Growth Milestones 3-5 years

Growth Milestones - THREE YEARS

"Goodbye Babyhood, Hello Childhood"

While rearing a child at any age is no snap, things should get easier during the third year. Most 3-year-olds can be reasoned with. They will take turns and may even share toys. A child in this age group will help the parents get him or her dressed. Most are toilet trained during the day, although it is common for an occasional "accident" while busy playing. In previous generations, moms and dads learned what to expect of their child from their mother, grandmother or another family member. Today, most families are so scattered that parents do not have this help available. Therefore, do not hesitante to ask any questions you might have about your child's growth and development during the three year checkup. This is the reason for regular well-child exams.

Parenting and Behavioral The 3-year-old will ask more questions than a district attorney. Nothing is sacred and some questions will throw you for a loop! Continue reading books to your child. Arrange times for safe running and exploring outdoors. Playmates are important. Allow your child to experience interaction with peers. Three-year-olds are usually quite social and enjoy being with other 3-year-olds. This can be accomplished in a preschool, play group or just having another child over for a few hours. It is normal for children this age to have imaginary friends. Parents can sometimes use the youngster's imaginary "playmate" to their advantage (like getting your 3-year-old to do something you want them to do.) Limit television viewing. Do not use the TV as a baby sitter or as a substitute for interaction with your child. Watch children's programs with your child when possible. Do not worry if the child becomes curious about body parts. This is normal at this age. Always use the correct terms for genitals. Children this age begin to recognize gender differences and will correctly say "I am a girl" or "I am a boy." Discipline should be firm and consistent, but loving and understanding. Praise your child for his or her good behavior and accomplishments. Three-year-olds like to do things for themselves. The 3-year-old does not understand "tongue-in-cheek" comments and can not always tell when a parent is joking. For example, never threaten to leave a child at the store when he or she misbehaves. Your child may continue to use a security object (such as a blanket, favorite stuffed toy, etc.). This is normal and the youngster will give up the item when he or she is ready. Keep family outings short and simple. Children have a short attention span at this age and lengthy activities will cause them to become irritable and tired. The question of preschool usually comes up now. Daycare has already been established for a family when both parents work outside the home. Even for moms who stay at home with their child, preschool a few mornings a week can be helpful. It gives mom a welcome break and provides the child an opportunity to meet new friends.The success or failure of preschool will depend upon the child's maturity and the quality of the preschool. For example, if your child seems anxious and dependent away from home, perhaps he or she is not ready for preschool. If you are expecting another baby, discuss with your child's physician how to prepare your 3-year-old.

Discipline Encourage your 3-year-old to make choices whenever possible, but the choices should be limited to those you can live with ("red shirt or green shirt.") Never ask a toddler an open question ("Do you want to take a bath") unless you are willing to accept the answer. Use the two "I's" of discipline (ignore or isolate) rather than the two "S's" (shouting or spanking). When disciplining, try to separate the child and his or her behavior ("I love you, but I do not like it when you touch the VCR."). Provide alternatives. "No, you cannot play with the telephone, but you can play with these blocks." Avoid power struggles. No one wins! The 3-year-old still uses temper tantrums as a weapon. Respond to this behavior with the two I's of discipline - ignore or isolate (time out!). Discipline should be consistent. Do not make threats that you can not carry out. If you say you are going to do something, do it!

Development Can name pictures in a book. Names at least one color. Knows his or her own name, age and sex. Begins to use pronouns. Able to put on his or her own shirt, but will need help with shoes and buttons. May be able to ride a tricycle. Can jump in place and stand briefly on one foot. Can (unfortunately!) open doors. More than 50 percent of the child's speech is intelligible. There may be temporary episodes of stuttering during this time. Understands such words as "cold," "tired," "hungry." Comprehends the meaning of "on or under", and "bigger or smaller."

