4 Years to 5 Years

Eating and Drinking

Your child needs 600 IU of vitamin D per day.
- The vitamin D will can from vitamin D-enriched milk (cow, goat, almond, soy, pea, etc).
16 ounces per day of cow’s milk provides the required vitamin D your child needs.
Limit milk to 20 ounces per day. Drinking more than 20 ounces per day will negatively affect your child’s appetite, which can cause nutritional deficiencies.
- Receiving too much cow’s milk per day is a known cause of anemia.
Your child does not need juice, unless it's being used to treat constipation.
- If you do give your child juice, serve all-natural 100% fruit juice

Offer your child water freely throughout the day.
Don’t worry if they don’t want to drink, this simply means they aren’t thirsty.
- Please note that the amount of water needed daily may vary by individual and may need to be adjusted depending on levels of activity and environmental conditions like heat and humidity.

We recommend 3 meals and 1-2 snacks per day.
Avoid letting your child “graze” on food throughout the day.
- This will negatively affect the appetite and can worry parents that their child “doesn’t eat enough” at mealtimes.
Eat meals together as a family when possible.
Avoid distractions during mealtimes, which many parents use to get their child to eat more.
- We want your child to pay attention to their own hunger level, rather than eating out of distraction.
Common distractions to avoid: TV, screens (phone/iPad), pets, music.
If your child cleans their plate, offer more!
- Provided there are no distractions, you can trust your child to eat when hungry, and stop when full.
Avoid small, hard foods that can cause choking—nuts, popcorn, hot dogs, grapes, and hard, raw veggies.

Most caregivers will experience concerns about picky eating between 12 and 36 months of life.
See our article on picky eating for more information.

At 5, your child can hop on one foot, walk on tiptoes when asked, and catch a bounced ball with 2 hands

Your child will tell a story they heard or made up
Your child can answer simple questions about a book or story after you read or tell it
Your child can count to 10, name some numbers between 1 and 5 when you point to them, and recognize some letters
Continue talking to your child all the time and reading together every day

Your child will follows rules or takes turns when playing games with other children
Your child loves to put on a show! They will sing, dance, or act for you!
Your child can do simple chores at home, like matching socks or clearing the table after eating
Your child can pay attention for 5 to 10 minutes during activities. For example, during story time
or making arts and crafts (screen time does not count)

Tips for Emotional development

Use words to help your child begin to understand time.
- For example, sing songs about the days of the week and let him know what day it is. Use words about time, such as today, tomorrow, and yesterday.
Let your child do things for himself, even if he doesn’t do it perfectly.
- For example, let him make his bed, button his shirt, or pour water into a cup. Celebrate when he does it and try not to “fix” anything you don’t have to.
Talk about and label your child’s and your own feelings. Read books and talk about the feelings characters have and why they have them.

Sleep

Behavioral sleep issues may arise (or be persisting), such as:
- Delaying or stalling bedtime by asking for something i.e. “One more book” or “I need more water” (referred to as limit-setting behavioral insomnia)
- Requiring specific conditions (your presence, a certain stuffed animal, etc) in order to fall asleep, or fall back asleep after waking up overnight (referred to as sleep-onset association behavioral insomnia)
- This linked article has excellent information for parents that may need help managing these issues.
For information on other common toddler sleep problems and how to best handle them, read this article.

Apply a pea sized amount of fluoride-based toothpaste to a soft toothbrush.
- Press the toothpaste into the bristles to prevent your child from sucking the toothpaste right off of the brush.
Most toothpaste specifically labeled for “babies” does not contain fluoride.
- Please make sure you buy toothpaste that does contain fluoride, even if labeled for “children.”
Brush teeth once in the morning and once before bed.
Your child should regularly see the dentist
Your child may seem capable of brushing teeth by themselves, however most dentists do no recommend allowing children to do so independently until 6-8 years of age.
On average, children begin losing their primary teeth around age 6

Colds become less frequent but are still common. Each cold can last for up to 3 weeks.
Vomiting and diarrheal illnesses are common as well.
Fever will accompany many of these illnesses.
Falls and head injuries are the rule, not the exception.

Keep your child in a 5 point restraint carseat until they reach the maximum height or weight requirements from the carseat manufacture, at which point they will sit in a booster.
Please review our guide on water safety for young children. If your child has not taken swim lessons yet, now is the time to start! Here is some information on safety tips for kids learning how to swim.
Your child should wear a helmet when riding a bike or scooter (this also includes riding in bike trailers)
As children become more independent, it is important to teach them about how to stay safe in public.
- Now is a great time to start teaching them their full name, caregivers real names, phone number, and address.
- Make it fun and easier to remember by making up a song! For more tips check out this article.

Most children achieve bladder control during the day by age 4. If your child has been dry and starts having daytime accidents here are some things we think about.
Your child may still require pull ups or diapers at night.
- Most children will gradually stop urinating overnight on their own.
- If they have been consistently dry for several weeks you may transition to underwear at night if you choose to do so.
- in general, we do not worry about bed wetting until a child is around 6-7 years of age.
- Even if your child has been previously dry overnight, it can be normal to have occasional night time accidents until around age 6-7.
- Here is a helpful article with more information about bedwetting.