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Child's Routine Checkup, 4 Years: Care Instructions


Your child probably likes to sing songs, hop, and dance around. At age 4, children are more independent and may prefer to dress without your help.

Most 4-year-olds can tell someone their first and last name. They usually can draw a person with three body parts, like a head, body, and arms or legs.

Most children at this age like to hop on one foot, ride a tricycle (or a small bike with training wheels), throw a ball overhand, and go up and down stairs without holding onto anything. Some 4-year-olds know what is real and what is pretend but most will play make-believe. Many four-year-olds like to tell short stories.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

Eating and a healthy weight

  • Encourage healthy eating habits. Most children do well with three meals and two or three snacks a day. Offer fruits and vegetables at meals and snacks.
  • Check in with your child's school or daycare to make sure that healthy meals and snacks are given.
  • Limit fast food. Help your child with healthier food choices when you eat out.
  • Offer water when your child is thirsty. Do not give your child more than ½ cup (125 mL) of fruit juice per day. Juice does not have the valuable fibre that whole fruit has. Do not give your child soda pop.
  • Make meals a family time. Have nice conversations at mealtime and turn the TV off. If your child decides not to eat at a meal, wait until the next snack or meal to offer food.
  • Do not use food as a reward or punishment for your child's behaviour. Do not make your children "clean their plates."
  • Let all your children know that you love them whatever their size. Help your children feel good about their bodies. Remind your child that people come in different shapes and sizes. Do not tease or nag children about their weight. And do not say your child is skinny, fat, or chubby.
  • Limit TV or video time to 1 hour or less per day. Research shows that the more TV children watch, the higher the chance that they will be overweight. Do not put a TV in your child's bedroom, and do not use TV and videos as a babysitter.

Healthy habits

  • Have your child play actively for at least 3 hours every day. Plan family activities, such as trips to the park, walks, bike rides, swimming, and gardening.
  • Help your child brush their teeth 2 times a day and floss one time a day.
  • Limit TV and video time to 1 hour or less per day. Check for TV programs that are good for 4 year olds.
  • Put a broad-spectrum sunscreen (SPF 30 or higher) on your child before going outside. Use a broad-brimmed hat to shade your child's ears, nose, and lips.
  • Do not smoke or allow others to smoke around your child. Smoking around your child increases the child's risk for ear infections, asthma, colds, and pneumonia. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.


  • For every ride in a car, secure your child into a properly installed car seat that meets all current safety standards and laws. Use a car seat or booster that is made for their height and weight.
  • Make sure your child wears a helmet that fits properly when riding a bike.
  • Keep cleaning products and medicines in locked cabinets out of your child's reach. Keep the number for your local or provincial poison control centre on or near your phone.
  • Put locks or guards on all windows above the first floor. Watch your child at all times near play equipment and stairs.
  • Watch your child at all times when your child is near water, including pools, hot tubs, and bathtubs.
  • Do not let your child play in or near the street. Children younger than age 8 should not cross the street alone.


Influenza (flu) immunization is recommended once a year for all children ages 6 months and older.


  • Read stories to your child every day. One way children learn to read is by hearing the same story over and over.
  • Play games, talk, and sing to your child every day. Give your child love and attention.
  • Give your child simple chores to do. Children usually like to help.
  • Teach your child not to take anything from strangers and not to go with strangers.
  • Praise good behaviour. Do not yell or spank. Use time-out instead. Be fair with your rules and use them in the same way every time. Your child learns from watching and listening to you.

Going to kindergarten

It is a good idea to send your child to kindergarten. Kindergarten teachers know how to help young children with different skills and backgrounds. They will help your child enjoy school and get ready for grade 1. Most children start kindergarten between 4½ and 6 years old. Kindergarten will help your child:

  • Learn about school.
  • Make new friends.
  • Prepare for grade 1.

When should you call for help?

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse advice line if:

  • You are concerned that your child is not growing or developing normally.
  • You are worried about your child's behaviour.
  • You need more information about how to care for your child, or you have questions or concerns.

Where can you learn more?

Go to

Enter W873 in the search box to learn more about "Child's Routine Checkup, 4 Years: Care Instructions".

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.