206 – 3 Years Old

Introduction to the Three-Year-Old Stage 0:00

Hi, welcome to season two of the Baby Manual podcast for parents of toddlers. This season will help you feel confident as you navigate the difficulties of toddlerhood, from tantrums to sleep schedules to potty training. I'm your host, a pediatrician and mom, Dr. Carol Keim. Hello and welcome to the sixth episode of Second Season of Baby Manual Podcast. This is for your three-year-old child. So three years old, that is one age that I hear over and over again from parents saying, I thought two was bad and then they hit three.

So what happens at age three, we sometimes call it the three-nager phase. There's really a lot of emotional growth, a lots of drama, and also big, big feelings and tantrums over little things. And then, they also go through a phase where they ask why repeatedly, then that can really try your patience. they become oppositional at this age and defiant. At age two, they were just opposational where like you would ask them to do something and they'd say no. But at age three, They say, no, and then they take it so far as to go and do exactly what you don't want them be doing just to make it even harder to accomplish that task you first wanted them get done.

So they're really pushing those limits and seeing if you will still love them even though they act this way and see where those boundaries lie. So having said all that, even though I knew this when I was going into it as a parent, I still lost my temper a few times. I lost, my cool. It was really hard. Um, it's a very difficult phase to get through and, and some three year olds don't go through this, but many do. So just to be prepared for that. You know, just remember that your child is partly testing you and making sure you still love them.

And sometimes their, their behavior should not be taken at face value. Like. Maybe they're angry about something else or they've been feeling frustrated throughout the day. So we'll talk through that a little bit more later in the podcast about what to do for those sorts of situations.

Social, Language, and Cognitive Milestones 1:58

On a social level for development at this age, they are having really elaborate imaginative play. They tell really good stories at his age and they love to play pretend. they like to pretend that they were animals, cats and dogs especially it seems. And that's a very normal and really cute phase that the go through. They can typically put on a shirt by themselves now at age three and a coat or a jacket. One trick that you can do is put the jacket on the floor upside down in front of them. So like the head, like top of the Jacket is facing them and have them lean forward, put their arms through and flip it over their head and it puts it on.

It's a really easy way to get a Jack on at this age. They can play with other kids and they can start to share at age three. So you can Start teaching them a little bit more about sharing and you Can tell them when they, you know, when They're interacting with someone and They don't share or they're not being a good friend. You can just have them look at their friends face and have Them try to guess what their friend is thinking or feeling. And they Can typically, You know let you Know what they think their Friend is feeling and you can sort of start to talk about, you know, what can we do differently next time at this age?

Don't expect them to get it right away. It's definitely a learning process, but this is the beginning of being able to understand those kinds of things. They can follow a multi-step command when they want to at this age. So that's something like go into your room, take off your jacket and hang it on the hook. You know, something that has multiple steps like that. They're able to keep that all in mind and get through it and do it. they can typically put three words together. Short sentences and three word phrases are common at his age and their speech is about three quarters intelligible to strangers.

When they speak, If they make mistakes, it's, I know it was really tempting to repeat back what they said because it is really cute, but try to repeated back in correct grammar and pronunciation and that way they will learn how to say things over time. They can also tell you a story at this age of something that happened from a book or TV or at school. And keep in mind, they also make up stories. So they might be telling you story and then they end up that they're, you know, on the moon with their friend.

So yeah, just enjoy those stories, encourage them to keep telling you creatively, ask them about their day, if they were at daycare or preschool, and definitely engage with them. And keep in mind that some of it might not be true. Children can compare things with words like bigger and smaller, and they can understand simple prepositions like on and under. And that asking why. They will ask why repeatedly. But they don't always want to know the answer why, they typically are just trying to have a conversation.

That's one easy word that they could use that gets you to keep talking. So, you know, when they ask why and you're getting down the rabbit hole and it's like, okay, at the point where I just don't know anymore, um, You can start asking them, why do you want to know or change the subject? Or you can even do that earlier on before they've asked it a whole bunch of times. Um, but yeah, just talk, talk with them and teach them things. Cause that's what they're really wanting when asking why. Many children start preschool around age two to three, so they're probably in preschool at this age.

And I've talked a little bit about preschool types in my previous couple of podcasts, and I'll do one just on preschools pretty soon. Daycare is like preschool, but they don't have a formal curriculum like a preschool does. So yeah, they're typically getting friends at this age. They can't always name their friends, but they know that they have them and they are learning how to be good friends. So daycare settings or any sort of group child care type of settings are great at the age for social interactions.

For motor skills at a three-year-old age, they can eat independently.