Oral Health Supervise brushing twice a day with a small amount of fluoridated toothpaste. Take your 3-year-old to the dentist, if you have not already done so. Limit juice and sweets. Continue giving a fluoride supplement if your drinking water is not fluoridated. Some dentists recommend fluoride be continued through age 8; others recommend continuing through age 12 or 16. Check with your pediatrician and dentist. Stop pacifier use

Feeding Appetite is perhaps a shade better than it was a few months ago, but it is still not what most parents (or grandparents) think it should be. "My child will not eat," is a familiar complaint heard at the three year checkup. Remember, feeding problems may arise if parents make their child eat more than the child needs to, or shows too much concern in what the youngster eats. The 3-year-old should pretty much be able to feed himself or herself. During meal time, the 3-year-old is sometimes very demanding of parent's attention and may also dawdle! Avoid nuts, hard candy, uncut grapes, hot dogs or raw vegetables. Control sweets and avoid junk food. Eat dinner together as a family whenever possible. Begin to teach proper table manners and encourage conversation during family meals. Turn the TV off during meals. Make sure your child's caregiver is following your feeding instructions.

Sleep An afternoon nap is usually still needed by the 3-year-old. Fears of the dark, thunder, lightning, etc. are quite common at this age. Maintain a consistent bedtime and bedtime routine. Using a night light, security blanket or toy are all ways to help lessen nighttime fears. Read to your child when possible before "lights out." Nightmares can wake a child up from sleep. The nightmares can be triggered by changes or stress. Reassure your child and put him or her back to bed.

Toilet Training Many 3-year-olds are trained during the day but still do not stay dry at night. Others are completely trained. Remember, the age a child uses the bathroom by himself or herself varies and it is based only on a child's readiness to be trained and the positive attitude of the parents. Avoid putting too many demands on the child or shaming him about wearing diapers. Instead, let your child no how proud and happy you are about any potty successes. Some children may postpone having a bowel movement as a way to manipulate their parents or because they are busy doing something else. Try not to make an issue of this.

Safety Responsibility for accident prevention will gradually shift to your child as he or she grows older. It is still necessary for parents to keep dangerous and poisonous items out of their 3-year-old's reach and protect him or her from other indoor and outdoor hazards. Insist that your home and car be smoke free. Begin to teach your child his or her full name, address and phone number If bicycling, teach safety rules and insist on helmet use. Continue to use proper car safety restraints in the back seat of every car trip. A 3-4 year old child (once 40 lbs. or over) is safest using a belt-positioning booster seat. The greatest risk to your child's health continues to be motor vehicle accidents. Remember, it is impossible for you to protect your child during an accident by just holding him or her. Always walk behind your car before backing out of the driveway. If your home uses gas appliances, install and maintain carbon monoxide detectors. The purchase of a trampoline is not recommended because of the risk of serious injury. Keep firearms out of the home or in a locked, out of sight container, unloaded Pools must be gated. Knowing how to "swim" does not make a child water- safe at this age. Never leave a child unattended in a bathtub, even for a few seconds. Ensure your child wears a life vest if boating. Be careful of items that can be left a counter level elsewhere, such as knives, scissors, cleaning agents, nail polish remover, household repair items, weed killers, insecticides, gasoline, oil, kerosene, lighter fluid and all medicines. Always keep potentially poisonous things in the original containers. Never put poisons in food containers or bottles. There is no such thing as a "child proof cap." Ingestion of toxic substances is common at this age. Keep syrup of Ipecac in the home to be used only as directed by your child's doctor or the poison control center. Never buy toys or other objects that can cut or ingested. Suffocation by plastic bags and balloons still occurs at this age. Always supervise when your child is playing near a street. Remember, a 3-year-old child does not understand danger or remembers "no"; your child cannot be counted on to be aware of outside hazards. Be especially careful when using power lawn mowers and other power tools. Never leave a child unattended in a car or a house. Test smoke detectors to ensure they are working properly. Continue to use a water proof sunscreen on your child before going outside. Avoid the hours between 10 a.m. and 3 p.m. when the sun is the most dangerous. Advise your 3-year-old to be careful around strange dogs, especially ones that are eating. Begin to teach your child not to talk to strangers.

