Ask the Doctor: Preschool Pointers

Babies no longer! Your young child is ready to enter the big wide world of preschool, start the journey of learning and exploring with its sticky art projects, circle time, sharing and singing and making first little friends. Follow these tips to ensure your little one has the best possible start at preschool and develops life-long healthy habits.



Although your child may prefer to play with his or her veggies or feed them to the family dog, this is an important time to help your child establish healthy eating habits for life. Follow these simple steps to work toward that goal:


  • Use the food pyramid as your guide: six portions of grains (preferably whole grains), three portions of vegetables, two portions of fruit, two portions of protein (lean meats, fish, dried beans or peas), two portions of dairy or dairy substitutes (low-fat regular or soy milk, cheese and yogurt) and limited fats and sugary foods.


  • Set a good example! Your child wants to be like you, so buy, prepare and eat healthy foods yourself, and your child is more likely to do the same.


  • Eat together as a family to encourage healthy eating habits, socializing and bonding.


  • Limit juice to four ounces and milk to 16 to 24 ounces a day. When your child turns 2, switch to low-fat (two percent) milk.


  • Stick to three meals and two snacks a day.




An hour of exercise most days of the week is recommended for both children and adults. Your activity level will dictate how active your child is now and in the future. Encourage your child to develop healthy exercise habits by:


  • Enjoying active pastimes together that will benefit everyone, like a weekend walk in the beautiful outdoors and playing ball, tag or jump rope.


  • Finding activities that are age-appropriate and fun. Between the ages of 3 and 5, your child can begin taking part in team sports, such as soccer or baseball, or enjoy individual sports, such as gymnastics.


  • Leaving time for your child to enjoy unstructured, free play – important for your young child’s physical and mental development.


  • Most importantly, limit screen time. The American Academy of Pediatrics recommends that your child watch no more than one to two hours of quality television programs a day. 



Preschool Readiness

There are many simple steps you can take to ensure your child eases into preschool. These include:


  • Let your child mix and interact with other little ones at library reading times, play dates and at the park.


  • Encourage your child to work on activities at home by him or herself, such as playing with play dough, painting or building with bricks.


  • Help your child get used to separating from you for a short time – arrange or swap play dates with other parents or family members.


  • Establish a daily routine.


As your child nears the end of preschool, you’ll be considering the next big milestone – kindergarten! Look for these signs to ensure he or she is ready for the ABCs and more:


  • Able to listen to and follow instructions


  • Is curious and wants to learn, for example, about letters and numbers


  • Has the fine motor skills to hold a pencil and use scissors


  • Is socially ready – plays and interacts with his or her peers at preschool


Remember that children will face challenges in kindergarten. Some children are very shy, while others find it hard to sit down and pay attention. Be patient and work with the teacher to assist your child. Reassure your child that it is okay to feel shy and guide him to feel more confident around others. Some children may also be aggressive until they learn to use language skills to resolve problems. The goal of kindergarten is not for your child to be a perfect student, but to be prepared for first grade by the end of the year. 



Toilet Training

This is a developmental milestone, and each child will be ready for toilet training at a different time. Wait for your child to be ready before beginning the trip to the potty, and don’t put pressure on him or her to start too soon. Some signs that your child may be ready for toilet training include:


  • Regular bowel movements


  • Dry for two hours or more (for example, dry after a nap)


  • Can follow simple directions


  • Wants to sit on the potty or toilet


Night-time dryness is a separate developmental milestone that may take a lot longer to reach. Many 4- and 5-year-olds still wet the bed at night. Speak to your doctor if you are concerned. Choose a preschool that supports wherever your child is in the toilet-training process. 




When your child starts kindergarten, there are some important immunizations to take care of. These include:


  • DTap (diphtheria, tetanus and pertussis -- also known as whooping cough)


  • Polio


  • Second dose of MMR (measles, mumps and rubella)


  • Tuberculosis screening


  • Second dose of chickenpox, varicella vaccine (VZV)


It’s important not to skip any of your child’s immunizations to protect him or her against dangerous and life-threatening diseases. To protect everyone against an outbreak of such a disease, at least 90 percent of the population needs to be vaccinated.


If the sheer number of vaccinations seems overwhelming to you or your child, split them between the 4- and 5-year checkups or arrange a separate doctor’s visit for some of the vaccinations.


Swati Pandya, M.D., is a board-certified pediatrician at the Palo Alto Medical Foundation’s West Valley Center. Advice is not intended to take the place of an exam or diagnosis by a physician.

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