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Preschoolers: Everyday Care & Injury PreventionPreschoolers: 3 and 4 Year Olds

Introduction

Your preschooler is learning how to help care for themselves, including feeding, dressing and brushing their teeth. They’re starting to take more initiative and feel proud of themselves and their new abilities.

Learn what to expect as you provide everyday care, continue their health checkups, and keep them safe from injuries.

Sleeping

When children get the sleep they need, they’re happier and healthier. Preschoolers need about 10–13 hours of sleep, including naps. Many children continue to nap for about 1 hour a day until they’re over 4 years old, but some children may stop napping before that.

Your preschooler is probably not getting enough sleep if they:

  • regularly fall asleep during the day such as in the car, watching TV or while looking at books
  • need you to wake them up every morning
  • seem cranky during the day
  • nap more than once a day

A regular sleep routine will help your child shift from their active, busy day to getting ready for sleep. Learn more about bedtime routines and helping your child stay in bed. If you’re concerned about your child’s sleep patterns, call Health Link at 811 or talk with your health care provider.

Toilet teaching

We have a whole section on toilet teaching! Find signs that your child may be ready, toilet teaching tips, and more here!

Your preschooler may just be starting to learn how to use the toilet or they may already be comfortable using it. Girls tend to be ready for toilet teaching before boys. Some boys are not ready until they’re 3 ½ or 4 years old.

Here are some things to think about when you’re toilet teaching your preschooler:

  • Have them wear clothing that’s easy to pull up or down will make toilet time easier.
  • You may need to help your child with wiping after they have a bowel movement.
  • Be patient, toileting accidents are common when your child is learning to use the toilet.

Learn more about toilet teaching.

“Don’t push toileting. If your child can’t get on the toilet, doesn’t have the words or doesn’t show interest, then they’re not ready. Watch for interest, are they dry part of the day, or can they pull their pants on and off—then it’s two steps forward and one step back. Do what you can. Be patient and remind yourself that they’re just learning.”

~Anna, mom of three children

Bedwetting

Urinating during sleep (bedwetting) is common in preschoolers—they don’t do it on purpose. Your child may be a deep sleeper and unable to recognize the signal that tells them their bladder is full. It may also be that they are just not yet developmentally ready to be able to hold it in all night long. It’s very common for bedwetting to run in families and often times a parent may have had this problem as a child as well. Bedwetting can be upsetting and your child may feel bad or embarrassed. They need your understanding, love and support.

Try taking your child to the bathroom right before they go to bed. You can also try taking them a second time before you’re ready for bed. Use a waterproof cover to protect your child’s mattress and be calm and reassuring if you have to clean up in the morning. Show your child that you have confidence that they’ll soon be able to stay dry all night.

While most children outgrow bedwetting by the time they’re 5 or 6 years old, some may take longer. If you have questions or concerns, call Health Link at 811 or with your health care provider.

Teeth and mouth

Caring for your preschooler's teeth

By now your preschooler may feel that they’re big enough to brush their own teeth. Encourage this by letting them brush at the start, then help them finish brushing and flossing their teeth. Talk about what you’re doing as you’re doing it and let them see you doing the same with your own teeth. Your child will continue to need your help until they have the co-ordination to brush and floss their own teeth, about the time when they’re able to write their name. Regular dental care will give your child the best chance of having healthy teeth for life. Take them to see your dentist for regular checkups. Learn more about your child’s teeth and mouth and financial support for dental care.

Many preschoolers are able to spit. Once your child is able to spit, increase the amount of fluoride toothpaste to a pea-sized amount on their toothbrush. Remind them to spit it all out after brushing.

During this age, preschoolers usually have:

  • All 20 of their baby (primary) teeth
  • Spaces between their teeth to give the larger adult teeth room to grow in over the next few years

Sucking thumb, finger or soother

It’s a natural reflex for young children to suck their thumbs, their fingers or a soother. They suck for pleasure, comfort and security. Sucking can affect how your child’s teeth bite together, as well as how the jaw and bones that support the teeth grow. The earlier your child stops sucking their thumbs, their fingers or a soother, the less likely that the sucking will affect their teeth. Most children stop on their own by the time they’re 3 years old. After that, your child may need help from you and their dentist.

If you have questions or concerns, call Health Link at 811 or talk with your dentist or health care provider.

Help your child stop sucking their thumb, finger or soother:

  • Limit sucking to certain times or places.
  • Look for triggers and distract your child or offer a substitute. If they suck their thumb while doing one activity, switch to another activity. They may suck their thumb when they feel stressed or afraid. Reassure them or give them a hug or their favourite toy to cuddle.
  • Offer gentle reminders. Speak calmly about how sucking may affect their teeth. Do not punish or make fun of them.
  • Encourage and be patient. Try not to draw attention to it.

Health checkups

Well child clinic visit

Immunizations that are up to date protect everyone from many communicable diseases. Your preschooler is due for immunizations at their well child clinic when they’re 4 years old. If their immunizations are not up to date, talk to your public health nurse about how to get back on schedule. During your visit, your public health nurse will also check things such as your child’s growth, ask about their health, as well as about how you’re doing and answer any questions you may have.

Vision

Have your child’s vision checked by an optometrist by the time they’re 2−5 years old or sooner if they:

  • often blink or rub their eyes
  • avoid doing ‘close’ work, such as looking at books or making crafts
  • don’t notice things that are far away

You don’t need a doctor’s referral to have an optometrist check your child’s vision. There is no cost to you to have your child’s vision tested in Alberta for children who are 18 years old and younger. To learn more, call Health Link at 811 or talk with your health care provider.

Hearing

It can be difficult to notice if your child has signs of hearing loss, as children can often adapt to a hearing loss until it’s quite bad. You can arrange to have your child’s hearing checked if you notice any concerns, such as if your child:

  • often asks you to repeat things
  • speaks loudly
  • often turns up the TV, tablet or phone volume
  • starts talking later than expected, or if it’s difficult for you to understand what they’re saying
  • has trouble following simple commands, such as “Go get your pyjamas, please.”

Hearing tests are available at no cost in Alberta for children 17 years and younger. To learn more, call Health Link at 811 or talk with your health care provider.

Financial support

You may qualify for financial support for health costs for your child through the Alberta Child Health Benefit plan. You may be able to get eyeglasses, prescriptions and dental visits for your children at no cost to you. To learn more, call toll-free at 1‑877‑469‑5437 or visit Government of Alberta – Alberta Child Health Benefit.

Preventing injuries

Your preschooler’s adventures can put them in risky situations. They’re too young to understand danger because they’re still developing the physical and thinking skills they need to protect themselves. Supervise them at all times and be consistent with them about safety rules so they can learn to follow these rules all the time. Children should not be given choices in situations that have to do with their safety.

For their age and stage of development, here are some areas that need attention to keep your preschooler safe from injuries.

Learn more about how to prevent injuries in the early years.

Caregiver standing beside a slide and watching preschooler as they get ready to go down the slide.Preschooler wearing a helmet while riding a bicycle with training wheels on a clear sidewalk. Grandparents are walking behind the bike, supervising.Preschooler standing beside their scooter on a paved path while parent crouches beside them to fasten the strap on the preschooler’s helmet.

Water safety

Never leave your child alone near water, like a wading pool, dugout, pond or lake—even if they know how to swim.

Get trained

Keep your child safe by making sure they wear protective gear and get appropriate training for whatever sport or recreational activity they are doing.

Helmets save lives

Make helmets a habit for your whole family. They reduce the risk of head injury in a crash by 80%.