What to expect at your three-year visit
Here are a few things your doctor might discuss with you at the three-year visit.

• Children at this age should have started toilet training. If you are having difficulty, bring your concerns to your doctor.
• Children learn most of their social skills from other children. If your child does not attend a structured program or day care, you might want to arrange time with other children his or her age.
• Temper tantrums are very common among this age group. See below for information on how to effectively deal with them.
• Toddlers are curious about their bodies and others. This is natural. Try to distract, not embarrass or scold when a child is touching his or her genitals.

Three-year immunizations
Make sure all vaccinations are up-to-date

Today’s Report For Your 3-year-old

Child’s Name

Examined by Dr.

Weight

%

Length

%

Head

Immunizations

Milestones

Notes

Trial and error: Feeding your 3-year-old
You might find your child is a picky eater, with strong opinions about what he or she will or will not eat. In fact, there might only be a few foods your child will eat. Do not worry. Continue to offer your child a variety of healthy food, but do not force your child to eat. Instead ask him or her to "try" a little bit of everything. If he or she does not like it, he or she does not have to eat it.

You can begin to serve your child low-fat milk, rather than whole milk, as well as other lower-fat products. If you are concerned about your child’s weight, you should discuss the diet with your health care provider.

Try to avoid serving foods that are high in sugar and fat, such as ice cream, cookies, and cake. Save these foods for occasional snacks. Try to set regular feeding schedules (with the rest of the family) so your child is not continually snacking. If your child must snack, offer healthy foods, such as:

• Peanut butter on crackers
• Fresh fruit or vegetables
• Rice cakes
• Dry cereal
• Popsicles made from unsweetened fruit juice

Development and your child
Your 3-year-old can be very engaging. Social, language, and motor skills are developing rapidly during this time. Your child will display curiosity of the world. The question "Why?" will be asked over and over again.

Three-year-olds gain a greater sense of self. Your child will identify gender differences and imitate his or her adult male and female role models. During play activity, your child will now interact more with his or her peers. Vocabulary increases to several hundred words. Three- to four-word sentences are used regularly. Although articulation is not perfect, your child can be understood approximately 75 percent of the time.

Motor skills demonstrate improving coordination. Your child might enjoy cutting with scissors, stacking multiple objects, and drawing circles. A greater sense of physical independence is gained when your child is able to go up and down stairs using alternating feet.

Shop ‘til ya’ drop: How to shop with your child
Keep in mind that no matter how old your child is, shopping is very difficult for children. It is hard for them to stay in one position for a long time, sit in a cart with their legs dangling, and walking while holding mom or dad’s hand. Here are some tips to make your trips easier for everyone:

• Plan trips after meals and naps.
• Allow your child time to get ready or finish what they are doing before you leave.
• Tell your child before you leave: Where you are going, what you will be doing, what they can have, and how long you will be gone. Most importantly, stick to it.
• Loosen or remove coats, hats, or scarves upon arrival.
• Take crackers or fruit for a snack.
• Bring a favorite toy.
• Have your child look for things on your shopping list. Give them coupons with pictures and see if they can find the items.
• Many grocery stores now offer short-term day care for parents while they shop. Even if these stores are a further drive, the end result might well be worth it.

• Do not threaten to leave your child. (This often makes the situation worse.)
• Keep your cool, do not spank or grab.
• Help your child calm down and identify the problem.
• If all else fails, go home.

• Leave your child alone in a car, not even for a moment.
• Walk away from a child in a shopping cart.

• Poison-proof your home, paying special attention to cabinets at child level. In the event your child ingests a potentially harmful substance, keep the container and call the poison control center at 1-800-222-1222.
• Hot tap water should be less than 120 degrees Fahrenheit.
• Smoke detectors should be located on each level of your home and outside of each bedroom. Test smoke detectors once a month.
• Keep firearms unloaded and locked in a cabinet if you must have them in the home.
• Your child should always ride in a car seat until he or she weighs 40 pounds and is at least 4 years old.
• When your child is ready to learn to ride a bike, buy him or her a helmet.
• Discuss stranger safety.
• Until your child can be taught to cross the street independently, an adult should always accompany him or her.
• Remove doors from old appliances and warn your child never to hide in appliances.
• Teach your child his or her name, address, and telephone number (with area code). You might also want to teach your child to dial "911" and "0" for the operator.
• By this time, your child should also know your first name as well as other family member’s names.

• Play dough with cookie cutters
• Musical instruments
• Bubbles
• Imaginative play (kitchen with dishes or baby dolls)
• Simple puzzles
• Coloring or painting
• Games (Candyland or Chutes & Ladders)

Should I call the doctor?
Yes. If your child:

• Becomes sluggish or inactive
• Will not eat
• Cries more than usual
• Develops an unusual rash (not prickly heat or diaper rash)
• Has a fever at any age
• Vomits repeatedly (not just spitting up)
• Has frequent loose, watery bowel movements
• Breathes rapidly, wheezes or has any difficulty breathing

Before you call your child's doctor or nurse, write down your child’s symptoms. Take his or her temperature. Have your pharmacy’s phone number on-hand to tell the doctor and a notepad on hand to write down any instructions.