Age: 3 Years

July 06, 2020

Three-year-olds are self-determined individuals with a good sense of right and wrong. They understand that they can influence the world around them and have discovered the art of talking their way out of a situation. It’s the delightfully funny, yet tiresome age of “why, why, why.”

SAFETY

    1. Car: Use a Convertible Car Seat in the back seat of the vehicle

      1. Important Note: As of 11/2018, the American Academy of Pediatrics (AAP) recommends car seats remain rear facing as long as possible, until the child reaches the highest weight or height allowed by the seat. This replaces the previous age specific milestone of 2 years and 30 lbs. The recommendations are based on scientific studies showing that rear facing is safest in a crash.

      2. Many children will easily fit rear facing in their car seats still at 3 years (albeit with bent legs in the seat). If your child simply will not fit (you can’t safely buckle up the child), turn the car seat forward facing (but continue to use the 5-point harness style seat). Rear facing is best if possible.

  1. Playgrounds: Teach playground/street safety.

  2. Strangers: Teach stranger safety (who is a safe adult should they get lost).

  3. Childproofing: Injuries are a big concern at this age. Three-year-olds will manage to get into and onto everything and usually don’t have innate fear of getting hurt to stop them.

    1. Store matches/lighters/chemicals/medications/cleaners/toxic household products out of reach or locked. (TIP: Add poison control’s number to your cell phone now 1-800-222-1222).

    2. Burns are common at this age, both by pulling hot things down onto themselves (e.g., cords from curling irons, handles from pots) and touching hot surfaces (e.g., fireplaces, grills, stovetops, etc.)

    3. Lock guns with ammunition separate and in a gun safe. (Disturbing fact: More children are killed from guns every year than intruders)

  4. Water:

    1. Do not leave children in the bathtub unattended.

    2. Do not allow children to swim unattended.

  5. Smoking: Do not smoke in the home or in your car. Check smoke alarms to ensure they work properly and change batteries annually.

  6. Riding: Wear a helmet on all things a kid can ride (e.g., bicycles, tricycles, scooters, ATVs, as passengers on adult bicycles, etc.).

  7. Sun: Use sunscreen when outside.

  8. Never alone: Do not leave your child unattended in the house, yard, or car.

Nutrition

  • Provide 3 meals and 2-3 nutritious snacks a day.

  • Limit the number of fats and sweets your child gets in a day. In addition, you child does not need juice, it is essentially fruit sugar. If you choose to give it to your child, do so in limited quantities (e.g., 4 oz a day). There is no place for soft drinks/soda in a child’s diet.

  • You choose the menu. Offering good nutrition at an early age builds good lifetime eating habits. Consider the fact that you’re fueling your child’s growing brain. As a society, we are propagating this notion of “kid food” (e.g., mac n’ cheese, hot dogs, French fries, chicken nuggets). These have very little nutritional value. Offer a variety of foods rich in fruits and vegetables. Also try to include some foods rich in protein.

  • Dairy products should be low fat. This includes all milk (unless your child is failing to thrive and you are directed to do otherwise by your pediatrician). All members over the age of 2 in a family should be drinking low fat milk. Maximum amount is 24 oz/day. If your child isn’t a big milk drinker, just ensure your child is getting enough calcium and vitamin D from other sources (e.g., almond milk, dark leafy greens, milk products, supplements, etc.)

  • Eat meals as a family (around a table with the television off). Not only does eating together as a family develop good nutritional habits, it has multiple lasting effects on the social support of a family. Most 3 year-olds can sit at the table independently.

  • Model good eating habits.

  • Keep in mind it is very difficult to eat healthy when eating out (especially at fast food restaurants).

  • Give a multivitamin daily only if your child is not eating a balanced diet.

Sleep

Total sleep at night is usually 10-13 hours. Most 3-year-olds still need one nap or rest period a day, usually in the afternoon. As your child approaches 4 years of age, he or she may start to wean off the nap. Every child’s need for sleep is a little different. If your child is acting sleepy and grumpy by 4 or 5 in the afternoon, he or she may not be quite ready to eliminate the nap. Most children this age are ready to transition to a “big kid bed.”

Milestones

  1. Jumps forward

  2. Can kick a ball

  3. Knows name, age, and sex

  4. Draws a circle

  5. Can dress self

  6. Can feed self

  7. Rides a tricycle

  8. Shows early imaginative behavior

  9. Speaks in 3-4 word sentences, has 500+ words, and is 75% understandable

ORAL HEALTH

  1. Media Exposure: Limit total media time (TV, movies, ipad, etc.) to no more than 1 hour a day of high-quality material. Watch programs together so you are aware of what your child is exposed to. Keep in mind that children this age have a hard time distinguishing reality from fiction. Consequently, be extra cautious about movies with scary villains (this can cause nightmares and fears).

  2. Sexual Education: Expect normal curiosity, use correct terms, answer questions frankly, and teach that certain body parts are private.

  3. Social Interactions: Praise good behavior, encourage talking, consider structured learning (e.g., preschool). Children this age should interactively play but are not naturally good at sharing.

  4. Read together, encourage safe exploration, physical activity.

  5. Provide choices, reinforce limits, use “time out.”

  6. Toilet Training: If your child is not trained, now is the time.

Illness

At this age you may treat fever and minor illnesses at home as long as your child looks and acts ok. Bring your child to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your child has signs of dehydration, your child reports specific symptoms (e.g., sore throat, hurt arm, etc.), your child has difficult or labored breathing, your child is lethargic, or you are concerned.

YOUR NEXT VISIT

From this age on, your child’s visits are on an annual basis. So, your child’s next well child check is at 4 years of age. As for vaccines, you may do the “kindergarten” shots at 4 or 5 years of age (children with summer birthdays should do them at 4 years old to be ready for kindergarten registration in the Spring). The shots are: DtaP (diphtheria, tetanus, and pertussis), IPV (inactivated polio), MMR (measles, mumps, and rubella), varicella (chickenpox). Depending on the time of year, your child may also need a flu shot.

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