About this topic
Your childs 4-year well child exam is a visit with the doctor to check your child's health. The doctor measures your child's weight, height, and head size. The doctor plots these numbers on a growth curve. The growth curve gives a picture of your child's growth at each visit. The doctor may listen to your child's heart, lungs, and belly. Your doctor will do a full exam of your child from the head to the toes. ‚
Your child may also need shots or blood tests during this visit. ‚
General
Growth and Development ‚
Your doctor will ask you how your child is developing. The doctor will focus on the skills that most children your childs age are expected to do. During this time of your child's life, here are some things you can expect. ‚
- Movement ¢ ˆ ’ Your child may:
- Be able to skip
- Hop and stand on one foot
- Use scissors
- Draw circles, squares, and some letters
- Get dressed without help
- Catch a ball some of the time
- Hearing, seeing, and talking ¢ ˆ ’ Your child will likely:
- Be able to tell a simple story
- Speak clearly so others can understand
- Speak in longer sentence
- Understand concepts of counting, same and different, and time
- Learn letters and numbers
- Feelings and behavior ¢ ˆ ’ Your child will likely:
- Enjoy playing mom or dad
- Have problems telling the difference between what is and is not real
- Be more independent
- Have a good imagination
- Work together with others
- Test rules. Help your child learn what the rules are by having rules that do not change. Make your rules the same all the time. Use a short time out to discipline your child.
- Feeding ¢ ˆ ’ Your child:
- Can start to drink lowfat or fat-free milk
- Will be eating 3 meals and 1 to 2 snacks a day. Make sure to give your child the right size portions and healthy choices.
- Should be given a variety of healthy foods. Let your child decide how much to eat.
- Should have no more than 4 to 6 ounces of fruit juice a day. Do not give your child soda.
- May be able to start brushing teeth. You will still need to help as well. Start using a pea-sized amount of toothpaste with fluoride. Brush your child's teeth 2 to 3 times each day.
- Sleep ¢ ˆ ’ Your child:
- Is likely sleeping about 8 to 10 hours in a row at night. Your child may still take one nap during the day. If your child does not nap, it is good to have some quiet time each day.
- May have bad dreams or wake up at night. Try to have the same routine before bedtime.
- Potty training ¢ ˆ ’ Your child is often potty trained by age 4. It is still normal for accidents to happen when your child is busy. Remind your child to take potty breaks often. It is also normal if your child still has night-time accidents. Encourage your child by:
- Using lots of praise and stickers or a chart as rewards when your child is able to go on the potty without being reminded
- Dressing your child in clothes that are easy to pull up and down
- Understanding that accidents will happen. Do not punish or scold your child if an accident happens.
- Shots or vaccines ¢ ˆ ’ It is important for your child to get shots on time. This protects your child from very serious illnesses like pertussis or some kinds of pneumonia. Your child may need some shots if they were missed earlier. Talk with the doctor to make sure your child is up to date on shots.
Help for Parents ‚
- Play with your child.
- Go outside as often as you can. Visit playgrounds. Give your child a tricycle or bicycle to ride. Make sure your child wears a helmet when using anything with wheels like skates, skateboard, bike, etc.
- Ask your child to talk about the day. Talk about plans for the next day.
- Make a game out of household chores. Sort clothes by color or size. Race to pick up toys.
- Read to your child. Have your child tell the story back to you. Find word that rhyme or start with the same letter.
- Give your child paper, safe scissors, glue, and other craft supplies. Help your child make a project.
- Here are some things you can do to help keep your child safe and healthy.
- Schedule a dentist appointment for your child.
- Put sunscreen with a SPF30 or higher on your child at least 15 to 30 minutes before going outside. Put more sunscreen on after about 2 hours.
- Do not allow anyone to smoke in your home or around your child.
- Have the right size car seat for your child and use it every time your child is in the car. Seats with a harness are safer than just a booster seat with a belt.
- Take extra care around water. Make sure your child cannot get to pools or spas. Consider teaching your child to swim.
- Never leave your child alone. Do not leave your child in the car or at home alone, even for a few minutes.
- Protect your child from gun injuries. If you have a gun, use a trigger lock. Keep the gun locked up and the bullets kept in a separate place.
- Limit screen time for children to 1 to 2 hours per day. This means TV, phones, computers, or video games.
- Parents need to think about:
- Enrolling your child in preschool or having time for your child to play with other children the same age
- How to encourage your child to be physically active
- Talking to your child about strangers, unwanted touch, and keeping private parts safe
- The next well child visit will most likely be when your child is 5 years old. At this visit your doctor may:
- Do a full check up on your child
- Talk about limiting screen time for your child, how well your child is eating, and how to promote physical activity
- Talk about discipline and how to correct your child
- Getting your child ready for school
When do I need to call the doctor?
- Fever of 100.4 ‚ °F (38 ‚ °C) or higher
- Is not potty trained
- Has trouble with constipation
- Does not respond to others
- You are worried about your childs development
Where can I learn more?
American Academy of Pediatrics ‚
http://www.healthychildren.org/English/ages-stages/Pages/default.aspx ‚
Centers for Disease Control and Prevention ‚
http://www.cdc.gov/vaccines/parents/downloads/milestones-tracker.pdf ‚
Last Reviewed Date
2015-02-02 ‚
List_set bdysylist
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider 's advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
Copyright
Copyright ‚ © 2016 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved. ‚