Four years old is another big year in the pediatric world.  We expect them to be speaking pretty clearly, know colors, and they get their last shots before school starts.  

Child development.

Children at four are able to speak in clear sentences, and often will tell long stories about all kinds of things.  They are getting more creative, and enjoy make believe play.  However, they can have trouble with what’s real and what’s make believe.  They are able to name some colors, letters, and numbers, and can understand the idea of counting.  They can also hop and stand on one foot for a few seconds.  

Child growth.

We continue to plot your child’s weight and height on the growth curve to make sure they are growing appropriately.

General health.

During your child’s visit, we will examine your child, and watch them as they interact with their caregivers and the clinic staff.  Let us know if there’s something in particular you’re concerned about.

Food and nutrition.

Healthy balanced meals that are eaten with the family allow you a chance to connect with your child while being a good example for eating healthy.  Have healthy snacks on hand for when your child is hungry between meals.  We still prefer milk and water for drinks.

Health history.

Let us know about any new visits to the urgent care, ER, or specialist.  Even if your doctor referred you somewhere, they may not have gotten a note back, so letting them know how it went will help your pediatrician take care of your child.

Family history.

Let your pediatrician know if there’s anyone in your family with a new illness.

Social history.

We still ask about your child’s living environment, and if they go to daycare.  Keeping track of these things helps us take better care of your child, and help us get to know you all better.

Safety and health issues.

Make sure your child has a car seat in the back seat of the car, and a helmet for their bike.  Keep an eye on your child any time they are outside, especially near water.  Help your child brush their teeth twice a day, and if they haven’t already been to the dentist make an appointment for them.  Limit the time your child watches TV, computers, tablets to an hour or less, and talk to your child about what they do see.  Encourage activity and imagination, and join your child in play when you can.  

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Vaccines.

At 4 years old children get MMR, Varicella, DTaP, and IPV.  These are all immunizations they have had before, and actually mark an end of series for all four of them.  Your child will also be given any immunizations previously missed at this time if it is appropriate.  The next regular set of vaccines will be at 11 years old.  (Influenza is considered a seasonal vaccine.)

Links.

Essentials for parenting toddlers.

Choose my plate-health and nutrition.

Vaccines at 4-6 years.