4 Year Visit

Printable Info Sheet


Your child’s appetite may wax and wane, with the majority of his or her foods being carbohydrates. Offer healthy choices, avoiding favorite foods in lieu of what is served at meal time. Eat meals as a family. Continue to provide your child 16-24 ounces of milk per day.

Oral Health

If your child is able to spit out toothpaste, then brush with a fluoride containing toothpaste. Swallowing fluorinated tooth paste may give them too much fluoride; fluoride should either be in your water or given as a prescription supplement. Your child should see a dentist twice yearly.

This may be a good time to discourage sucking habits.


Resistance to bedtime may persist, but continue with a night time routine, including putting him or her to bed awake.


A car seat with a five point harness should be used if your child weighs less than forty pounds. Children greater than forty pounds should be in a belt adjusting booster seat.

Ensure water and playground safety; closely supervise. Reinforce the concept of strangers, personal privacy, good touch and bad touch. Help them learn their phone number and address.

Use bike helmets. Use sunscreen daily. Recheck home safety being sure poisons, medicines, matches, and weapons are well locked up.

If there is an accidental ingestion call Poison Control (1800 222 1222); do not use Syrup of Ipecac.


Give your child individual attention. Listen to and respect their thoughts and feelings. Encourage socialization, exploration and physical activity. Consider enrollment in a preschool.

Encourage your child to be verbally expressive by listening to their thoughts and feelings. Read together. Limit “screen time” to 1-2 hours per day.

Model good behavior and affection.


Encourage self expression and assertiveness, but not aggression. Place firm boundaries around behaviors using time out when needed. Praise good behaviors.

Help your child learn to resolve conflicts with peers and siblings. Continue to help them learn about their feelings, how they express them and how their actions affect other’s feelings. Continue to be a good model.


Signs of illness may include fever, failure to eat, vomiting, diarrhea, irritability, lethargy, rash, or cough. If your child experiences one of these symptoms or you are concerned, feel free to call our office for advice or an appointment.

Contact Us

(603) 437-1003

We are located in Building E at 25 Buttrick Road in Londonderry. Buttrick Road is off Mammoth Road (Route 128) just north of the intersection of Routes 128 and 102.  From the east and west, take Route 102 turning north onto Route 128. Two tenths of a mile is Buttrick road, turn right, travel half a mile passing the Elliot Urgent Care on the left and Buttrick Road is on the right.

From the north and south, take Interstae 93 to exit 4.  Take Route 102 west to Route 128. Follow above directions to Buttrick Road.  Click here for a map.



Building E at 25 Buttrick Rd Londonderry, NH 03053


(603) 437-1003


Monday - Thursday: 7:30am - 7pm, Friday: 7:30am - 5pm, Saturday (sick visits only): 9:00am - 11:30 am