3 Year Well-Child Visit

Some people call them “threenagers,” some the “trusting three’s,” but whatever the case may be for your child, it is likely that he or she is active, demanding of your attention, and curious about everything. This year is all about learning – rules, acceptable behaviors, shapes, colors, and social skills. What can you expect at this visit with the Pediatrician?

Vitals – Heart rate and respiratory rate will be counted, temperature and blood pressure is taken.

Growth measurements – Height, weight, and BMI (Body Mass Index) continue to be measured and plotted on growth curves for age and gender.  The BMI is s a person’s weight in kilograms (kg) divided by the square of height in meters. Higher BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the health of an individual by itself. It is another marker we use to help determine the health of your child. 

Development –

• Social: They use imagination and play cooperatively with others. They can share. 
• Speech & Language: They speak in 3-5 word sentences. 75% of speech is understandable by others. They can tell you a story and determine if one thing is bigger or smaller than another. They understand directions such as “under” or “on top of.”
• Gross (large) motor: They can pedal a tricycle, climb onto a chair, and jump forwards. 
• Fine motor: They can draw circles and a basic stick-figure person. 

Questions from the Pediatrician – your child’s doctor will ask questions about nutrition and meals, sleeping, voiding (urination) and stooling (bowel movements), and development.

Nutrition – Continue to offer your child a variety of fruits, vegetables, proteins, dairy, fats, and carbohydrates. Promote family meal times with snacks in between. Allow your child to decide how much to eat at once.  Avoid fruit juices or other sweetened beverages. 

Healthy Teeth – brushing your child’s teeth before bed should be an important part of the nighttime routine. Clean teeth and avoidance of any sippy cups before bedtime can help prevent cavities even in very young children. Your child should be seen by the dentist every 6 months for check ups and cleanings. 

Exam – your child will have a head-to-toe exam at every well-child visit. This is often a fun time for three year olds, as they are often very engaged with the exam.

Vaccinations – If you have followed the CDC recommended vaccination schedule there are no routine vaccines given at this visit. Depending on the time of year, your child’s doctor may recommend the Influenza vaccine.  

Questions from you – you will likely have questions about proper developmental milestones, nutrition, sleep habits, and behavior. Bring your questions to the visit and never hesitate to ask your child’s Pediatrician about your concerns.

Safety information – part of every well-child visit is discussion of safety that is appropriate for age. For pre-school aged children, this includes:

• car seat instructions – children should continue to be in their car seats, in the back seat. Never leave your child in the car alone. 
• water safety – young children should never be left alone in the water, even if it is only a few inches or only for a short amount of time. Drowning occurs quickly. 
• fall risks – young children are climbers. Make sure furniture such as bookshelves and dressers are attached securely to the wall when possible. Monitor them closely on the playground.
• choking – young children will not always chew foods well so make sure foods are cut into tiny pieces. Avoid contact with small objects and plastic bags. 
• child proofing – make sure all cleaning supplies, medications, and chemicals are up high or locked away. Check your floors and lower cabinets/shelves for small objects. Use outlet covers and hide electrical cords. Place barriers around space heaters and fireplaces. 
• sun exposure – avoid direct exposure during the middle of the day as much as possible. Use hats and long sleeves. Use sunscreen with a high SPF. 
• firearms – remove all firearms from the home, if possible. Otherwise, ensure they are locked in a safe and stored unloaded. 

Next visit:  4 years

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