Dr. M.J. Bazos, MD, Patient Handout
4 Year Old Anticipatory Guidance

• Establish and enforce consistent, explicit, and firm rules for safe behavior.
• Use a car seat or a properly secured booster until the child weighs 27 kg (60lb) or his head is higher than the back of the seat.
• Ensure that swimming pools in the child's community, in his apartment complex, or at his home have a four-sided fence with a self-closing, self-latching gate. Children should be supervised by an adult whenever they are in or around water. Teach the child how to swim.
• Continue to put sunscreen on the child before he goes outside to play or swim. Sunscreens should be of at least a Sun Protection Factor of 15.
• Continue to keep the child's environment free of smoke. Keep the home and car nonsmoking zones. Test smoke detectors to ensure that they work properly. Change batteries yearly.
• Keep cigarettes, lighters, matches, alcohol, and electrical tools locked up and/or out of the child's sight and reach.
• Exclude poisons, medications, and toxic household products from the home or keep them in locked cabinets. Have safety caps on all medications. Keep Syrup of Ipecac in the home to be used as directed by the poison control center or the health professional. Never give Ipecac or induce vomiting without first contacting the poison control center.
• Ensure that guns, if in the home, are locked up and that ammunition is stored separately. A trigger lock is an additional important precaution.
• Never leave the child alone in the car or the house or while taking a bath. Supervise all play near streets or driveways. Know where the child is all the time. He is too young to be roaming the neighborhood alone. Teach your child pedestrian and neighborhood safety skills. Teach the child about playground
safety.
• Ensure that the child wears a bicycle helmet when riding a tricycle or a bicycle with training wheels.
• Choose caregivers carefully. Discuss with them their attitudes about and behavior in relation to discipline. Prohibit corporal punishment.
• Teach the child safety rules regarding strangers.