Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0
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Well Child Care at 4 Years


Your child should always be a part of the family at mealtime. This should be a pleasant time for the family. Give small portions of food to your child. If he is still hungry, let him have seconds.

Development and Discipline

At this age children usually become more cooperative in their play with other children. They are curious and imaginative.

Allow privacy while your child is changing clothes or using the bathroom. When your child starts wanting privacy on his own, let him know that you think this is good.

Breaking rules occasionally is common at this age. Making children stand in a corner by themselves for 4 minutes is usually an effective punishment. If you have questions about behavior ask your doctor.

For more information see: Normal Development: 4 Years

Safety Tips

Car Safety

  • Never leave your child alone in a car.
  • Everyone in a car must always wear seat belts.

Pedestrian and Bicycle Safety

  • Teach your child to never ride a tricycle or bicycle in the street.
  • Have your child wear a bicycle helmet while riding a tricycle or bicycle.
  • It is too early to expect a child to look both ways before crossing the street. Supervise all street crossing.


  • Teach your child to never take medicines without supervision and not to eat unknown substances.
  • Put the poison center number on all phones. The poison control number is ____________________.
  • Ask your doctor about syrup of Ipecac. Use it only if you are told to do so.

Safety Around Strangers

  • Teach your child the first and last names of family members.
  • Teach your child to never go anywhere with a stranger.

Avoid Injuries

  • Do not allow your child to be near knives, power tools, or mowers.

Dental Care

  • Brushing teeth regularly after meals is important. Think up a game and make it fun.
  • It is also a good idea to make an appointment for your child to see the dentist.


Your child may receive one or more shots. After a shot your child may run a fever and become irritable for about 1 day. Your child may also have some soreness, redness, and swelling where a shot was given. For fever, give your child an appropriate dose of acetaminophen. For swelling or soreness, put a wet, warm washcloth on the area of the shot 4 times a day.

Call your child's physician immediately if:

  • Your child has a fever over 105 degrees F (40.5 degrees C).
  • Your child has a severe allergic reaction beginning within 2 hours of the shot (for example, hives, wheezing or noisy breathing, swelling of the mouth or throat).
  • Your child has any other unusual reaction.

Next Visit

A once-a-year check-up is recommended. Be sure to check your child's shot records before starting school to make sure he or she has all the required vaccinations.

Written by Robert Brayden, M.D.
Copyright 1999 Clinical Reference Systems