Illnesses Your 3-year-old may continue to experience respiratory infections, such as colds, ear infections and sinus infections. These frequent ailments often become frustrating for parents. Unfortunately, most illnesses are unavoidable, especially if your child is in preschool or has older siblings who bring the colds home from school. When your child is ill, the pediatrician will determine whether antibiotics are needed. Remember, most illnesses at this age are viral, which means antibiotics will not shorten the course of the illness

Immunizations Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to seek the advice of your child's health care provider concerning your child's vaccine schedule. Normally, no immunizations are given at this checkup unless your child is behind in the immunization schedule. Hepatitis A (HepA) may be administered at this visit for children living in selected states. Annual flu vaccines may be recommended for children with chronic illnesses like asthma and heart defects. Check with your doctor. Some physicians at 3years do a hemoglobin or hematocrit determination to check for anemia ("low blood"). This requires a small poke on the finger to obtain a drop of blood. A urinalysis will also be done if the child is toilet trained to check for kidney and bladder problems. By this age, most children have received the following immunizations: By this age, most children have received the following immunizations 3 doses of Hepatitis B vaccine 4 doses of DTaP vaccine 4 doses of HIB vaccine 1 dose of the MMR vaccine 1 dose of the Chickenpox vaccine 4 doses of the Pneumococcal vaccine 3 doses of the Inactivated Polio Vaccine 3 doses of the rotavirus vaccine ►Kidsgrowth Vaccine Guide ►The Vaccines and the Diseases they Prevent ►Keep a record of your child's immunizations. (Click to download a blank immunization record)

Growth Milestones - FOUR YEARS

"Growing self-reliance"

Can you believe that four years ago your child was born? Boy, "does time fly when you are having fun." Now you know why your parents used to say that you were growing up too fast. Ties to your apron strings will begin to loosen as the 4-year-old develops more independence and self-confidence. Before you know it, it will be time to start kindergarten. In previous generations, moms and dads learned what to expect of their child from their mother, grandmother or another family member. Today, most families are so scattered that parents do not have this help available. Therefore, do not hesitate to ask any questions you might have about your child's growth and development during the four year checkup. This is the reason for regular well-child exams.

Parenting and Behavioral The 4-year-old really enjoys playmates. At this stage the toddler will begin to play cooperatively with others. It is normal for children this age to have imaginary friends. Parents can sometimes use the youngster's imaginary "playmate" to their advantage (like getting your 4-year-old to do something you want him or her to do.) Limit television viewing to one hour per day. Do not use the TV as a baby sitter or it as a substitute for interaction with your child. Watch children's programs with your child when possible. Do not worry if your child becomes curious about body parts. This is normal at this age. Always use the correct terms for genitals. Modesty and a desire for privacy begin to emerge at this age. When your child starts to want privacy of his or her own, let your child know that you think this is good. Your child may continue to use a security object (such as a blanket, favorite stuffed toy, night light, etc.). This is normal and your youngster will give up the item when he or she is ready. If you are expecting another baby, discuss with your child's physician how to prepare your 4-year-old. Allow your child to participate in setting and cleaning up the table. Always praise him or her for a job well done. Provide some type of structured learning environment in preparation for kindergarten next year. Examples include preschool, Head Start or Sunday School. Show an interest in your child's preschool activities.

Discipline Discipline should be firm and consistent, but loving and understanding. Praise your child for his or her good behavior and accomplishments. Continue to allow your 4-year-old to make choices whenever possible but the choices should be limited to those you can live with ("red shirt or green shirt"). Never ask a 4-year-old an open question ("Do you want to take a bath") unless you are willing to accept the answer. Use the two "I's" of discipline (ignore or isolate) rather than the two "S's" (shouting or spanking). When disciplining, try to separate your child and his or her behavior ("I love you, but I do not like it when you touch the VCR.") Provide your 4-year-old with clearly stated limits along with an explanation of the consequences if rules are broken. Making children stand in the corner ("time out" by themselves for four minutes is usually an effective punishment. If you have any questions about your child's behavior, discuss them with the doctor. Meaningless threats are ineffective. Follow through with the previously stated consequences when rules are broken. Whenever possible, give reprimands privately. Always bear in mind the positive effects of praise.

Development Speech is almost always understandable. Can usually count from 1 to 10. Can walk on tiptoes, climb a ladder and ride a tricycle. May name and match three or four primary colors. Knows his or her own name. Correctly uses the pronoun "I." Children this age recognize gender differences and will correctly say "I am a girl" or "I am a boy." Can dress and undress with supervision but still has trouble with laces and buttons. Children this age also begin to be selective about what they wear. Holds and uses a pencil with good control. Can copy a cross, circle and possibly a square. Can to draw a person with a face, arms and legs. Engages in conversational "give-and-take." Can sing a song. Talks about his or her day's activities and experiences. Can identify emotions such as sadness, anger, anxiety and fear. Enjoys the companionship of other children; plays cooperatively and shows interest in other children's bodies.

