Welcome to Alpine Pediatrics.   Our Pediatricians provide excellent healthcare to children from birth through adolescence.  We serve Northern Utah County with offices in Lehi, Saratoga Springs, and Pleasant Grove.  Come Grow With Us! Also serving American Fork, Eagle Mountain, Highland, Alpine, Riverton, Draper, and Lindon.

  

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2-4 weeks
2 months
4 months
12 months
15 months
18 months
2 years

3 years
4 years
5 years
6-9 years
9-11 years


4 Years

Development:  

Can sing a song. Speaks in 4-5 word sentences and uses 1500-2000 words. Can count to 5. Identifies some shapes. Knows own name, age and sex. Shows early imaginative behavior. Hops, jumps on one foot, runs and climbs well. Can use a toilet independently. Can ride a trike. Always wear a helmet. Throws ball overhand. Talks with other children but does not listen to them. Comfortable with other children but still doesn’t like to share. Plays well by self.

     
Nutrition:  

Your child should feed himself at family mealtimes; offer 2 nutritious snacks a day. Provide nutritious foods and let them decide how much to eat. 4 year olds will imitate the likes and dislikes of their peers. Their list of acceptable foods will increase as you serve a variety of foods and model how to eat them. Enforce desired mealtime behavior, not eating. Make servings small. One tablespoon of each food for each year of age or one quarter of an adult servings generally an appropriate serving.

     
Oral Health:   Continue to brush your child’s teeth twice a day with a fluoridated toothpaste. The manual dexterity to clean their own teeth is present at the age of 4 or 5 years so you may want to start teaching your child how to brush his own teeth. Schedule regular dental visits every six months. If your child sucks their fingers or thumb you can begin to intervene. This information can be obtained from our office. Your goal is to eliminate thumb or finger sucking by the time the permanent teeth erupt at the age of 5 or 6. Do not punish the child or create a power struggle because you will lose. With a little help most children will give up thumb sucking naturally.
     
Sleep:   4 year olds sleep 10-12 hours a night and have one nap or rest period. At 4 the child is still trying to distinguish dreams from reality which makes dreams frightening. Occasional bad dreams are normal and are usually related to monsters or the dark. Reassure your child. Talk about the dreams during the day and do not expose them to violent of frightening movies or TV. Children can experience night terrors anytime after the age of 1. During these, the child is frightened but cannot be awakened or comforted, and may scream or talk wildly. Speak calmly to the child to reassure them that they are all right and protect them from injury. These episodes usually last 10-30 minutes. The child cannot remember it the next day.
     
Toilet Training:   Most children are toilet trained by the age of 4. They may have occasional accidents caused by illness, changes in the environment, or some traumatic experience. Continued soiling or the return to bed-wetting should be discussed with your physician.
     
Behavior:   They are more relaxed and flexible but will constantly test limits, still crying and hitting at times. They need safe boundaries and consistent limits. Demonstrate acceptable behavior by giving more attention to desirable behaviors instead of concentrating on the undesirable behaviors. They seek approval from adults so praise them for good behavior. Too many rules are confusing. Limit the number of rules and enforce them consistently and promptly. Spend most of your time rewarding good behavior. Limit disciplining by using structure, routine, distraction, gentle restraint, removing the object or child from the situation, and ‘time out’. Time out establishes who is in charge and provides a chance for the child to think about the misbehavior. A good rule of thumb for length of a time out session is 1 minute for every year of age.
     
Injury Prevention:   Continue to use car seats at all times because they protect your child from the major threat to his health. Booster seats are recommended as a transition to safety belts for children who are between 4 and 8 years old and 40 to 60 pounds. Seat belts should not be used alone until they fit securely across the child’s hips, do not cross the child’s face or neck, and don’t ride up across the stomach. Helmets should be worn at all times when riding a trike or a bike, even when in a seat on the parent’s bike. Most injuries on bikes involve falls not cars. Know where the child is at all times. They are too young to be roaming the neighborhood alone. Provide constant supervision by an adult whenever the child is around water, bathtubs or pools. Teach the child to swim and use life jackets for boating or swimming. Swimming pools should be completely enclosed by a fence and self locking gate. Obtain a bottle Ipecac to have on hand should the child ingest a harmful substance. Obtain instructions from the poison control center or other health professional before using.
     
Safety Tips:  
  • Use plastic plugs for outlets and safety latches on cabinets and drawers.
  • Keep poisonous substances out of reach or behind locked doors.
  • Keep sharp objects out of reach.
  • Guns should be stored outside the home if possible. If not, lock them in a cabinet and keep the ammunition in a separate location.
  • Latex balloons can cause choking if pieces are swallowed after popping.
  • Turn handles of pans on the stove inward. Avoid placing hot liquids where they can be tipped or on surfaces with tablecloths that can be pulled off.
  • Use smoke alarms and change the batteries yearly. Never leave a child alone in the house.
  • Never leave a child alone with a pet and teach them to use caution when approaching an eating or unknown dog.
  • Keep your child away from moving machinery, driveways and streets.
  • Use safety locks on windows.
  • Teach your child not to talk to strangers.
  • Always use sunscreen with a SPF of 15 or greater.
     
Immunizations:  

A DTaP (diphtheria, tetanus, and pertussis), IPV (polio), and MMR (measles, mumps and rubella) may be given at this visit or may not be given until the 5 year exam. Also, if the patient has not had chicken pox or the chicken pox vaccine, we recommend they be vaccinated at this time. Hepatitis A and B vaccinations are also recommended at this time if they haven’t been previously given and are required for school entrance.

     
Next visit at 5 years. If the immunizations above were not given, they will need to be given at this visit. These vaccines are commonly given at the 5 year check up for admission into Kindergarten. Your child will be tested for anemia through a blood test. A urine sample will be taken and a vision test conducted.
 
Please call your insurance company before your next visit to find out if they cover vaccines. If they do not, it will be much less expensive for you to have the vaccines done at the Health Department. We can give you more information about this if you call us at 492-1999.