206 – 3 Years Old

In Episode 6 of Season 2, Dr. Carole Keim walks us through what to expect from three year olds. This can be a difficult age because children experience a lot of emotional growth and often become oppositional. Dr. Keim offers guidance on what to expect and how to handle it.

Three year olds have a lot of big feelings and drama, they often ask “why” a lot, they do the opposite of what is asked to test boundaries. They are trying to see exactly where the boundaries lie and that they’ll still be loved if they push limits. They have more refined motor skills, are more independent, and their speech has become more coherent. Dr. Keim advises on everything from behavior to nutrition and how best to handle certain patience-testing behaviors.

In this episode:

• Social development
• Motor skills
• Behavior
• Parenting
• Nutrition
• Potty training
• Safety
• 3 year checkup

Social development 02:04

• Imaginative play, often elaborate
• Can put on a shirt, coat, or jacket by themselves
• Plays with others and can share 
• Able to follow a multi-step command (when they want to!)
• 3-word sentences 
• Speech 75% intelligible to strangers
• When they speak, repeat back with correct grammar and pronunciation
• Tells you a story from a book or TV; make up great stories 
• Can compare things with words like bigger/smaller 
• Understands simple prepositions like on/under
• Asks “why” repeatedly 
• Many children start preschool around age 2-3
• Types of preschools – Montessori, Waldorf, Reggio Emilia
• Preschool vs daycare 

Motor skills 05:51

• Eats independently
• Typically potty trained for urine – can enter bathroom and pee by themselves 
• Pedal a tricycle
• Climb on and off chairs, couches
• Jump forward
• Draw a circle
• Draws a person as a face with arms or legs 
• Can cut with scissors

Behavior 08:31

• Test boundaries
• Lots of defiance
• Praise/notice good behavior 
• Offer two reasonable choices as often as possible 
• Teach them what is ok to do when they are angry 

Parenting 12:17

• Maintain routines and limits – meals, bedtime
• Encourage fantasy play 
• Play games that require taking turns 
• Teach your child about empathy (but don’t expect them to fully grasp it yet)
• Rhyme together
• Let your child pretend to read books to you 
• Limit TV to 1 hour of high quality programming that you watch together
• Avoid TV during meal times and in bedrooms
• Be aware of your own screen use around child

Nutrition 16:51

• Pattern: eat 1 meal, skip 1 meal, pick at 1 meal
• Often picky at this age; try to offer a variety and avoid falling into the trap of beige foods and sweets.  Have healthy snacks ready to go for them – cut up fruit/veggies, healthy dips like hummus / soy sauce
• Water is the best thing they can drink and can/should be the only thing they drink; limit milk to 24oz per day and juice to 4oz per day 

Potty training 17:42

• Daytime dryness comes 6-12 mos before nighttime
• Encourage frequent sitting to avoid constipation; can become a vicious cycle when they have a painful BM
• Dress them in clothing that is easy for them to remove 

Safety 18:35

• Car seat – can be forward facing
• Use helmet for anything with wheels
• Remove firearms from home
• Supervise around dogs, cars and start teaching them about safety 
• Touch supervision near water – pools, toilet, bathtubs 
• Move furniture away from windows
• Use door locks and window locks 

3-year checkup 20:22

• No vaccines other than flu/covid until age 4
• Ok to allow child to answer questions, but expect that they will give wrong answers 
• They typically feel comfortable during the physical exam; time to start talking about safety around adults / private parts  
• Ask your doctor if you have any specific questions about preschool, behavior, tantrums, nutrition, vitamins, potty training, constipation, and sleep routines 
• Regular dental visits 1-2x per year 

This guide aims to help you with your “threenager”, guiding you through the three years old development stages. For additional tips and advice on babies and toddlers, follow Dr. Carole Keim on her TikTok and YouTube channels. Her book, “The Baby Manual”, covers the first year of baby life and is the subject of Season One of this podcast. Remember it is always okay to call your doctor or emergency services if you have concerns about your child’s health.   

Resources discussed in this episode:

• The Baby Manual (https://www.amazon.com/Baby-Manual-Ultimate-Guide-Parents/dp/1977608698/ref=sr_1_2?crid=37H1GELHZW5FJ&keywords=The+Baby+manual&qid=1643324113&sprefix=the+baby+manual%2Caps%2C118&sr=8-2) – Available on Amazon

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Dr. Carole Keim MD: linktree (https://linktr.ee/drkeim) | tiktok (https://www.tiktok.com/@doctoratyourdoor) | instagram (https://www.instagram.com/doctoratyourdoo…