Oral Health Supervise brushing twice a day with a small amount of fluoridated toothpaste. Take your 4-year-old to the dentist again this year and schedule re-checks as recommended by the dentist. If the child sucks his or her fingers or thumb, ask the dentist how to discourage these habits. Stop pacifier use. Continue giving a fluoride supplement if your drinking water is not fluoridated. Some dentists recommend fluoride be continued through age 8; others recommend continuing through age 12 or 16. Check with your pediatrician and dentist. Learn how to prevent dental injuries and what to do in case of a dental emergency, especially the loss or fracture of a tooth.

Feeding The 4-year-old continues in a period of relatively slow growth. Average weight gain per year is only three to four pounds. Therefore, the appetite still is not what most parents (or grandparents) think it should be. Remember, feeding problems may arise if parents make their child eat more than he or she needs to, or show too much concern in what their child eats. Provide snacks rich in carbohydrates and limit high-fat, low nutrient foods. The 4-year-old can and usually insists on feeding himself or herself. Mealtime should be pleasant and food should never be forced. Provide nutritious foods and let your child decide what and how much to eat. Offer small portions with the availability of a second helping. The 4-year-old will often imitate peers in food likes and dislikes. Avoid nuts, hard candy, uncut grapes, hot dogs or raw vegetables. Control sweets and avoid junk food. Eat dinner together as a family whenever possible. Insist on good table manners and encourage pleasant conversation during meals. Turn the TV off during meals.

Sleep An afternoon nap may still be necessary. Fears of the dark, thunder, lightning, etc. are quite common at this age. Maintain a consistent bedtime and bedtime routine, using a night light, security blanket or toy are all ways to help lessen nighttime fears. Nightmares can wake a child up from sleep. They can be triggered by changes or stress. Reassure your child and put him or her back to bed.

Immunizations Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to seek the advice of your child's health care provider concerning your child's vaccine schedule. Your child may receive one or more immunization depending on your doctor's schedule. Other doctors prefer to wait until the child is five for these immunizations. Annual flu vaccines may be recommended for children with chronic illnesses like asthma and heart defects. Check with your doctor. If the child can cooperate or a problem is suspected, vision and hearing will also be checked. The child's blood pressure will be recorded. A urinalysis will be preformed and many physicians apply a tuberculin test at this checkup as well. The following immunizations may be given at the 4-year old checkup.

	1 dose of DTaP vaccine
	1 dose of the MMR vaccine
	1 dose of the Inactivated Polio Vaccine

Toilet Training By age 4, 95 percent of children are bowel trained. By age 4, 90 percent of children are dry in the daytime and 75 percent at night.

Safety Your child continues to require close supervision. Accidents continue to be the principal cause of death in children in this age group. Know where your child is at all times. A 4-year-old is too young to be roaming the neighborhood alone. If your home uses gas appliances, install and maintain carbon monoxide detectors. The purchase of a trampoline is not recommended because of the risk of serious injury. Insist that your home and car be smoke free. Select toys that are safe. Electrical tools, firearms, matches and poisons should be locked up, out of reach. The child should not have unsupervised access to, or ride a bike in, the street. Some 4-year-olds can be taught their full name, address and phone number. If bicycling, teach safety rules and insist on helmet use. It is too ealy to expect your child to look both ways before crossing the street. Supervise all street crossings. Continue to use a car seat or booster seat secured properly until the child weighs at least 60 pounds or his or her head is higher than the back of the rear seat. The greatest risk to your child's health continues to be motor vehicle accidents. Remember, it is impossible for you to protect your child during an accident by just holding him or her. Set a good example by always using a seat belt when driving. Always walk behind your car before backing out of the driveway. Many 4-year-olds are fairly good "swimmers," but knowing how to "swim" does not make the youngster water safe. Never leave a child unattended in a bathtub, even for a few seconds. Ensure that your child wears a life vest if boating. There is no such thing as a "child proof cap." Ingestion of toxic substances is common at this age. Keep syrup of Ipecac in the home to be used only as directed by your child's doctor or the poison control center. Never buy toys or other objects that can be cut or ingested. Suffocation by plastic bags and balloons still occurs at this age. Be especially careful when using power lawn mowers and other power tools. Test smoke detectors to ensure they are working properly. Continue to use a water proof sunscreen on your child before he or she goes outside. If possible, avoid the hours between 10 a.m. and 3 p.m. when the sun is the most dangerous. Advise your 4-year-old to be careful around strange dogs, especially ones that are eating. Begin to teach your child not to talk to strangers or accept food from strangers. Teach your child the first and last names of family members. Teach your child pedestrian safety ("look both ways before crossing the street").

