A kindergarten child, who has developed a fever since arriving at school, is resting in the school nurse’s office. It is 11:30 a.m. The child asks, “When is my mommy going to get me?” The nurse knows that the mother will arrive in approximately 30 minutes. Which is the best response for the nurse to give to the child? “Your mommy should get here:

Preschoolers typically exhibit unpredictable eating patterns. It’s important for parents to understand that occasional variations in intake are normal, and healthy children often balance their nutritional needs over the course of a day or week.

Rationale for correct answer:

2. Research supports that preschoolers have an innate ability to self-regulate food intake when offered a variety of nutritious options. They may eat little at one meal and make up for it at another. This anticipatory guidance reassures parents and prevents unnecessary anxiety or pressure around eating.

Rationale for incorrect answers:

1. Preschoolers need about 90–100 kcal/kg/day, not 110 kcal/kg. The average total intake is closer to 1,200–1,800 calories/day, depending on age, size, and activity, not 2,200 calories, which is more appropriate for adolescents or very active older children.

3. While it is true that fat intake should be moderated, dairy and meat are important sources of protein, calcium, iron, and other nutrients. Limiting them to twice a day may undermine adequate nutritional intake unless replaced with high-quality alternatives. Instead, the focus should be on choosing lean meats and low-fat dairy rather than reducing frequency.

4. Fruit juice is not a healthy alternative to milk. Juice lacks the protein, fat, and calcium found in milk and is high in sugar. The American Academy of Pediatrics recommends limiting juice to 4–6 ounces per day for preschoolers, and water or calcium-fortified plant-based milks (e.g., almond or soy) may be better alternatives for children who dislike cow’s milk.

Take home points

• Preschoolers often self-regulate food intake and should not be forced to eat when not hungry.
• Parental anxiety about eating can lead to power struggles; offering a variety of healthy choices is more effective.
• Nutrient-dense foods are more important than calorie quantity, quality over quantity matters.
• Limit juice consumption and avoid using it as a milk substitute; consider other calcium-rich options if milk is refused.

Mild stuttering is common in children aged 3–5 years as they experience rapid language development. This developmental disfluency often resolves on its own. The goal is to support the child’s confidence and reduce any anxiety or pressure around speaking.

Rationale for correct answers:

1. Waiting patiently shows the child that her words are valued. Interrupting or rushing can increase anxiety and worsen stuttering.

3. Making eye contact while listening conveys attention, acceptance, and support, helping the child feel understood and confident.

4. Speaking slowly and clearly models fluent speech and creates a calm environment. It encourages the child to slow down without needing direct correction.

5. Avoiding comments about stuttering prevents the child from becoming self-conscious, which can exacerbate the problem. Keeping communication natural and pressure-free is key.

Rationale for incorrect answer:

2. Giving treats for clear speech turns normal communication into a performance and may cause the child to feel pressure or shame when stuttering occurs. This approach is counterproductive and may lead to increased anxiety or reluctance to speak.

Take home points

• Developmental stuttering is common and usually temporary in preschoolers.
• Encourage speech by being attentive, patient, and supportive, not by correcting or rewarding.
• Avoid drawing attention to the stuttering, pressure can worsen disfluency.
• If stuttering persists beyond age 6, worsens, or is accompanied by physical tension or frustration, referral to a speech-language pathologist is appropriate.