Food intake and preferences may vary from day to day, but continue to offer your child 3 meals and 2-3 snacks a day of healthy foods. Your child will eat when he is hungry and will not lose weight from periodically refusing to eat. Limit high fat or low nutrient foods and beverages (candy, chips, pop); it is often less tempting to just avoid having them in the house at all except for special treats. Milk is still recommended (about 2 cups a day), but yogurt and calcium-fortified orange juice are appropriate substitutes for children who do not care for milk.
Mealtime is often a very active, sometimes giddy, time of day. Encourage control but also happy family time, as this may be the only time all family members are together at one time. This is a good age to enlist the help of children for mealtime "jobs" and in safe help with food preparation. Keep a copy of the USDA Food Pyramid on your refrigerator so you can help your child learn the value of nutritious eating.
You are still your child's primary tooth brusher. Brush at least twice a day with a small amount of toothpaste. Dental visits are recommended every 6 months.
Most children sleep 8-12 hours a night. Naps sometimes become "rest periods" at this age but still allow both the child and caregiver to have a break. Try to make bedtime pleasant and consistent (even if an older sibling has a later bedtime).
Remember that all children have accidents, even after successful toilet training. Help your child learn to clean up after himself and listen more closely to his own body's signals. Nighttime wetting may take longer to master, as this is a developmental (versus behavioral) skill and the timing can also be inherited. Try to remain positive and not focus on the issue. It should resolve with time. If your child reaches 7-8 years of age or becomes bothered by it, consult your health care provider.
Minnesota law requires all children to be in appropriately sized, federally approved car restraints until they are age 4 and 40 pounds. After that, your child will continue be safer in a booster (now approved up to 80+ pounds) and all children under 12 should ride in the back seat. Make sure the seatbelt fits properly, and teach by your own good example.
Discuss "good" and "bad" touch and appropriate contact with strangers.
Use sunscreen (at least SPF 15) during all outdoor daytime activity.
Teach respect and caution around all animals (even your own).
If you have a gun, lock it out of sight and lock the ammunition separately.
Enforce helmets (without exception) for biking, scooters, skateboards, and in-line skating.
Never leave your child unattended near water, even if he can swim. Wear life vests when boating (it's a Minnesota law) or in deep water.
Continue to update your childproofing. Choking, burns, injuries, and poisonings still occur at alarming rates at this age. Keep all medications and toxic household products in a locked cabinet and make sure all have working safety caps. We also recommend that you keep the Poison Control Center (800-222-1222) phone number handy next to all of your home phones and programmed into your cell phone. Remember that children imitate parents, so avoid taking medications in front of your child.
Continue to monitor your child's exposure to second-hand smoke.
Children at this age are often eager to please and are very proud of their knowledge and skills. They enjoy having parents (and occasionally siblings) participate in games and school preparation challenges (counting, ABC's, songs, crafts). Most parents also start to realize that children become more independent and sometimes choose friends over family for certain activities! Encourage more of that independence by having your child practice routine self-care skills (choosing clothes, getting dressed, washing the face, brushing teeth and hair). Discipline can become more of an issue, with many children openly disobeying rules. Teach acceptable behavior by setting limits and dealing with misbehavior promptly and fairly. Daily and weekly family time helps cohesiveness and communication.
We look forward to seeing your child again at age FIVE, the infamous pre-kindergarten visit. The DTaP, Polio, MMR, and Varicella (Chicken Pox) vaccine boosters will be due, so prepare your child the way you think is best. Please try to be at least 10 minutes early for all scheduled well-child visits.