Motor Skills and Self-Care Development 5:54

So they use utensils and eat without making a giant mess anymore. They're typically potty trained for pee during the day. The should have all of the motor skill to get themselves to the bathroom, take off their clothes, sit on the toilet, get back off, put the clothes back on, wash their hands and dry their hand. If they're not yet doing that, it is okay, but it's a good time to start teaching them because they developmentally are ready to do those things. It takes a while for children to be potty-trained for poop after they've been potter-trained for pee and also to pot-ty trained at night.

So both of those can take 6 to 12 months. Sometimes even longer can be normal. Yeah, if your child is potry trained for P during the day and only that that is still okay at this age. A three-year-old can usually pedal a tricycle, so they have the muscles and skills to be able to do that sort of a movement. They can climb on and off chairs and couches. If your furniture is not bolted down to the walls, it's a great idea to that right now because if they open the drawers of the dresser and climb up it, they can tip over because the weight of clothes in the drawer, when they pull them out, changes the center of gravity.

It can be crushed. also bookshelves. Children sometimes will climb up book shelves and those can tip over onto them and it can be very dangerous. So make sure you have furniture anchors sticking those to the walls before your child climbs on it and gets in trouble. They can jump forward at this age so a lot of three-year-olds will come up onto the couch, jump off of it, and many of them get injured on the coffee table. If you a table with sharp corners, it might be a good idea to get those little rubber protectors, cover those corners in case your child does do that.

And yes, they love jumping and also going to playgrounds is great at this age, but keep in mind that they may try to jump off of high surfaces. So keep them within arm's reach at all times. Uh, they can draw a circle at this age, so you might see them starting to draw circles as they're scribbling. They can also sometimes draw person as a face with arms and legs attached to it. I just, I love when they get to that milestone. So keep encouraging them to drawing and ask them draw people and it's really adorable.

And they can cut with scissors. So you can teach them how to cut. Make sure they keep their thumb up. Keep your thumb when you cut, when cut when, you know, teach how they cut safely on just regular paper with child safe scissors and then make sure the scissors are put away and out of reach when they are not using them because a lot of kids will cut their own hair at some point. All right, for behavior, like I said, they are testing boundaries at this age, so they're trying to see what they can get away with and do as much as they and get way with it.

So you just need to be really firm on boundaries. Make sure that all caregivers have equal boundaries so you know, You know, what is okay? How many cookies are they allowed to have when they ask for them? Or are you allowed have screen time? Like what things can they get away with? Are there any consequences? are there toys that have been taken away for some reason, you know because they were not playing with them in a safe way. Like whatever type of things you have to these firm boundaries and limits among all the caregivers.

If you tell them that there's going to be a consequence for something you need to follow through on that consequence. because they will learn whether or not you're serious and they'll test it every time. There's a lot of defiance at this age, so you ask them to pick up the toys and then they take them and scatter them further around the room.

Behavior, Boundaries, and Emotional Regulation 9:26

So one way to handle that is to just sort of sit down on the floor with them, and say, hey, I'm going to help you. try to be really empathetic about it. A lot of time they're just really flooded with emotion and they don't know how to express that. And so that comes through as this really angry and defiant and explosive behavior. Yeah, then if you can try and turn things into a game, you know, let's see who can put away most things the fastest or, You know let see if we can find all the things that are blue and put those away first.

Things like that can make it fun and when you're working together, they are a little bit more likely to comply with you. If you notice their good behavior and lightly praise it, you know, like, oh, wow, You picked up those toys so well. Oh, I see that you're you. I say that. You got so many in your arms right now that You're putting away noticing those types of things can really encourage them to keep doing them. And also offering them choices throughout the day can really help them to feel more empowered and like they're, you know, in charge of their lives more in control so that they are less likely to have those other power struggles over things like brushing teeth and putting stuff away and getting dressed.

offering two reasonable choices, any opportunity you get. Do you wanna put on your shoes or do you want me to help you put them on? Do want this foot or this, but do want cup or cup? Which spoon would you rather have? You want your sandwich kind of just squares or triangles? which stuffy would rather take with us in the car? Like any time that you can give them two options that your okay with either choice, do that to them. And then they're going to feel like they are really in control. And yeah, it'll strengthen your relationship.

It'll make them more likely to actually hurry up and do things when they have to. Also, you can start to teach them what's OK to do when their angry. You can Google the anger wheel of choice. There's a lot of different ones, a lotta different choices to give children. Things like squishing Play-Doh in their hands is a great thing, or playing with a poppet, Or chewing on one of those silicone necklaces that are meant for chewing out for babies, screaming into a pillow or squeezing a pillar really tightly, like whatever type of things are okay.

