Your Three Year Old

Ages and Stages

Young boy eating dinner in kitchen
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Preschool Nutrition

You should now be giving your child 2%, low fat, or skim milk, as the American Academy of Pediatrics recommending switching to low-fat milk at age two years. So you should likely make the switch to low-fat milk if you haven't already.

Your child's diet should now resemble that of the rest of the families, with 3 meals and 2 snacks each day. You should limit milk and dairy products to about 16 to 24oz each day, and juice to 4 to 6oz each day, and offer a variety of foods to encourage good eating habits later.

To prevent feeding problems, teach your child to feed himself as early as possible, provide him with healthy choices and allow experimentation. Mealtimes should be enjoyable and pleasant and not a source of struggle. Common mistakes are allowing your child to drink too much milk or juice so that he isn't hungry for solids, forcing your child to eat when he isn't hungry, or forcing him to eat foods that he doesn't want.

Your child may now start to refuse to eat some foods, become a very picky eater or even go on binges where he will only want to eat a certain food. An important way that children learn to be independent is through establishing independence about feeding. Even though your child may not be eating as well rounded a diet as you would like, as long as your child is growing normally and has a normal energy level, there is probably little to worry about. Remember that this is a period in his development where he is not growing very fast and doesn't need a lot of calories.

Also, most children do not eat a balanced diet each and every day, but over the course of a week or so, their diet will usually be well balanced. You can consider giving your child a daily vitamin if you think he is not eating well, although most children don't need them.

While you should provide three well-balanced meals each day, it is important to keep in mind that some children will only eat one or two full meals each day.

If you child has had a good breakfast and lunch, then it is okay that he doesn't want to eat much at dinner.

Other ways to prevent feeding problems are to not use food as a bribe or reward for desired behaviors, avoid punishing your child for not eating well, limit mealtime conversation to positive and pleasant topics, avoid discussing or commenting on your child's poor eating habits while at the table, limit eating and drinking to the table or high chair, and limit snacks to two nutritious snacks each day.

To avoid having to supplement with fluoride, use fluoridated tap water. If you are using bottled or filtered water only, then your child may need fluoride supplements (check with the manufacturer for your water's fluoride levels).

Feeding practices to avoid are continuing to use a bottle or sippy cup, giving large amounts of sweet deserts, soft drinks, fruit-flavored drinks, sugarcoated cereals, chips or candy, as they have little nutritional value. Also avoid giving foods that your child can choke on, such as raw carrots, peanuts, whole grapes, tough meats, popcorn, chewing gum or hard candy.

For more information on your preschooler's nutrition:

Preschool Growth and Development

At this age your child is becoming more independent and you can expect him to dress himself and button clothes, brush his teeth with help, stack 9-10 blocks, draw circles and squares, use scissors, walk up steps by alternating his feet, jump from a step, hop, walk on his toes, pedal a tricycle, play with imaginary friends, have a very large vocabulary and use 3-4 word sentences and his speech should be 3/4 understandable.

Over the next year his speech will become fully understandable.

Your child may now begin to ask 'why' questions, tell stories, remember nursery rhymes, appreciate special events, and understand daily routines.

Your three year old will now begin to play cooperatively with other children in small groups, share his toys and develop friendships. Playtime may include structured games and fantasy activities.

Most toddlers take at least one nap (length of naps are usually very variable between different children, but naps are usually 1-1 1/2 hours long) during the day at this age and are able to sleep all night (for about 11 hours). If not, check to make sure that your toddler has a good bedtime routine and has developed the proper sleep associations.

Once your child is able to climb out of his crib (and you have already lowered the mattress and removed the bumper pads), it is time to move him into a toddler bed.

If your child is three feet tall, you may want to move him to a toddler bed even if he isn't climbing out of his crib yet. The usual age for moving out of a crib is about eighteen months to two years.

For more information on your preschooler's growth and development:

Safety

Accidents are the leading cause of death for children. Most of these deaths could easily be prevented and it is therefore very important to keep your child's safety in mind at all times. Here are some tips to keep your preschooler safe:

