Here are some suggestions from Bright Futures experts that may be of value to your family.
How Your Family is Doing
Take time for yourself and to be with your partner.
Stay connected to friends, their personal interests, and work.
Have regular playtimes and mealtimes together as a family.
Give your child hugs. Show your child how much you love him.
Show your child how to handle anger well—time alone, respectful talk, or being active. Stop hitting, biting, and fighting right away.
Give your child the chance to make choices.
Don’t smoke or use e-cigarettes. Keep your home and car smoke-free. Tobacco-free spaces keep children healthy.
Don’t use alcohol or drugs.
If you are worried about your living or food situation, talk with us. Community agencies and programs such as WIC and SNAP can also provide information and assistance.
Eating Healthy and Being Active
Give your child 16 to 24 oz of milk every day.
Limit juice. It is not necessary. If you choose to serve juice, give no more than 4 oz a day of 100% juice and always serve it with a meal.
Let your child have cool water when she is thirsty.
Offer a variety of healthy foods and snacks, especially vegetables, fruits, and lean protein.
Let your child decide how much to eat.
Be sure your child is active at home and in preschool or child care.
Apart from sleeping, children should not be inactive for longer than 1 hour at a time.
Be active together as a family.
Limit TV, tablet, or smartphone use to no more than 1 hour of high-quality programs each day.
Be aware of what your child is watching.
Don’t put a TV, computer, tablet, or smartphone in your child’s bedroom.
Consider making a family media plan. It helps you make rules for media use and balance screen time with other activities, including exercise.
Playing With Others
Give your child a variety of toys for dressing up, make-believe, and imitation.
Make sure your child has the chance to play with other preschoolers often. Playing with children who are the same age helps get your child ready for school.
Help your child learn to take turns while playing games with other children.
Reading and Talking With Your Child
Read books, sing songs, and play rhyming games with your child each day.
Use books as a way to talk together. Reading together and talking about a book’s story and pictures helps your child learn how to read.
Look for ways to practice reading everywhere you go, such as stop signs, or labels and signs in the store.
Ask your child questions about the story or pictures in books. Ask him to tell a part of the story.
Ask your child specific questions about his day, friends, and activities.
Continue to use a car safety seat that is installed correctly in the back seat. The safest seat is one with a 5-point harness, not a booster seat.
Prevent choking. Cut food into small pieces.
Supervise all outdoor play, especially near streets and driveways.
Never leave your child alone in the car, house, or yard.
Keep your child within arm’s reach when she is near or in water. She should always wear a life jacket when on a boat.
Teach your child to ask if it is OK to pet a dog or another animal before touching it.
If it is necessary to keep a gun in your home, store it unloaded and locked with the ammunition locked separately.
Ask if there are guns in homes where your child plays. If so, make sure they are stored safely.
What to Expect at Your Child's 4 Year Visit
We will talk about:
- Caring for your child, your family, and yourself
- Getting ready for school
- Eating healthy
- Promoting physical activity and limiting TV time
- Keeping your child safe at home, outside, and in the car
- Smoking Quit Line: 800-784-8669
- Family Media Use Plan: www.healthychildren.org/MediaUsePlan
- Information About Car Safety Seats: www.nhtsa.gov/parents-and-caregivers
- Toll-free Auto Safety Hotline: 888-327-4236
Consistent with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition
The information contained in this webpage should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Original handout included as part of the Bright Futures Tool and Resource Kit, 2nd Edition.
Inclusion in this webpage does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this webpage. Website addresses are as current as possible but may change at any time.
The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this handout and in no event shall the AAP be liable for any such changes.
American Academy of Pediatrics