Well Check-Up / 4 Year Olds
DIET/NUTRITION
Your child should be drinking no more than 16-24 ounces of milk each day. Eating 2-3 servings of other dairy products is good for children who do not drink milk. Continue to offer your child foods from different food groups every day, including fruits and vegetables. 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! Limiting juice intake to no more than 4-6 of 100% fruit or vegetable juice can improve appetite and prevent cavities. If your child refuses to eat at mealtime, 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. More than anything, mealtime should pleasant, so try to establish simple rules and sit down together as a family and relax.
DEVELOPMENT
Most four year olds can hop and skip, alternate feet when going down stairs, dress themselves, copy a square, and catch a ball. They can remember a song or poem and are very curious, asking lots of questions all the time. Their speech should be close to 100% understandable to strangers, although some children will continue to have difficulty with particular sounds. Four year olds should be able to play well with a group of children. Many four year olds know their ABCs and have begun to learn their numbers. Some can already write their names. Reading to children every day helps them develop their own reading skills when they are older!
BEHAVIOR/DISCIPLINE
Provide clear and easy to understand rules for your child and make consequences consistent for bad behavior. Praise for good behavior often works better than punishment for bad behavior, but make sure to carry out whatever penalty you have discussed for broken rules, so your child learns what behavior will not be tolerated and takes your rules seriously. Using time-outs at this age can be effective with the general rule of 1 minute of time-out for every year of age (4 year old = 4 minute time-outs). Withholding privileges can also be effective, such as removing a toy from play for a short time or not allowing television or screen time if your child misbehaves.
DENTAL CARE
At this age, it is very important regularly to clean your child’s teeth at bedtime, using a pea-sized amount of toothpaste with fluoride. It is important for an adult to go over all the teeth, especially the back teeth, to make sure all are cleaned. All children should visit the dentist every 6 months.
SAFETY
Children should remain in car seats in the back seat until they are at least 4 years old and at least 40 pounds. At that point they should ride in a booster seat until at least age 8. (Indiana law requires children to ride in booster seats until age 8.) If children are placed in the car with regular seat belts before they are old enough and tall enough, they are risk for serious neck and abdominal injuries in the event of a crash. All children under age 13 should ride in the backseat only. Model good behavior for young children by making sure everyone in the car always wears their seat belts. Teach bicycle safety from an early age by requiring your child to wear a helmet if he rides a tricycle or bicycle. Make sure that smoke detectors work properly and change the batteries twice a year. Use sunscreen with SPF of at least 30 and insect repellent when necessary. Never let your child out of your sight near any water. It only takes seconds for a child to slip under water and drown, and drowning often happens without any noise or splashing and with groups of people around who are not paying attention to small children. Use life jackets on open water or when boating. If you have firearms in your home, make sure they are locked away with ammunition kept in a separate location. Teach your child the dangers of talking to or accepting items or rides from adults they do not know.