Thumbsucking

Answer 1

Information

Thumbsucking is the process of sucking on the thumb for oral pleasure. It is a normal activity that peaks around age 1 and 2. However, if thumbsucking continues past age 4 - 5, dental problems may develop.

Thumbsucking is most common when the child is hungry or tired.

Some parents are concerned by thumbsucking and may even try to restrain the infant or child. In most cases this is not necessary. Most children stop thumbsucking on their own. When older children continue to suck their thumbs, it could mean they are bored, anxiety, or have emotional problems such as depression. Seek advice from your pediatrician if you are concerned.

There is no definitive treatment for persistent thumbsucking, but there are several options you can try:

• Praise the child for not sucking the thumb.
• Use a thumb guard, if your pediatrician recommends one.
• Place a bitter substance on the thumb, but be careful NOT to use something that may be poisonous to a small child.
• Create a contract with the child, making a mutual agreement with goals and rewards.
• Use dental appliances as recommended by your health care provider (if the child's teeth and mouth are affected).

Answer 2

Information

Thumbsucking is a natural habit of infants and young children. They do it to soothe themselves. Children most often suck their thumb when they are hungry or tired.

Some parents are worried by thumbsucking and may even try to stop the infant or child. In most cases this is not needed. Most children stop sucking their thumb on their own by around age 1 or 2.

If thumbsucking continues after the child's permanent front teeth come in (most often by age 5), problems may develop. Pacifiers may cause some of the same problems and should be stopped by age 4.

When older children continue to suck their thumb, it could mean they are bored or feel insecure. Seek advice from your child's health care provider if you are concerned.

There is no "best" treatment when thumbsucking continues. However, these methods often work:

• Praise your child for not sucking the thumb.
• Find other ways to help your child find comfort and feel secure.
• Work with the child to find a way to stop sucking the thumb.
• Have your child's dentist or health care provider explain the reasons to stop sucking.

If these methods do not work, ask your dentist or health care provider about the following:

• Use a bandage or thumb guard to help remind your child.
• Use dental appliances (most often if your child's teeth and mouth are affected).
• Place a bitter medication on the thumb, but be careful NOT to use something that may be poisonous to a small child.

References

Gleason MM, Boris NW, Dalton R. Habit and tic disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 23.

Sexton S, Natale R. Risks and benefits of pacifiers. Am Fam Physician. 2009;79:681-685.

Reviewed By

Review Date: 01/24/2011

Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital; and Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.