Illnesses The 4-year-old experiences less respiratory infections, such as colds, ear infections and sinus infections than the previous year. Begin to teach good habits: washing his or her hands after using the toilet, putting his or her hands in front of his or her mouth before coughing or sneezing, and washing his or her hands after coughing or sneezing. Remember, most illnesses at this age are viral, which means antibiotics will not shorten the course of the illness.

Immunizations Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to seek the advice of your child's health care provider concerning your child's vaccine schedule. Your child may receive one or more immunization depending on your doctor's schedule. Other doctors prefer to wait until the child is five for these immunizations. Annual flu vaccines may be recommended for children with chronic illnesses like asthma and heart defects. Check with your doctor. If the child can cooperate or a problem is suspected, vision and hearing will also be checked. The child's blood pressure will be recorded. A urinalysis will be preformed and many physicians apply a tuberculin test at this checkup as well. The following immunizations may be given at the 4-year old checkup. 1 dose of DTaP vaccine 1 dose of the MMR vaccine 1 dose of the Inactivated Polio Vaccine 1 dose of the varicella (chickenpox vaccine)

►Kidsgrowth Vaccine Guide ►The Vaccines and the Diseases they Prevent ►Keep a record of your child's immunizations. (Click to download a blank immunization record)

Growth Milestones - FIVE YEARS

"Leaving the Nest"

Your 5-year-old is about to begin "real" school for the first time. Your child changes from a little one, protected by home, to a kindergartner, with the demands of a new school and new expectations. Children this age need approval, praise and encouragement. They want to please and are proud of their work.

School Readiness Is my child ready for kindergarten? Should you send your child with a late summer or fall birthday to kindergarten, or should you wait another year? These are some of the questions parents of 5-year-olds ask themselves. Ideally, kindergarten should be ready for the child rather than getting the child ready for kindergarten. Use the following to see how well your child is doing in acquiring the skills found on most kindergarten checklists. Good physical health, can see and hear well and visits the doctor and dentist regularly. Has self-care skills (dressing, feeding, washing, manages bathroom needs). Follows directions and rules. Pays attention for short periods of time to adult-directed tasks. Able to work independently for short periods. Tolerates frustration and failure. Knows his or her full name as well as the name of his or her parents. Easily makes changes and accepts adult supervision and help. Able to play in small groups with other children. Begins to share with others. Listens to stories without interrupting. Recognizes rhyming sounds. Speaks clearly with age-appropriate language skills;Talks in complete sentences of five to six words. Understands that actions have both causes and effects. Shows understanding of general times of the day. Cuts with scissors. Holds crayon or marker; has a collection of paper, pencils, crayons. Separates from parents without being upset. Looks at pictures and then tells stories. Is able to recognize authority. Identifies some alphabet letters and most colors. Buttons shirts, pants, coats and zips up zippers. Begins to control himself or herself. Recognizes groups of one, two, three, four and five objects. Sorts similar objects by color, size and shape. Recognizes some common sight words like "stop." Counts to 10. Uses words like bigger, smaller or heaviest to show comparison. Rides a tricycle. Draws a picture of herself or himself including head, body, arms and legs. Knows her or his body parts. Understands concepts such as: in, out, under, on, off, front and back. Follows through when you give him or her one or two directions. Attempts to write his or her name.

