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3 Year Check Up

DIET/NUTRITION: Your child should be drinking 16-24 oz of skim or 2% milk each day or taking in 2-3 servings of other dairy products.  Dairy products are an important source of calcium, which is needed to build strong bones.  If your child does not like plain milk, other options include flavored milk (chocolate or strawberry), orange juice with added calcium, yogurt, and cheese.  Continue to offer your child a variety of foods from different food groups, including fruits and vegetables, every day.  Don’t be alarmed if your child refuses a certain food more than once.  Many children will eventually try something that they have refused as many as 10 times in the past.   Many toddlers will only have 1 good meal a day and will eat smaller amounts throughout the rest of the day.   Try not to fall into the trap of only offering typical “kid” foods, such as hot dogs, peanut butter, and macaroni and cheese.  While there is nothing wrong with your child occasionally eating these foods, children learn to eat what is familiar to them and what they see others eat, and they need variety for a healthy diet.  Filling up on juice or drinking more than 24 ounces of milk each day also can cause toddlers not to eat well.  Limiting your child’s juice intake to no more than 1 cup each day can improve the appetite and prevent cavities, and learning to drink water at this age is helpful.  If your child refuses to eat anything at mealtime, sometimes you may have to allow him to get down and leave his plate for later.  Let him know that when he gets hungry he may try again to eat his meal, but try to avoid giving him sweets or snacks if he fusses again later, or he may learn that all he has to do to get his way is wait and wear you down.  More than anything, mealtime should not always be unpleasant, so try to establish simple rules, sit down together as a family and relax.  If your child is growing well and eating food from different food groups his diet is probably adequate.

DEVELOPMENTMost three year olds can alternate feet when going up steps, pedal a tricycle, copy a circle, undress completely, and dress themselves partially.  Vocabulary includes more than 200 words from which they should be able to make 3 word sentences and use pronouns (I, you, me, she, he, etc.) correctly.  Language should be around 75% understandable to a stranger.  At this age, children should be able to play well with others, including sharing toys and taking turns.  It remains very important to read to your child at this age so he or she can develop his own reading skills in the next few years.

BEHAVIOR/DISCIPLINE: Provide clear and easy to understand rules for you child, and make consequences consistent for bad behavior.  Praise for good behavior often works better than punishment for bad behavior, but make sure you carry out whatever penalty you have discussed for broken rules, so your child learns that bad behavior will not be tolerated and takes your rules seriously.  Using time-outs at this age is often effective with the general rule being one minute of time-out for each year of age. 

DENTAL CARE: By age 3 children should visit the dentist for the first time and begin a schedule of regular visits every 6 months.  Teeth should be brushed before bed with parental guidance to assure all surfaces are cleaned and if possible also in the mornings.  Children should use fluoride-free toothpaste for kids until they are able to spit out adult toothpaste to avoid swallowing too much fluoride.

POTTY TRAINING: Some three year olds are already potty-trained and some have not yet shown any interest.  If your child is already working on it, give lots of praise and encouragement for any effort.  If your child has not yet shown interest, consider buying a special potty or potty seat and letting him sit on it with clothes or a diaper until he gets used to it.  Talk about how “big boys” or “big girls” use the potty often and consider buying a book or video for your child about using the potty.  When your child begins to have luck with urinating when sitting on the potty, take him often and try to give him the chance to empty his bladder in the potty before having an accident.   It takes most kids some time before they feel very comfortable sitting on a toilet and until they understand what is supposed to happen when they sit there, and it takes more time before they usually can tell a parent ahead of time that they need to use the potty.  Most children become dry during the daytime weeks or even months before nighttime.  Consider using a sticker or star chart to get your child excited and to show her progress.   Be positive and patient during this process and remember there is great variety in the ages that different children will become potty trained.

SAFETY:  Children should remain in carseats in the backseat until they are around 4 years and 40 pounds, and then they should ride in booster seats until they are 60-80 pounds.  Teach good behavior from an early age by requiring your child to wear a helmet if he rides a tricycle or bicycle.  Make sure that smoke detectors in your home work properly, and form a fire escape plan in your home.  Use sunscreen and insect repellent in the summer as needed to avoid sunburn and insect bites.  Never let a child out of your sight near any water.