Well Child Care 3 Years

Mealtime should be a pleasant time for the family. Your child should be feeding himself completely on his own now. Buy and serve healthy foods and limit junk foods. Your child will still have a daily snack. Choose and eat healthy snacks such as cheese, fruit, or yogurt. Televisions should never be on during mealtime. If you are having problems at mealtime, ask your healthcare provider for advice.

Lower fat content in milk and other dairy products is almost always a good idea. Lower fat content in milk and other dairy products is almost always a good idea. Lowering the fat content of milk DOES NOT change any of the nutritional value of the milk.  Most families should be using nonfat or 1% milk. Your doctor will advise you if you should be using milk with a higher fat content.

If your doctor recommends Vitamin D please continue it every day.  Most children will be ready for chewable vitamins that contain 400 I.U. of Vitamin D.  Make sure your child consumes 4 or more calcium servings per day (milk, cheese, yogurt, cottage cheese or calcium fortified fruit juices such as orange or apple).

Children at this age often want to do things by themselves; this is normal. Patience and encouragement will help 3-year-olds develop new skills and build self-confidence. Many children still require diapers during the day or night. Avoid putting too many demands on the child or shaming him about wearing diapers. Let your child know how proud and happy you are as toilet training progresses.

Preschoolers require 11-13 hours of sleep per night

Children should not have televisions in their bedrooms.

For behaviors that you would like to encourage in your child, try to “catch your child being good.” That is, tell your child how proud you are when he does what you want him to do. Be positive and enthusiastic when your child does things to please you.

Here are some good methods for helping children learn about rules:

·         Divert and substitute. If a child is playing with something you don’t want him to have, replace it with another object or toy that the child enjoys. This approach avoids a fight and does not place children in a situation where they’ll say “no.”

·         Teach and lead. Have as few rules as necessary and enforce them. These rules should be rules important for the child’s safety. If a rule is broken, after a short, clear, and gentle explanation, immediately find a place for your child to sit alone for 3 minutes. It is very important that a “time-out” comes immediately after a rule is broken. Time-outs can serve as an excellent tool to teach a child a rule. Time outs require skill and careful planning. If you use time-out, be sure to read about the technique before using it.

·         Make consequences as logical as possible. For example, if you don’t stay in your car seat, the car doesn’t go. If you throw your food, you don’t get any more and may be hungry.

·         Be consistent with discipline. Remember that encouragement and praise are more likely to motivate a young child than threats and fear. Do not threaten a consequence that you are not prepared to carry out. If you say there is a consequence for misbehavior and the child misbehaves, carry through with the consequence gently, but firmly.  Children do best with ONE set of rules that mom and dad enforce equally. 

Children learn reading skills while watching you read. They start to figure out that printed symbols have certain meanings. Young children love to participate directly with you and the book. They like to open flaps, ask questions, and make comments. It is important to set rules about television watching. Limit total TV time to no more than 1 to 2 hours per day.  NEVER have a TV or DVD player in your child’s bedroom.

·         Brushing teeth regularly after meals is important. Think up a game and make brushing fun.   You may now use a fluoridated toothpaste.

·         Make an appointment for your child to see the dentist.

·         Fluoride supplementation is important to make teeth stronger and prevent decay.  If the water in your community is fluoridated you will not require an additional supplement.  If there is no fluoride in the water your doctor will recommend a fluoride supplement for your child.  Since your child is receiving fluoride in either the water or by supplement please do not use toothpaste that contains fluoride.

Child-proof the home. Go through every room in your house and remove anything that is either valuable, dangerous, or messy. Preventive child-proofing will stop many possible discipline problems. Don’t expect a child not to get into things just because you say no.

·         Practice a fire escape plan every 3 months.  First,  set off your smoke detectors.  Everyone in the house should walk outside and go to the same meeting place every time.  Children under the age of 5 should be led outside by a parent.  Make sure the meeting place is at least 20 adult paces from your home so that your children are not standing in smoke.

·         Check smoke detectors and carbon monoxide detectors. Replace the batteries if necessary.

·         Keep matches and lighters out of reach.

·         Turn your water heater down to 120°F (50°C).

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·         Do not allow your child to climb on ladders, chairs, or cabinets.

·         Make sure windows are closed or have screens that cannot be pushed out.

·         Never leave your child alone in a car.

·         Everyone in a car must always wear seat belts. Make sure your child is always in an appropriate booster seat or car seat.

·         Children must ride in the back seat of the car

·         Hold onto your child’s hand when you are near traffic.

·         Practice crossing the street. Make sure your child stays right with you.

·         Do not allow riding of a tricycle or other riding toys on driveways or near traffic.

·         All family members should use a bicycle helmet, even when riding a tricycle.

·         Watch your child constantly when he is around any water.

Keep all medicines, vitamins, cleaning fluids, and other chemicals locked away.

Keep the POISON CONTROL number (1-800-222-1222) on all phones.

Buy medicines in containers with safety caps.

Do not put poisons into drink bottles, glasses, or jars.

·         Teach your child the first and last names of family members.

·         Teach your child never to go anywhere with a stranger.

·         Children who live in a house where someone smokes have more respiratory infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.

·         If you smoke, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.

Routine vaccinations are usually completed before this age. Before starting kindergarten your child will need vaccinations.

The virus that causes influenza (also called the flu) changes each year.  Children over 6 months of age should receive an annual flu vaccine starting in late September.  Many offices offer both tradition flu shots as well as Flumist (which is a painless squirt in the nose without any needles).