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What most children do by this age: Four

Social/Emotional Milestones
Pretends to be something else during play (teacher, superhero, dog)
Asks to go play with children if none are around, like “Can I play with Alex?”
Comforts others who are hurt or sad, like hugging a crying friend
Avoids danger, like not jumping from tall heights at the playground
Likes to be a “helper”
Changes behavior based on where she is (place of worship, library, playground)

Language/Communication Milestones

Says sentences with four or more words
Says some words from a song, story, or nursery rhyme
Talks about at least one thing that happened during his day, like “I played soccer.”
Answers simple questions like “What is a coat for?” or “What is a crayon for?”

Cognitive Milestones (learning, thinking, problem-solving)

Names a few colors of items
Tells what comes next in a well-known story
Draws a person with three or more body parts
Movement/Physical Development Milestones
Catches a large ball most of the time
Serves himself food or pours water, with adult supervision
Unbuttons some buttons
Holds crayon or pencil between fingers and thumb (not a fist)

Check the milestones your child has reached by the end of 4 years by completing a checklist with CDC’s free Milestone Tracker mobile app, for iOSexternal icon and Androidexternal icon devices, using the Digital Online Checklist

A pediatrician's advice to parents of kids under 5 on omicron, travel and daycare
January 2, 20225:00 AM ET
Jonaki Mehta
JONAKI MEHTA

Twitter
Mary Louise Kelly 2018 square
MARY LOUISE KELLY

Twitter
Christopher Intagliata
CHRISTOPHER INTAGLIATA


As the pandemic drags on, there are still a lot of questions to be answered about how to keep kids safe.
Cindy Ord/Getty Images
Amid the omicron surge there is understandable anxiety among parents, particularly those with kids under 5 who can't yet get a COVID vaccine.

They're wondering how to navigate life with young children, what this means for travel plans and daycare, and when the vaccine will become available.

Dr. Ibukun Kalu is a pediatric infectious disease doctor at Duke University and says her hospital has already seen a rise in children being admitted.

"Unfortunately, more of the children that are in the hospital are unvaccinated. However, we have younger children that are not eligible for vaccination also end up in the hospital with COVID," she said.

As the world enters its third year of the pandemic, we asked parents of kids under 5 to send us their questions. Here, Dr. Kalu answers them.

The questions and answers have been edited for length and clarity.

Alex McCarty, Tumwater, WA — 4-year-old daughter and 18-month-old son
Q: What do we know about the severity and risk of the omicron variant to children? Does it seem to be more dangerous than previous variants, is it about the same, or less so?

What we know so far is that omicron is milder in both children and adults. Where in the context of recently dealing with Delta — which was much worse than the virus that was spreading 2020 — omicron is milder than Delta. But it's still pretty severe, and it can cause significant symptoms in a small group of children, not across the board, but a small subset that do end up with more severe symptoms and end up in the hospital.

In kids, partly because COVID seems to cause the initial infection and then just track through the body and cause post-COVID syndromes, it is worse than influenza. And currently we are seeing influenza spread in our community. But COVID is just outpacing that across the board.

If we see more cases, we'll likely see a higher number of kids end up in the hospital just by sheer numbers.

Children have become masters at the temperature check.
Christopher Furlong/Getty Images
Hilary Anderson Carter, Austin, TX — 2-year-old daughter
Q: I have an almost 3-year-old toddler in daycare, and she obviously isn't eligible for COVID vaccination, but we've had several program closures due to exposures to COVID cases in the classroom in the fall semester. And I'm wondering if there are any studies that have been done on the test-to-stay protocols for kids under the age of five?

We do not know enough about test-to-stay in under kids five. And the reason is simple: we approached test-to-stay studies focusing on K-12 environments because they were directly impacted by the quarantine policies that took a ton of kids out of in-person learning. For the daycare setting, pre-school, pre-K, some of the data can be used in those settings, but it's important to understand the context. Masking behavior may be slightly different in younger kids, and the ability to comply with frequent testing may be slightly different. However, I'm encouraged by the data. It showed that we've seen lower transmission within school settings where universal masking exists, and we can continue to promote in-person education for those that find it helpful and can do it through multiple surges in the community.