Well Child Care 4 Years


Your child should always be a part of the family at mealtime. This should be a pleasant time for the family to be together and share stories and experiences. Give small portions of food to your child. If he is still hungry, let him have seconds. Selecting foods from all food groups (meat, dairy, grains, fruits, and vegetables) is a good way to provide a balanced diet. Choose and eat healthy snacks such as cheese, fruit, or yogurt. Televisions should never be on during mealtime.
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 are 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).
Limit Fast Food – No more than one time a week.  When you do go to a fast food restaurant select the smallest portions available.  Your child may drink milk or water.  Soda or pop should be an infrequent, special treat.


At this age children usually become more cooperative in their play with other children. They are curious and imaginative. Allow privacy while your child is changing clothes or using the bathroom. When your child starts wanting privacy on his own, let him know that you think this is good.
Preschoolers require 11-13 hours of sleep per night.

Behavior Control

Breaking rules occasionally occurs at this age. Making children stand in a corner by themselves for 4 minutes is usually an effective way to correct the undesirable behavior. This technique is called time-out.

Reading and Electronic Media

It is important to set rules about television watching. Limit total TV time to no more than 1-2 hours day. Children should not be allowed to watch shows with violence or sexual behaviors. Watch TV with your child and discuss the shows. Find other activities you can do with your child. Reading, hobbies, and physical activities are good alternatives to TV.   Never put a television in your child’s room.

Dental Care

·         Brushing teeth regularly after meals and before bedtime is important. Think of a way to make it fun.
·         Your child should see the dentist every 6 months.
·         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.

Safety Tips

Keep your child away from knives, power tools, or mowers.

All parents, caregivers and babysitters should be certified in CPR every two years.  Your local hospital may have a class available.

Fires and Burns
·         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 replace the batteries as needed.
·         Keep a fire extinguisher in or near the kitchen.
·         Teach your child to never play with matches or lighters.
·         Teach your child emergency phone numbers.
·         Turn your water heater down to 120°F (50°C).
Car Safety
Your child should use a forward facing car seat as long as possible, up to the highest weight and height allowed by the manufacturer.   Your child must ride in the back seat. All children whose weight or height has outgrown the forward-facing limit for their car seat should use a booster seat until they are 4 feet 9 inches tall and are at least 8 years old. 
·         Never leave your child alone in a car.
Pedestrian and Bicycle Safety
·         Teach your child to never ride a tricycle or bicycle in the street.
·         All family members should use a bicycle helmet, even when riding a tricycle.
·         It is much too early to expect a child to look both ways before crossing the street. Supervise all street crossing.
·         Teach your child to never take medicines without supervision and not to eat unknown substances.
·         Keep the POISON CONTROL number (1-800-222-1222) on all phones.
·         Teach your child the first and last names of family members.
·         Teach your child to never go anywhere with a stranger.
·         Teach your child that no adult should tell a child to keep secrets from parents, no adult should show interest in private parts, and no adult should ask a child for help with private parts.
·         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, NEVER smoke in the house or near children.


The virus that causes influenza (which is also called the flu) changes every 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).

For fever, give your child an appropriate dose of acetaminophen or ibuprofen. For swelling or soreness, put a wet, warm washcloth on the area of the shot as often and as long as needed for comfort.