Throwing ping pong balls in the house, they can't do a lot of damage, and that's one great thing to be able to throw in a house that, you know, the only thing we throw on the houses is ping-pong balls. These are all things that children can do when they're angry that are not going to hurt anyone and not gonna break anything, that aren't gonna be destructive, but it still allows them to express that they are angry. Maybe even, crossing their arms, stomping their feet, walking outside to shout, those kind of thing.

Yeah, so whatever you think will be okay for them to do, you can make a list. You can cut out little pictures and make like a little poster for then so they have ideas. And also keep in mind, they're still, not very much in control of their very big emotions that they for their tiny bodies. So it's gonna take some practice for this. All right, so for parenting stuff that I recommended this time, remember routines and limits around bedtime and meals, because those can very easily slip. Children at this age are having that weird eating pattern still.

A lot of times they're doing, they skip a meal, They pick at one meal and they eat one. So that one that they might be at school. You might not be seeing it and you might think that They're not eating much at home, but they still seem to be growing. They might eat at Home and just pick stuff at School. Or some children will start to have normal eating patterns around three and a half, and some will have it earlier. So your child might start eating better. They might also still be in that phase where they only eat about five different foods.

Remember to just keep offering lots of fruit and vegetables, cut up for them at every meal. Try to do at least half a plate of fruits and veggies with every meals that you offer. At some point, they will star picking at them. It might take a while, but they'll get used to seeing them and start trying stuff like that. And then with bedtime, it's great to have a bedtime routine. A lot of families will do a bath as part of that and then, you know, change into pajamas, brush teeth, read some stories, maybe sing a song, and have some snuggle time and tucked in and turn out the lights, kind of a thing.

Whatever works for your family is great, but try to be consistent and try start it around the same time every night. Keep in mind, children at this age need 10 to 14 hours of sleep to well rested. So make sure that you're starting bedtime nice and early. A lot of time it's right after dinner. You just start getting them ready for bed at this age so that they can get enough sleep. You want to encourage fantasy play, so play with them as much as you can. If you haven't seen the show Bluey, I highly recommend it.

It's this really cute cartoon with these families that, you know, they're dogs and they play all of these great games with their kids for like everyday

Routines, Play, Screen Time, and Nutrition 14:06

life situations. And so there's so many great ideas there. But that sort of thing, just play them throughout the day, make everything fun. You can start to play games that require taking turns. So things like card games, you can play Go Fish. You know, if you play things, like simple board games. There's lots of boardgames for young children at this age. Things like Shoots and Ladders when we were kids. Things that you just take turns and count. Those are great skills for them to be learning. You can start to teach them about empathy, where you have them look at someone's face after they've done something, or look when you're maybe watching TV.

How do you think that person is feeling? They can then start guess, but don't expect them fully grasp it yet. It takes a little while. You can start rhyming together. Dr. Seuss books are great for this at this age. You ask them to make up rhymes. So you can say cat and see what rhymes with cat, and how many words they can come up with. And you let them start to pretend to read to you at bedtime. Sometimes you read a story and they'll read it first. They're not actually reading usually, they're just pointing out the pictures and guessing what's going on and telling the story to you.

Sometimes they'll memorize books because they like to have a lot of repetition too. But yeah, let them pretend to read to, it's super fun and it is great for their development. You want to try to limit TV to one hour of high quality programming that you watch together. So things like PBS Kids, Disney, things that I've mentioned previously, those are all great, for you guys to watch, together and Do talk about it while you're watching it. Make it more interactive so it's not just kind of sitting and vegging out.

Try to avoid TV during mealtimes, and I suggest no TVs in any of the bedrooms in the house. Also, you wanna avoid screen time for at least two hours before bed because it can interfere with your brainwaves and make it a little harder to get into deep sleep and really get that full, restful sleep. They can also make kids a bit hyper and hard to put down at bedtime, make them a And so try for, yeah, avoiding screen time two hours before bedtime. And then also just be aware of your own screen-time use around your child because they pick up on subtle things that we do.

If you are frequently on your phone, then you can expect them to want to also be on a device like that a lot of the time. Just to be more mindful of that and try to limit that. And also, anytime you're on your phone, it's typically taking away from interaction with your child. If you are doing things together, like maybe you were looking at photos together on the phone. That's great. It's a good bonding activity. But if you doing something on you own, then it is taking your attention away for your own child, so try it.