Parenting and Behavioral Listen to and show respect for your child. Continue reading to your child or read together. Get a library card and use it regularly. Ask the librarian to pick out age appropriate books. By the end of this year many 5-year-olds can recognize simple words and may even be reading. Praise your child's progress. Children this age show concern for each other so parents should encourage diversity, respect and tolerance. The 5-year-old enjoys crafts, coloring and painting. He or she may also begin enjoying simple board games (like "Candyland," etc.). It is not unusual to have occasional accidents at night and during play. Be understanding and do not make a big deal out of it. However, if it happens frequently, it would be a good idea to discuss the matter with the child's doctor. Enhance your 5-year-old's experience with trips to parks, libraries, zoos and other points of interest. Teach your child the difference between right and wrong. Begin age appropriate chores. Always show affection. A 5-year-old is usually imaginative and has lots of energy. Be sure to praise children. Building self-esteem is very important at this age. Give your child encouragement and praise not only for completing a task but also while working on the task. Avoid physical punishment - it only promotes fear and guilt and teaches the child that violence is acceptable in certain situations. Instead, send the child to a quiet, boring place without anything to do for five minutes as a form of discipline.

Development Skips, can walk on tiptoes and jumps forward. Throws a ball overhand. Washes and dries hands and brushes teeth unassisted. Can cut and paste. Can name four or five colors. Can state his or her age. Has a vocabulary of six to eight word sentences. Can tell a simple story. Can dress and undress without supervision. Knows his or her own phone number, address and several nursery rhymes. Can copy a triangle from a picture. Draws a person with a head, body, arms and legs. Understands right and wrong, fair and unfair. Understands games that have rules. Engages in make-believe and dress-up play, in which your child may assume a specific role ("mommy or daddy").

Oral Health Encourage teeth brushing twice a day with small amount of fluoride toothpaste. Continue to give fluoride supplements if not in the water supply. Continue seeing a dentist at least twice a year. Consider the use of dental sealants. Learn how to prevent dental injuries and what to do in case of a dental emergency, especially the loss or fracture of a tooth.

Feeding Appetite is usually much better at 5 as the child begins the second of three growth spurts. Continue to offer your child a selection from the basic food groups. Make meal time pleasant, turn off the TV and encourage conversation. Limit carbohydrate snacks like soft drinks, chips, candy and cookies. Instead, encourage healthy snacks, such as fruit and vegetables. Ensure your child eats a balanced breakfast and a nutritious lunch at school. Your child may enjoy helping to choose and prepare meals with supervision.

Sleep At this age expect an occasional nightmare or night terror. If the behavior become frequent, speak to your child's doctor about it.

Sexuality Now is the time to begin to teach your child the names of all body parts including genitals. Give your youngster a vocabulary to avoid unwanted touching. If this is a difficult subject for you to discuss, ask the help of your doctor or the child's teacher. Recognize that a child's sexual curiosity and exploration are normal.

Safety Continue to use a seat belt in the back seat of the car at all times. Teach your 5-year-old how to swim. Make sure all swimming pools in your area are secure. Always use sun screen when your child is outside playing or swimming. Keep your child's environment free of smoke. Conduct fire drills and make sure all smoke alarms are operating properly. Make sure any guns in the home are locked up and the ammunition is stored separately. A trigger lock is an additional precaution. And make sure these same safety precautions are followed at friends' homes. Never allow your child to handle firearms. Teach bicycle safety and make sure your child always wears an approved helmet as well as shoes while riding a bicycle. If your home uses gas appliances, install and maintain carbon monoxide detectors. The purchase of a trampoline is not recommended because of the risk of serious injury. Begin to teach your child rules for interacting with strangers, either on the phone or at the door. Never let your child play unsupervised outside.

Immunizations Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to seek the advice of your child's health care provider concerning your child's vaccine schedule. Your child may receive one or more immunizations depending on your doctor's schedule. Some doctors prefer to wait until the child actually starts kindergarten (if not at 5) or has already given the recommended immunizations at the 4-year checkup. Annual flu vaccines for children with chronic illnesses like asthma and heart defects. Check with your doctor. Vision and hearing are usually checked at this visit. Other screening done at this age may include a tuberculin test (if indicated) and blood pressure. If there is a family history of elevated cholesterol, some physicians will also obtain a screening blood test. The following immunizations may be given at the 5-year old checkup. 1 dose of DTaP vaccine 1 dose of the MMR vaccine 1 dose of the Inactivated Polio Vaccine 1 dose varicella (chickenpox) vaccine

►Kidsgrowth Vaccine Guide ►The Vaccines and the Diseases they Prevent ►Keep a record of your child's immunizations. (Click to download a blank immunization record)