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3-4 Years

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Welcome to the preschool years. This is an age of growing motor skills, language development, emotional development and budding social skills. Your child may alternate between being agreeable and oppositional. His or her growing independence and determination can lead to both parental frustration and pride.
Diet

  • Growth will now be slower and more sporadic.
  • Expect pickier eating. Keep the “big picture” in mind – if your child generally eats some variety of foods over a week he or she is doing fine. Don’t be a short order cook – if your child eats poorly at one meal wait until the next meal to feed him/her. You may offer a multivitamin to especially picky eaters.
  • Set a good example. Offer three regular meals and 2-3 healthy snacks.
  • Let your child feed himself/herself with fingers/utensils.
  • Your child should exclusively be using a cup.
  • Limit milk to 16-24 ounces per day of lower fat milk (skim or 1% unless they are underweight). If your child is dairy intolerant or refuses to drink milk from a cup, offer other calcium rich substitutes (yogurt, cheese, calcium supplemented juices, soy milk, rice milk, etc.). Encourage plenty of water and limit juice to less than 4 ounces per day.
  • Choking is still a risk. Avoid larger firm pieces of food – grapes, hot dogs, hard candies, etc.

Sleep
A regular bedtime routine is important to your preschooler. On average, a 3-year-old sleeps about 12 hours per day, including one nap. By age four, some children may no longer nap but still sleep about 12 hours sleep at night. Even if your child no longer naps, it is important to have a quiet rest period in the afternoon. Refusing to stay in bed and nighttime fears are common issues. Consult with your provider or read Dr. Ferber’s book, Solve Your Child’s Sleep Problems for advice.
Development
Most 3 year olds can jump with two feet, walk up and down stairs, kick a ball, dress themselves, talk in sentences, know some numbers, letters, and colors, and play pretend games. Most 4 year olds can hop on one foot, draw a square and person with 3-6 body parts, speak in more complex sentences, dress unassisted and play cooperatively with other children.
Elimination

  • By age 3, roughly 90% of children are bowel trained and 85% are dry for urine during the day. It is less common for children to be dry at night; only 60% are dry at night.
  • By age 4, roughly 95% of children are bowel trained and 90% are dry for urine during the day. Roughly 75% will be dry at night.
  • Don’t despair if your child is slow or resistant to mastering toilet training. It will happen eventually.

Safety

  • Major hazards at this age include burns, falls, choking, drowning and poisoning. Lock cabinets and keep cleaning supplies, medications, plastic bags, and small objects away from your preschooler. If you have a gun, make sure guns and ammunition are kept locked in separate places. The Illinois Poison Control number is (800) 222-1222 – call them if your child has an accidental ingestion.
  • Your child should continue to be in a car seat at all times. Make sure their weight and height are appropriate for your forward facing seat.
  • In the summer months remember sun and mosquito protection.
  • Teach your child now to wear a properly fitted bicycle helmet whenever they are on a bike.
  • Teach stranger danger and that their body parts are private
  • Teach your child his or her full name, address and phone number.

Behavior/Discipline
This age can be challenging. Children can be single minded and haven’t yet learned to handle frustration. Your child is learning to be independent. Offer choices when reasonable but maintain your authority and rules. Praise your child when he or she is behaving well. Don’t yell or spank – if you feel angry take a few moments to calm yourself before you attempt to discipline your child. Try to reserve time outs for unacceptable or aggressive behaviors. Consider a reward system to reinforce good behavior.
A Few Other Things
Dental visits should now be scheduled every six months. Brush teeth twice a day with a soft toothbrush and a small dab of fluoridated toothpaste. Generally by age 3 children will have all 20 primary teeth. If they are not already in preschool/daycare, 3 to 4 years is a great age to start in school or play groups. This can be helpful for developing social skills.
Read, read and read with your child every day. Reading is a wonderful way to spend time with your child and encourages language and literacy development. Limit TV watching and video game usage and monitor what programs they are watching.
Immunizations
We recommend an influenza vaccine, generally given as a nasal spray at this age, in the winter months.

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