit with your child while eating and talk to them. Remove any distractions during meal time, in particular any screens. This promotes a more positive eating experience and will make it easier for your child to respond to their hunger and fullness cues.
It is also very important to continue the "responsive feeding" principles from earlier in life. While you determine what meals and snacks to offer and when to offer them (at least in the home setting), you should still allow your child to determine how much they want to eat each time food is available. Click on the button below for further advice.
- Most people do not have the same hunger levels every day, and it is normal to eat more or less on any given day. You do not need to worry that your child is not eating enough on the lesser eating days.
- Practice the Satter Division of Resonsibility in Feeding. You are responsible for what foods to offer your child, where to offer them, and when to offer them. Your child is responsible for whether they want to eat them and how much they want to eat.
- Expanding on the above advice, do not try to force your child to eat specific foods and do not make them eat all of the served food. This removes stress from meal time and makes a more pleasant experience for your child; it is generally best to not fight over meals.
- If your child chooses not to eat the food, consider putting it in the refrigerator and offering it again later.
If at any point in time you become concerned that your child is developing unhealthy eating habits, where they are excluding certain food groups, binge eating, restricting their food intake, or anything else, please discuss this with your child's healthcare team.
Exercise
Children at these ages should perform at least 60 minutes of moderate-to-vigorous intensity physical activity every single day. This means the exercise should get your child's heart rate up and and make them breathe faster. This exercise should include aerobic activity, muscle-strengthening activity, and bone-strengthening activity. Click on the cards below to learn more about these.
Aerobic
Muscle
Bone
Peeing/pooping
Your child should not have accidents during the day. Bedwetting can still occur overnight, though this should decrease as time goes on. If daytime accidents do occur, you should discuss this with your child's healthcare team so they can test for any possible underlying causes. Click the button below to learn about some potential causes and treatments for these.
- Withholding - this describes where your child holds it in when they are focused on other things or do not want to use the bathroom at school. Possible treatment strategies include:
- Have timed bathroom breaks, for example every 3 hours.
- Use a reward system. If your child does not have an accident during the day they get a small reward (like a sticker). If they go a whole week they get a bigger reward (like a new book or toy).
- If the issue is that your child does not want to use the bathroom at school, ask them why and see if you can help them work through this problem.
- Constipation - this describes where your child has difficulty pooping, may go 1 or more days without pooping, and the poop is hard or large. When this occurs it can cause your child to lose the sensation of needing to use the bathroom, which can lead to accidents. You can read this article for advice on treating this.
- Other medical issues - diabetes, urinary tract infections, and other medical issues can cause daytime accidents, and you cannot treat any of these at home without first discussing with your child's healthcare team. If you notice your child is drinking or peeing more than usual, or just seems to drink and pee a lot in general, please bring them in to be seen.
Otherwise, you generally only need to be concerned about your child using the bathroom if:
- the poop is hard, large, or difficult to pass consistently, which can indicate constipation
- there is frequent diarrhea, where the poop is watery
- the poop is dark black, a shade of red, or pale
- your child starts peeing much more or less than usual
- your child starts to have more accidents than they were previously
If any of the above concerns occur, let your child's healthcare team know so your child can get the treatment they need to be healthy.
Safety
There are several safety concerns in and out of the home. Click on the cards below to learn more about these, and you can read through the "Helpful Websites" for more general information.
Helpful websites
*This website is based in Australia so any discussion of laws or what is required may not apply to the United States.
Below are several different safety topics, click on each topic to learn more about them.
General
Car safety
Ingestions
Choking/CPR
Falls
Water/Bath
Burns/Fire
Outdoors
Bicycles
Home/Pets
Vaccines
In the gradeschool years children do not need that many vaccines relative to the earlier years. If your child is already fully caught up, then the recommended vaccines include:
- HPV - this can be given as early as 9 years of age and helps protect against the human papillomavirus. This virus can cause several types of cancers and warts. Your child will need a second dose, which can be given at the following year's check-up.
- Tdap - this is given at the 11 year check-up and protects agains tetanus, diptheria, and pertussis. This is a booster of the DTaP shots children receive earlier in life.
- Meningococcal ACWY - this protects against several strains of a bacteria that can cause meningococcal disease, which can lead to meningitis (a brain infection) and blood infections. More than 10% of people who get this will die from it even when treated.
Your child may also receive a flu vaccine (if it is the flu season) and a COVID-19 vaccine. Your child may need an additional dose of the flu vaccine for full protection, so you can ask your pediatrician about scheduling for this before the next check-up.
All the childhood vaccines have been given to millions of people and we know that they are safe and effective. If you would like more information, look through the "Helpful Websites" listed below:
Helpful websites
Common questions
Many parents have similar questions about their 6-11 year old children. Feel free to look through some of the most common ones below.
FAQ
Conclusion
Enjoy your time with your child as they move through grade school! There are many choices you can make to help influence your child's growth and development. Thankfully, you do not need to be perfect, and you should not worry about doing everything correctly every time. As long as you understand the main ideas presented here, you should be in a good position to help your child grow and develop well. If you have any additional questions make sure to check with your child's healthcare team.