Two to three years old is the first time children get to go a whole year between well checks.  They are still growing and developing, but not quite as quickly as they were in the first few years.

Child development.

Three year olds can be quite independent, often wanting to do things by themselves.  And they are able to do many things by this age.  Running and climbing are no problem by this age.  They can pedal a trike – although sometimes the pedaling is backwards – and walk up and down stairs with one foot per step.  They can copy a circle, and turn book pages one at a time.  

Verbally, they are saying sentences of at least three words, sometimes more.  Parents can understand most of what their child says, and everyone else can understand at least 70%.  Reading with your child, and taking time to point out words on signs you pass can help their development. 

Emotionally they show affection and concern for friends, and can take turns in a game.  They may, however, get upset with changes in schedule.  Their emotions can get the best of them, so help them work through their issues and feelings.   

Child growth.

We continue to follow your child’s growth on the growth chart.  Remember that all children are different, and that we want them to follow their own growth chart.

General health.

In the exam we will do a general physical exam on your child, as well as watch how they interact with you.  Some three year olds are comfortable enough to interact with their pediatrician, which allows us to get a good idea of how they are developing.

Food and nutrition.

We still prefer milk and water for drinks.  If you want to give juice, then only 4 oz or less a day.  Let them have a few healthy snacks a day as well as meals.  You can be a good example for your child by also eating healthy snacks, and engaging in mealtime with the family.  

Three year old appetites vary, so let them eat as much as they want, but don’t force them to eat more than they are hungry for.  If you’re concerned about weight gain, or lack of, then check with your pediatrician.  Most of the time, even though it seems like they’re not eating anything, they are growing just fine.  

Health history.

Keep track of any urgent care or ER visits you made during the year, and let your pediatrician know at your visit if you haven’t already let them know.  This way we can keep track of how many of each kind of infection your child has had, which lets us know what we need to be concerned about.

Family history.

Certain diseases and infections may affect your child.  Tell us if there have been any changes in your family history.

Social history.

Has anything changed with your family?  Let your pediatrician know.

Safety and health issues.

We still would like your child in a car seat-backwards until about 35-40 pounds, if possible.  Get started on helmets while on a tricycle, so they get used to wearing one.  Never leave your child unsupervised outside, especially if near water or roadways.  Make sure your child has a lifejacket if you go boating.  Teach your child to be kind to animals in your home, and to ask before touching someone else’s animal.

Give your child a few basic rules to follow, and post them somewhere obvious.  Too many or too complex can make them overwhelmed.  If they break a rule, then you can give them a minute time out.  You can encourage good behavior by praising them when they do things correctly, as opposed to only giving them time when they’re making mistakes.     

Vaccines.

As long as your child is up to date on their immunizations, there will not be any at this visit.  The next will be at 4 years old.

Links.

How to prevent aggressive behavior at healthychildren.org.

How to share books with 3 and 4 year olds.

3 year old milestones at cdc.gov.