The Ins and Outs of Thumb Sucking: Myths and Facts

Are you concerned about your baby or toddler sucking his thumb? Learn the facts and common misconceptions, and get advice on how to help your child shed this childhood habit.

Many parents find themselves relieved when their infants find their fingers or thumb and are able to soothe themselves. Yet for some, relief turns to concern as the child grows, and mom and dad begin to worry if the thumb sucking habit is normal, if it will damage their child’s bite, and if their child will ever stop the habit.

Fact: Thumb sucking is a ‘normal’ behavior

Infants have strong, pre-determined sucking and rooting reflexes. Finding an object to suck on is an extension of this normal behavior. About 90 percent of infants in Western cultures engage in what’s termed “non-nutritive sucking” (or sucking for purposes other than feeding), on thumbs, fingers, pacifiers, blankets, or other objects. About half of these children will stop on their own by six or seven months of age, but as many as one-third will continue beyond the preschool years. Though no official data exist on thumb sucking among adults, there are web sites devoted to help adults kick this habit!

Myth: There are no problems with thumb sucking in infants and toddlers

Though common enough, there are some early potential downsides to this habit. Fingers can become sore and even infected. Bacteria can be introduced into the mouth by dirty fingers. There is also the concern that infants and toddlers, happy with their mouths busy sucking, will be less inclined to babble or imitate the sounds around them. When they do attempt to talk around a thumb or pacifier, they are less likely to be understood.

Myth: Thumb suckers are insecure

This is not the case; sucking is an act of self-soothing and a source of comfort for young children. In a world where little ones rely on others for the most basic needs, sucking behavior offers children a soothing way to help alleviate some of the negative effects of boredom, hunger, fatigue, stress, fear, and over-excitement. The calming effect is most likely brought on by changes in brain chemicals called neurotransmitters. Insecurity and damage to a child’s self-esteem can result from criticism from adults and other children, however. This leads to more stress for the thumb-sucking child, which only generates a greater need to suck to relieve this stress.

Myth: Thumb sucking doesn’t have negative effects on teeth or the mouth until children are six or seven years old

Problems can actually begin in the preschool years, at around age four. A number of negative effects can eventually be seen, but the most common is a type of malocclusion called an anterior overbite. Upon closing the mouth, there is a gap between the upper and lower front teeth, with the upper teeth extending out in front. One problem that can follow is a TMJ syndrome of face, jaw, neck, ear, or shoulder pain. Another is a persistence of an infantile pattern of swallowing where the tongue is thrust into the gap between the front teeth to create the seal needed for swallowing. This situation has been linked to distortion of certain consonants, such as s, t, d, z, and l.

A second potential dental problem is a protrusion of the upper two front teeth. Teeth that protrude are more likely to be damaged or fractured in falls and accidents.

Additionally, there is a concern over premature loss of baby teeth. Normally, pressure on the roots of the primary (baby) teeth from the permanent teeth above them causes them to be resorbed into the body. Without its root, a tooth falls out. There is some evidence that excessive pressure put on baby teeth from sucking also causes root resorption, and loss of primary teeth before the permanent teeth are ready to replace them. This can lead to abnormal tooth spacing and other problems.

Can thumb sucking be prevented?

In as much as a certain amount of non-nutritive sucking in very young children is normal, it shouldn’t have to be. But parents should be aware that excessive dependence on sucking behavior can be seen in children whose needs are not being met. Appropriate feeding and sleeping schedules can prevent excessive fatigue and hunger. Parent-child time and a variety of interesting, safe objects to explore can help ward off boredom and stress. A happy, appropriately stimulating environment should be sought in a child care arrangement. Lastly, most small children find a structured day less stressful than a completely unstructured one.

Weaning children from the habit

Following are tips from Contemporary Pediatrics on how to wean children from the habit of thumb sucking:

Choose the right time

To give up digit sucking, your child must be mature enough to understand why you want him to quit and to practice self-control. Most five-year-olds are mature enough to take on the task of quitting; preschoolers, no matter how bright and articulate, are not. Trying to get a preschooler to give up thumb sucking will likely lead to repeated relapses, frustration, conflict, and resistance. It may even make the habit worse as the child seeks comfort through increased sucking.

Choose a time to break the habit when you and your child are not experiencing excessive stress or change in your lives—such as the arrival of a new sibling, a family move, or starting a new school. Children use sucking to relieve stress, and trying to quit during a stressful time increases the chances of failure.

Motivate your child

Before your child can give up sucking, she must want to quit. To help get her commitment:

  • Let her know that you love her unconditionally and that you want to help her out of concern for her well-being.
  • Show her with a mirror what sucking is doing to the teeth, and point out calluses or crooked fingers that are related to the habit.
  • Discuss any speech problems that may make it hard for others to understand her.
  • Talk about the unhealthy aspects of putting a finger or thumb with “germs” on it into the mouth.
  • Discuss hurtful comments made by others about the sucking behavoir.

Use rewards and reminders

Rewards for avoiding sucking can help your child stay on task long enough to make sure the habit is completely eliminated. During the first week give small rewards from a grab bag for good progress—such as markers, jewelry, small toys, sugarless gum, and certificates granting special privileges (staying up a little later, a trip to the ice cream store). Have your child pick out a reward after the first day without sucking, then every other day. Thereafter, help your child make a progress chart and set long-term goals such as a special reward after two weeks without sucking, another at six weeks, and another after three months.

Introduce reminders, such as a bandage on the finger or thumb, as special “helpers” (never penalties) to let your child know when the finger is trying to “sneak into the mouth.” Character bandages work well as daytime reminders. Help your child place the bandage comfortably on the top of the finger or thumb.

Take steps to promote success

To increase the chances of immediate success and encourage your child to persevere:

  • Be available (especially during the first two or three days), consistent, patient, and focused on helping the child in a positive way. Don’t force her to comply. The habit belongs to her, and she must be willing to cooperate if it is to be eliminated.
  • Plan activities to occupy the child’s hands (drawing, craft projects, puzzles, games), especially during the first several days when you are trying to break down the hand-to-mouth habit.
  • Be aware of situations in which the reminder bandage could come off the thumb or finger (such as handwashing) and offer to help replace it without being critical or intrusive.
  • Avoid situations that stimulate sucking, such as excessive fatigue, hunger, television watching, and conflict. Most children suck their thumbs unconsciously, especially when watching television. Limit TV time and place a small table in front of your child with toys, crafts, or art materials to occupy her hands while she is watching.
  • Offer plenty of empathy, encouragement, and praise for your child’s efforts.

Help your child stop sucking at naptime and nighttime

Because most children who engage in thumb sucking depend on it to fall asleep, and suck during sleep, this part of the habit takes the longest to break—usually about three months. You can help by providing a calming, comforting bedtime ritual, especially during the first week. A bedtime story or backrub can be very helpful. Avoid overstimulating physical activity or caffeine before bedtime or naptime.

A hand puppet made out of a cotton tube sock or glove can be placed on your child’s hand as a nighttime reminder. Fasten it securely or sew it to your child’s pajama top to prevent it from coming off during sleep. Emphasize to your child that sucking that occurs during sleep is not her fault because “that old finger/thumb just sneaks in.” Explain that if the sucking continues during sleep, the habit won’t go away.

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