Try to just be aware of it and limit your screen time use as well. For nutrition at this age, like I said, they typically eat a meal, skip a meals, pick at one meal and can be really picky eaters at his age. So just, you know, try to have a lot of cut up fruit and veggies ready to go and maybe some healthy dips like hummus or soy sauce, vinegar, dressings, things like that, that they can dunk their fruit veggies into. I guess just veggies for all those things I mentioned. But yes, to make them a little bit more fun.

Ketchup, whatever kind of things. Water is the best thing they can drink and can be the only thing that they drink. If they are drinking milk, you want to limit it to 24 ounces or less per day. And if they're drinking juice, You want a limit to four ounces, or per less day, and even if that's 100% fresh juice. Juice has quite a lot of sugar in it and it's almost as bad as soda for your body. If they can just do water, water is the very best thing. For potty training at this age, they are often potter trained during the day, but many children are not yet and that is okay too.

You want to encourage frequent potting sitting to avoid constipation because once they become constapated, it can become a vicious cycle where it hurts to poop. So the next time they have to go, if they don't want let it out and they get scared, They hold it in longer. And the longer that poop sits in their colon, the more water gets absorbed and the harder it gets. And so then the next time that when they finally do go, it's even more painful. And then. The cycles just kind of repeats. So that's why we have to go the route of things like Miralax and like really, you know, heavy duty aggressive stool softeners to get them to.

Go again in the toilet. so try to avoid that in first place by just having them sit frequently on the potty when you are doing potting training and try address them, including that it is really easy for them. To get in and out of. So like pants that are really easy to slip on and off. For safety, their car seat can be forward-facing, but it also can still be rear- facing.

Potty Training, Safety, and the Three-Year Checkup 18:38

It's safe to keep them rear facing as long as they still meet the weight and height limits of their current carseat. And rearfacing is a little bit safer because toddlers have pretty big heads and relatively weak necks. When they're forward facing and you tap on the brakes, they head goes forward and back and they could potentially get whiplash. So with rearfacing, the seat just cushions their head when you hit the breaks. But if they are forward-facing, that is absolutely okay at this age. Make sure that if you have anything with wheels like bikes, roller skates, skateboards, scooters, they're also using a helmet.

So if the wheels come out, the helmet also comes out. If there are any firearms or guns in the home, you want to remove those ideally or have them locked away, unloaded, and have the ammunition somewhere else so that your child cannot get access to it. You know, firearm injuries are a very big cause of morbidity and mortality in this age group. You want to supervise them around dogs and cars because they don't fully understand yet that dogs might bite them and that cars aren't always aware that they're there and could hit them.

They need to be at touch supervision near water, which means within arm's reach that you can reach out and grab them if they were to slip under the water. When you're in a pool around bathtubs, children can also fall into toilets and drown. So the best way to baby proof a bathroom is to keep the door closed all the time. And then second best, there are things like toilet locks and things that make it harder for them to open handles and Try to move furniture away from windows because they could potentially climb out of them, and then also use furniture anchors if they're climbing on furniture.

And also, you want to use door locks and window locks so that children can't open them. For the three-year-old checkup, there's typically not any routine vaccines at this check-up other than the seasonal vaccines like flu and COVID vaccine. At age four, they are going to get two boosters, the MMR chickenpox booster and the DTaP polio booster. So that's going be next year. It is okay to allow your child to answer questions, but keep in mind that they might get things wrong and so you might have to jump in and give some answers yourself.

And three-year-olds typically do still feel comfortable during this exam, But this is the time that we start talking about body safety around adults. We talk about how no adult should show interest in your private parts. we talk about why they're called private parts, and we use the medical names for them. So vulva and penis and scrotum and vagina and butt. Those are great ways to start talking with your child about private part too. You can tell them what their private are, that it is not okay for grownups to try to touch their parts.

That the only time we really talk to them is in private places, like in the bathroom. and it is okay for, you know, someone to help you wipe in the bathroom. It is ok at the doctor's office for them to examine your private parts because it's part of your body and its part your checkup. But outside of that, it not ok for friends to be asking about it, its not okay to show it to friends, to have friends try to touch it or touch friends private part, those kind of things. You can also ask your doctor if you have any specific questions about things like preschools, behavior, tantrums.

Child's nutrition, whether they should be on vitamins, probiotics, potty training, constipation, sleep routines, all of these kinds of things. We can help advise you more specifically during your checkup. And just keep in mind, they shall be going to the dentist once or twice per year. So if they haven't been recently, this is a good time to schedule a visit. Alright, thank you for listening. In the future, we are going to be deep diving more into specific topics about children, so make sure you tune in in two weeks.

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