Thumb-Sucking

Topic Overview

Is thumb-sucking normal?

Thumb-sucking is normal in babies and young children. A natural sucking instinct leads some babies to suck their thumbs during their first few months of life, or even before birth. Babies may also suck on their fingers, hands, or items such as pacifiers.

Why do babies suck their thumbs?

Babies have a natural urge to suck, which usually decreases after the age of 6 months. But many babies continue to suck their thumbs to soothe themselves. Thumb-sucking can become a habit in babies and young children who use it to comfort themselves when they feel hungry, afraid, restless, quiet, sleepy, or bored.

Most infants suck their thumbs. Toddlers suck their thumbs too. Little by little, most children stop on their own between ages 3 and 6.

Does thumb-sucking cause any problems?

Prolonged thumb-sucking may cause a child to develop dental problems. Thumb-sucking can cause a child's teeth to become improperly aligned (malocclusion) or push the teeth outward, sometimes malforming the roof (upper palate) of the mouth. Malocclusion usually corrects itself when the child stops thumb-sucking. But the longer thumb-sucking continues, the more likely it is that orthodontic treatment will be needed to correct any resulting dental problems.

A child may also develop speech problems, including mispronouncing Ts and Ds, lisping, and thrusting out the tongue when talking.

At what point does thumb-sucking become a problem?

Thumb-sucking in children younger than 4 is usually not a problem. Children who suck their thumbs frequently or with great intensity after the age of 4 or 5 or those who continue to suck their thumbs after age 5 are at risk for dental or speech problems.

In rare cases, thumb-sucking after age 5 is in response to an emotional problem or other disorder, such as anxiety. A child with this type of problem needs to be evaluated by a doctor. Most other children stop sucking their thumbs after simple treatment measures are introduced.

How is problem thumb-sucking treated?

Many experts recommend ignoring thumb-sucking in a child who is preschool age or younger. Most young children stop sucking their thumbs on their own.

Children who suck their thumbs may need treatment when they:

• Also pull their hair, especially when they are between 12 and 24 months of age.
• Continue to suck a thumb often or with great intensity after the age of 4 or 5.
• Ask for help to stop the behavior.
• Develop dental or speech problems as a result of the behavior.
• Feel embarrassed or are teased or shamed by other people because of the behavior.

Usually, treatment can be done at home and includes parents setting rules and providing distractions. It may be helpful to limit the times and places that your child is allowed to suck his or her thumb and to put away blankets or other items your child associates with thumb-sucking. Offering praise and rewards for not thumb-sucking may also help your child break the habit. As your child matures, usually around age 5, he or she may be able to take a more active role in treatment.

• Talk to your child openly about the effects of thumb-sucking.
• Put gloves on your child's hands or wrap the thumb with an adhesive bandage or a cloth. Explain that the glove, bandage, or cloth is not a punishment but is only there to remind him or her not to thumb-suck.
• Develop a reward system, such as putting stickers on a calendar or otherwise recording each day that your child does not suck his or her thumb. After an agreed-upon number of days, have a celebration for your child.
• Use a special nontoxic, bitter-tasting nail coating, such as Thum. Apply it like fingernail polish to the thumbnail each morning, before bed, and whenever you see your child sucking his or her thumb. This treatment is most successful when it is combined with a reward system.

If these treatments aren't successful, other methods—including behavioral therapy, thumb devices, or oral devices—may be used.

Frequently Asked Questions

Learning about thumb-sucking:	What is thumb-sucking? What causes children to suck their thumbs? When does thumb-sucking become a problem?
Being diagnosed:	When should my child see a doctor for thumb-sucking?
Getting treatment:	How is thumb-sucking treated? How can I help my child stop thumb-sucking?

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Author:	Debby Golonka, MPH	Last Updated: September 12, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
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