Your 4 Year Old

Developmental Milestones*

• Can balance on one foot for 2 seconds.
• Hops up and down on one foot.
• Can draw a person with 3 parts.
• Can copy a circle.
• Speech is 100% clear by all.
• Dresses with minimal to no help.
• Knows 4+ colors.
• Plays organized games.

 
*All children develop differently.  If your 4-year-old hasn’t yet reached these milestones, rest assured that she will soon. If you have concerns about your child’s development, please schedule an appointment.

Diet

Encourage 3 healthy meals a day and 2 snacks. 

Fiber is a very important part of a child’s diet and is usually lacking.  Consider switching to whole grain pastas, brown rice, and whole wheat bread.  There are a wide variety of Fiber One products in stores.  Offer fresh fruits and vegetables daily.  Try V8 products if your child dislikes fruits and vegetables.  Visit www.sneakychef.com for more ideas on sneaking vegetables into your child’s diet. 

Discourage soda as much as possible.  Many kids waste a lot of calories on drinks.  It is better for children to eat their calories.  Water is the best option.  Dilute juice if necessary. 

Avoid eating in fast food restaurants more than once per month.  Make healthy choices for your child.  He or she will learn how to eat healthy from you.  Bake at home instead of frying whenever possible. 

In trying to choose the healthy options, be wary of diet foods and foods with artificial ingredients and sweeteners. 

Continue to administer a multi-vitamin with fluoride once daily.  Please let us know when you need prescription refills.  Your child’s dose remains the same from ages 3-6. 

Bathroom Habits

• Make sure your child is going to the bathroom regularly. Children often are busy and ignore urges to empty their bladder or bowels. This can lead to problems such as urinary tract infections and/ or constipation. Remind children to urinate frequently. Allow time for your child to have a bowel movement at least once daily. If you are concerned about your child’s bowel or bladder habits, please let us know. 
• Bedwetting may persist even if successful training occurs during the daytime.  This is normal.  Try not to get frustrated.  Reward dry nights but do not punish accidents.  Protect their mattress and allow children to have accidents; this helps them learn. You’re your child help with the clean up of accidents.  This teaches them responsibility.  Restrict fluids after dinnertime.  Wake them to use the bathroom before your retire.  Be sure to discontinue use of Pull-ups as soon as mostly dry nights are achieved.  Once children become dependent upon Pull-ups at night, it is very difficult to take them away.  If your child has a family history of bedwetting they are more likely to have more problems themselves.  Visit onestepahead.com or bedwettingstore.com for some helpful products and ideas. 
• If your having trouble toilet training your child during the day, please let us know. 

Activity

• Sometimes a healthy diet is not enough for your child to stay in shape. Encourage at least 30-60 minutes of active play or physical activity per day. This is easier during the warmer months. In the winter, activities such as dance, gymnastics, karate, etc help to make this possible.
• Keep all dangerous objects and materials like caustic cleaning agents, sharp tools, and all firearms stored out of reach, out of sight, and locked away for security.
• Booster seats are necessary for children who have outgrown their forward facing car seats.  Booster seats are designed to raise the child up so that the lap and shoulder seat belts fit properly. High-back and backless booster seats are available. Many seats that look like high-back boosters are actually combination seats. They come with harnesses that can be used for smaller children and can then be removed for older children.  Booster seats should be used until your child can correctly fit in lap and shoulder seat belts, which is usually around 4’ 9’’ or 57 inches.  This may surprise some parents.   Children should always ride in the rear of the vehicle.
• Don’t let your child forget to brush their teeth at least twice a day.  Your child should now be visiting the dentist for routine cleanings and exams about every six months.
• Do your best to restrict TV, video game, and computer time to 2-4 hours per day. 
• Avoid sun exposure since your child’s skin is delicate and more likely to burn. Sunscreen can safely be used and should be reapplied often.   An SPF of 30 or more is recommended. 
• Monitor your child at the pool or beach at all times.  Educate your children never to swim unsupervised.  Even strong swimmers have accidents.  Strongly consider purchasing a pool safety fence or cover for your home pool.  Lock all hot tub covers. 
• Insect repellent may be used.  Deet-free brands are preferable.  To be safe, only apply insect repellents to exposed skin. Do not apply it under clothing, on a child's hands, near the mouth or eyes, or over cuts and irritated skin.  Wash off insect repellents once it is no longer needed. Combination sunscreen/insect repellent products should be avoided, as sunscreen needs to be reapplied often.  Insect repellent should only be applied once per day.  
• Helmet safety is extremely important.  Make sure your child always wears a helmet when riding a bicycle, skateboard or scooter, or when using roller blades. 

Vaccines

Your child will probably receive immunizations during his/her 4-year visit.  At this time, many booster vaccines are necessary.  Please visit the vaccine section of this website for more information on specific vaccines and their administration schedule. 

Please note that we will not administer vaccines to any child whose parent or guardian is not present for the visit.  This is our office policy.  We understand that parents have busy schedules but no exceptions to this rule will be made.

Medicines

Tylenol and Motrin can be safely given to your child.  Please ask for our dosing chart or follow the instructions on the bottle.  Let us know if you have any questions.  If you are using either medication regularly, please notify our office.  Please ask us before using administering any other medication to your child.