48 Month Check Up

DIET:

It is now ok to switch to 1% milk. Continue with healthy choices. Expect kids to not always be the best eater.

SLEEP:

Maintain a good bedtime routine. Your child still needs between 10-12 hours per night. Naps (unfortunately) begin to go away.

DEVELOPMENT:

Continue to read to your child. Limit time in front of TV. Encourage plenty of time outside. Unstructured play remains important. Children now will be ready for a bicycle with training wheels. Language will be very good-almost 100% recognizable by others. Most kids will now know all their shapes, colors and can count to 10-20 and recognize majority of their letters.

SAFETY:

Your child needs to remain in a 5 point booster seat. Continue to be aware of choking hazards. Learn child CPR. Use sunscreen daily and insect repellent when appropriate. Turn your hot water heater down one notch from the highest setting. Place all chemicals, cleaning agents, pet food, etc up and out of the way. Also do not keep water stored in 5 gallon buckets. Do not leave unattended in the bath. Avoid trampolines.

DISCIPLINE:

Continue to firm and consistent. Kids will do much better if they have a good, regular schedule to follow. Expect more “talking back” and not always following directions very well.

TEETH:

Try and brush teeth twice per day. Continue flossing. They should have now seen the dentist.

POTTY TRAINING:

Most kids should now be potty trained. Many kids will still not be dry at night. Constipation can become an issue. Watch for stool holding. Add OTC Benafiber (¼ to ½ adult dose daily) if constipation occurs.

Immunizations given today:

DTAP, IPV, MMR
Hearing screen and vision screen.

Next Appointment:

12 months

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