Your Child's 3-Year Checkup

Checkups are a way to make sure your child is growing properly and help you find out if there are any health problems. After the visit, make an appointment for your child's 4-year checkup.

• Help your child learn healthy eating habits:

  • Eat together as a family as often as possible.

  • Offer healthy food choices and include fruits and vegetables at every meal. Let your child eat when hungry and stop when full. Do not force your child to eat.

  • Limit foods and drinks that are high in sugar (such as cookies and soda), salt, and fat (such as fried food).

  • If your child drinks juice, do not give more than 4 ounces (120 ml) of 100% fruit juice a day.

  • Give your child about 16 ounces (480 ml) a day of low-fat (1%) or nonfat (skim) cow's milk. Include other calcium-rich foods in your child's diet, such as cheese; yogurt; and fortified juice, cereal, and bread.

• To help prevent choking:

  • Make sure your child is sitting while eating.

  • Avoid nuts, popcorn, hard candy, gum, thickly spread peanut butter, hard cheese, hard or raw fruits and vegetables, and hot dogs and sausages.

• Help your child get about 10–13 hours of sleep in a 24-hour period. If your child is no longer napping, allow for some quiet time during the day.

• Night awakenings and nightmares are common at this age. To help your child sleep well:

  • Set regular bed, wake, and nap (or quiet) times.

  • Create a relaxing bedtime routine. It should take about 20–30 minutes and can include a light snack, a warm bath, a favorite toy, and story time.

  • Use a night-light if your child is afraid of the dark.

  • Avoid scary stories, shows, or screen time, especially before bed.

• Children this age learn best by talking and playing with others and touching things in their world. Video chatting is OK, but if your child has other screen time:

  • Choose educational programming and apps.

  • View/play together when possible.

  • Limit screen time to less than 1 hour a day.

  • Do not allow a TV, computer, tablet, or smartphone in your child's bedroom.

• Play rhyming games and sing songs together every day. Read aloud to your child and ask questions about the story and pictures.

• Set clear rules. If you need to tell your child "No," explain what you want them to do instead. Do not hit or spank your child.

• To help your child get ready for preschool:

  • Teach your child how to share, take turns, speak respectfully, and be kind when playing with other children.

  • Help your child deal with anger by naming the angry feelings, talking about the other child's point of view, and finding a peaceful solution together. If your child is hitting or fighting, take them away from the other children right away.

  • Visit the school so your child can meet the teachers.

• Although most kids this age are using the toilet or potty, it is normal to have accidents and/or to need a diaper or disposable training pants such as Pull-Ups® or Easy Ups® at night.

• Build healthy family relationships:

  • Spend relaxed, fun time together.

  • Treat each other with respect.

  • Have family routines (for example, at mealtime and bedtime).

  • Have family traditions (such as birthday and holiday celebrations).

• Stay active as a family by visiting parks and playgrounds, taking walks, and playing games (such as tag or catch). Regular activity helps build strong bones, lessens stress, and helps prevent obesity.

In the car:

• If your child has outgrown the rear-facing height or weight limit allowed by the car seat manufacturer, turn the car seat forward-facing. Keep the car seat in the back seat and continue to use the car seat harness.

• Follow the manufacturer's instructions on installing and using the car seat, or go to a child safety seat check.

At home:

• Make your home safe:

  • Put gates at the top and bottom of stairs.

  • Put window guards on windows above the first floor.

  • Keep blinds, drapes, and cords out of your child's reach.

  • Be sure that all dressers, shelves, and TVs are attached to the wall.

  • Use a toy chest without a lid. Or if it has a lid, make sure it has safe hinges that hold the lid open.

  • Cover all outlets and keep any night-lights out of reach.

• Keep out of reach:

  • small objects such as toys, button batteries, and coins

  • plastic bags

  • medicines (keep in a locked cabinet, if possible)

  • cleaning supplies

  • anything that is hot, sharp, or breakable

• Put smoke and carbon monoxide alarms near all sleeping areas and on every level of your home.

• Have your child wear a helmet when riding a bike, trike, or scooter; or while in a child carrier on an adult bike.

• When around water, watch your child constantly. Look into swimming classes for your child.

• Watch your child carefully around grills and open fires. Keep matches and lighters out of reach.

• Do not allow anyone to smoke around your child.

• A gun in the home increases the risk of accidents and injuries. If you do have a gun, keep it unloaded and locked up. Lock bullets separately from the gun.

• Never leave your child alone at home, in the yard, or in the car. Only leave your child with responsible caregivers, and be sure to review safety information with them.

Prepare for emergencies:

• Take a first aid/CPR class. Be sure you know what to do if your child is choking.

• If you are ever worried that you will hurt your child, put them in a child-safe space for a few minutes and call a friend, a relative, or your health care provider for help. Never shake your child — it can cause bleeding in the brain and even death.

• Get all immunizations and tests that your child's health care provider recommends.

• Take care of your child's teeth and gums:

  • Take your child to the dentist every 6 months.

  • Follow your health care provider's recommendations about using a fluoride coating (called a varnish) on your child's teeth.

  • Let your child brush their teeth (with your help) twice a day. Use a soft toothbrush and a pea-sized amount of fluoride toothpaste. Brush for 2 minutes and encourage your child to spit after brushing.

  • As soon as two teeth touch, help your child floss between them every day.

  • If your child is thirsty between meals or at night, give water only. Do not let your child sip juice or milk throughout the day or in bed because this can cause tooth decay.

• In the sun, protect your child's skin with a water-resistant sunscreen with an SPF of at least 30, and re-apply every 2 hours or more often if swimming or sweating. It's best to keep your child in the shade, especially between 10 a.m. and 2 p.m.

• Your health care provider can tell you about help that is available in the community or through a social worker. Talk to your health care provider if you're worried that:

  • You don't have enough food for your child.

  • You don't have a safe place to live.

  • You don't have health insurance.

  • You have a problem with drugs or alcohol.

• Call your child's health care provider if you have concerns about your child's health, growth, or development.