4 Years
 | HEALTH ISSUES
Offer healthy snack and meal choices, limiting sugars. Children often don’t eat
meals well because they graze with snacks all day - that is fine, just make sure those
snacks are healthy snacks (yogurt, peanut butter, cheeses, crackers, cereals).
Avoid direct sun exposure. Use a sunblock - SPF 15-30.
Continue fluoride supplement if recommended by your doctor. Make an appointment with your
dentist for a routine exam and start routine cleanings every 6 months.
Continue to have your child brush his or her teeth daily with a pea-sized amount of
toothpaste. You should assist them to ensure proper cleaning.
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| SAFETY ISSUES
Continue safe car seat use. Read instructions for proper installation. Here are some
general guidelines:
Place seat in the middle of the back seat. Children this age should
face forward in an appropriate child car seat. A booster seat is appropriate as long as
your child is within the weight guidelines noted on the seat (usually 30 to 60 lbs).
Use the "H" or "I" clip if you have a retractable
shoulder harness.
Never put a child under 12 years of age in the front seat of a car with
a passenger side airbag.
Turn the hot water heater in your home down so the hottest water you can get from the
faucet is 120 degrees.
Install and test your smoke detector in or near your child's room.
Childproof your home (poisons, medicines, guns, plastic bags, sharp objects, cords,
outlets, cigarettes, hot liquids, latches on cabinets). Visit our poison safety tips page
at www.YourPediatrician.com.
Make sure any playground environment is safe.
If you haven’t yet, purchase a bottle of Activated Charcoal to have on
hand in case of ingestion of a poison.
Obtain your local Poison Control Center’s phone number and keep it on hand (you can
obtain this from our Web site, www.YourPediatrician.com).
Use a bike helmet for your child (and yourself) if riding on the back of a bike and
when learning to ride alone.
Supervise activities, especially around lawnmowers, large dogs, cars. Do not allow your
child to ride on a riding lawnmower.
Keep matches out of reach and instruct on fire safety.
Do not keep a firearm in your home. If you must, make sure it is locked and out of reach
from your curious child.
Start teaching your child not to take rides or food from strangers; also, teach that his
or her "privates" should not be touched or looked at by anyone other than mom,
dad, or a doctor.
Teach your child how to swim and follow water safety rules (see our water safety KidTOPIC at www.YourPediatrician.com).
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| YOUR CHILD SHOULD…
Know his or her first and last name.
Be able to draw a person with three parts.
Know fantasy from reality.
Throw a ball overhand and hop on one foot.
Be able to sing songs.
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| YOU SHOULD…
Praise your child at every opportunity.
Talk and sing regularly with your child.
Listen to music together with your child.
Introduce board games and card games to your child.
Limit TV to certain educational programs and to maximum of 1 hour per day. Practice
selective TV viewing (not channel surfing).
Continue to read books interactively with your child.
Encourage opportunities for safely exploring his or her environment .
Reward good behavior as much as possible.
Be consistent with rules. Be firm. You decide how strict or liberal to be, just make sure
you are consistent.
Keep discipline brief. "Time-out" is usually effective at this age (see our Time-out KidTOPIC at www.YourPediatrician.com).
Offer choices to your child at every opportunity to allow decision making.
Encourage assertiveness but not aggressive behavior.
Allow for self-care opportunities.
Have a bedtime routine and put your child to sleep in his or her own room. If they wake up
at night, take them back to their own room and, if needed, lay down with them in their
room until they are asleep again.
Eat meals as a family.
Expect a poor appetite and don’t argue with your child about not eating well.
Try to allow expression of feelings (anger, joy, sadness, fear).
Expect curiosity of genitalia and sexual matters. Use correct anatomy terminology. Answer
sex-related questions in a simple manner.
Expect your child to share, reward him or her when he or she does.
Consider enrolling in a preschool or regular Sunday school program to develop social
skills.
Be an example of the type of person you want your child to grow up to be - they are like
sponges and absorb everything around them !
Spend time alone with your partner - one of the best thing you can do for your child is to
maintain a quality relationship with your partner.
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GO TO 5 YEARS
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