4-Year Well Child Check

This is an age when children can learn to swim, however, they still need adult supervision when in or near water of any kind. Pools should be completely surrounded by a fence that separates it from the house and has a self-locking gate.
Your child can fall off play equipment, stairs, windows and anything that can be climbed on. Make sure the surfaces underneath play objects are well padded. Close doors and use gates as needed. Your child may be able to ride a tricycle or bicycle and should wear a helmet when riding. He may also be able to get to other objects that can cause burns, such as stovetops and hot liquids.
If your child weighs more than 40 pounds, you can use a belt-positioning booster seat in the car. The seatbelt should come across his shoulder, not his neck. Be sure the seat is used correctly.
The front yard and near the street can be a dangerous place for your child to play. He should have constant adult supervision preferably with you between him and the street. Be aware of where your children are when backing up in your car.
As your child will be starting school soon, this is a good time to start teaching your child about “stranger danger” and appropriate touches. It’s a good idea for him to know his home phone number, parents’ cell phone numbers and home address in case of emergency.
To prevent a sunburn, keep him out of direct sunlight, dress him in clothes that cover the body, and use children’s sunscreen of at least 30 SPF.

Continue to give your child skim or 1% milk at mealtimes. He should drink water the rest of the day and should avoid sugary drinks like soda, juice and Kool-Aid.
Mealtimes are a great time for families to interact together without distractions, if possible. A picky appetite may persist, but remember that it’s not what he eats for each individual meal that counts, but more of a total throughout a few days. Encourage a healthy variety of foods in normal portions.

Any smoke in the house is dangerous to kids. We encourage parents never to smoke around their child, and to not to smoke at all for their own health.
A regular sleep schedule and bedtime routine will promote healthy sleep patterns.
Continue to floss and brush your child’s teeth twice a day with fluoride toothpaste.
Be aware of the influence that all media can have over your child and limit the amount of screen time your child has. Encourage outdoor activity to prevent against obesity. You can model healthy living activities that the whole family can participate in.

Your child’s language skills continue to develop and expand. Direct conversation about all subjects will stimulate further development and help you get to know your child better. Books should still be incorporated into any activity. Encourage writing, drawing and story telling. Your child may ask a lot of “Why?” questions. This is a time when your child is very receptive to learning and you can work on school readiness. Your child doesn’t need to know how to read before starting school, but knowing numbers, letters, colors and shapes will help.
Your 4-year-old can ride a tricycle, hop and balance on one foot and draw pictures. Continue to encourage activities that strengthen his muscles and develop his coordination. He should be able to dress himself, and he can learn to tie his shoes.

Rewarding good behavior reinforces it, ignoring bad behavior discourages it.
There are many different effective discipline techniques. Parents need to find the one that works well for their individual child. Most children thrive when they have limits and a routine, but they still need to fulfill their exploration needs. The biggest key is to be consistent with enforcing limits with your child.

Next Visit – at 5 years of age