  • According to the latest car seat guidelines, once they are two years old (or, regardless of age, have outgrown their rear-facing car seat) children should sit in a forward-facing car seat with harness straps as long as possible and until they reach the weight and height limits of their car seat before moving to a booster seat. Keep in mind that many convertible car seats and combination car seats have forward-facing weight limits of 65 to 80 pounds when used with harness straps.
  • Make sure that used or hand-me-down equipment, such as car seats, strollers and cribs, etc, haven't been recalled for safety reasons. Call the manufacturer or the Consumer Product Safety Commission for an up to date list of recalled products.
  • Never leave small objects in your child's reach to prevent choking, including coins, toys with small parts (children under age three should not be allowed to play with toys that have parts that are smaller than 1 1/4 inch in diameter and/or 2 1/2 inches long), and rubber or latex balloons. Take the time to look for small items, especially coins, safety pins, tacks, etc in the areas where your children are playing.
  • Correctly use a harness when he is seated in a high chair.
  • Teach pedestrian (crossing streets, etc.) and playground safety (including not playing on trampolines).
  • Teach stranger awareness (review scenarios that predators may use, including offering candy or toys to get in the car, asking to help look for a lost pet, or being told they are picking your child up because you are sick).
  • Practice water safety: teach your child to swim, do not let your child play around any water (lake, pool, ocean, etc.) without adult supervision (even if he is a good swimmer), always wear a life preserver or safety vest when on a boat, and childproof the pool by enclosing it in a fence with a self-closing, self-latching door.
  • Be cautious of certain dog breeds (Rottweilers, pit bulls, German Shepards) that account for over fifty percent of fatal dog bites and closely supervise children when in the presence of animals.
  • Clean his teeth with a soft toothbrush with just a pea-sized amount of a fluoride toothpaste (to prevent fluorosis) until he learns to spit out the toothpaste. The first visit to the dentist is usually by age 3 years at the latest, although most experts recommend that you go soon after your infant gets his first tooth or by age 12 months. You might also need to start helping your child with flossing if his teeth are touching and you can't clean all around them by just brushing.
  • Limit television and encourage reading and storytelling.
  • Child Proof the House (Set the temperature of your hot water heater to 120 degrees F, use gates on stairs, covers on electrical outlets and latches on cabinets, keep household cleaners, chemicals and medicines completely out of reach and always store them in their original container and know the Poison Control Center number (1-800-222-1222), do not carry hot liquids or food near your child and do not allow your child near stoves, heaters or other hot appliances (especially curling irons), and when cooking, use the back burners and turn pot handles inward, to prevent drowning, empty all water from bathtubs and pails, keep the door to the bathroom closed and never leave your child alone near any container of water, keep a list of emergency numbers near the phone, and lock rooms that are not child proof).

For more information on your preschooler's safety:

Common Preschool Problems

  • Constipation: a very common and frustrating problem in children. It is usually defined as the passage of hard and painful stools or going four or more days without a bowel movement. Constiption is most commonly caused by a diet that is low in fiber, but can also be caused by drinking too much milk (more than 16 to 24oz/d), not drinking enough water or waiting too long to go to the bathroom. Initial treatment is increasing the amount of fluids he drinks and increasing the amount of fiber and bran in his diet. It is usually also helpful to decrease the amount of constipating foods in his diet, including cow's milk, yogurt, cheese, cooked carrots, and bananas. Stool softeners may be necessary if these steps don't work.
  • Upper Respiratory Infections: these are very common and include symptoms of a clear or green runny nose and cough and are usually caused by cold viruses. The best treatment is to use salt water nasal drops and a bulb suctioner to keep their nose clear. Call your Pediatrician if your child has high fever, difficulty breathing or is not improving in 7-10 days
  • Vomiting: usually accompanies diarrhea as part of a viral infection. If your child starts vomiting, it is best to give them a break from eating and drinking for an hour or so and then start to give small amounts of Pedialyte (1 teaspoon) every five or ten minutes. Once your child is able to tolerate drinking these small amounts you can increase the Pedialyte to about a tablespoon every five or ten minutes and then larger amounts as tolerated and then change back to his regular formula. Avoid giving just Pedialyte for more than 12 hours. Call your Pediatrician if the vomit has blood in it, if it is dark green, or if your child is showing signs of dehydration (which includes not urinating in 6-8 hours, having a dry mouth and weight loss).
  • Diarrhea: a common problem and is often caused by a viral infection. Call your Pediatrician if the diarrhea has blood or pus in it, if it is not getting better in 1-2 weeks or if you see signs of dehydration (which includes not urinating in 6-8 hours, having a dry mouth and weight loss). You should continue with their regular diet, but may give 1-2 ounces of Pedialyte each time that he has large diarrhea stool to prevent dehydration.
    For more information:

    Taking Your Child to your Pediatrician

    At the three year checkup, you can expect:

    • An examination of your preschooler's growth and development.
    • A review of feeding and sleep schedules.
    • Measurement of his height, weight and blood pressure.
    • Counseling for injury prevention, dental health, and a proper diet.
    • A discussion of toilet training progress.
    • Immunizations: a review of your child's immunizations to make sure they are up to date. If they are, the next immunizations will be his four year boosters.

    The next check up with your pediatrician will be when your child is four years old.

    For more information:

     

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