Thumb, Finger or Pacifier Sucking (page 3)
All healthy newborns start life and sustain it with an urge to suck. Embryos have been observed sucking their thumbs while in the womb. Sucking is one of a baby’s inherent reflexes that is an essential ability for basic survival—if it were not present, the infant would not seek food or nourishment.
For many infants, the sucking instinct is not satisfied by feedings alone. Non-nutritive sucking, that is sucking thumbs, fingers, pacifiers and other objects, is a healthy normal behavior and offers young children a feeling of security, comfort, pleasure and relaxation during the first few years of life. This habit helps children to cope with different situations and emotions. Virtually all young children at one time or another place their fingers, fist, pacifier, thumb, or other objects in their mouth to suck. As children grow and develop, most naturally discontinue this habit.
Thumb and Finger Sucking
Thumb and finger sucking is a natural, normal behavior for infants. Most young children suck their thumbs or fingers at some time, and it is an appropriate and useful behavior that allows them to soothe and entertain themselves. Children usually turn to their thumb or finger when they are tired, stressed, upset or bored. And it is not unusual for a thumb or finger sucker to simultaneously engage in other self-comforting behaviors like pulling at a strand of hair, touching the ear, or holding on to a favorite blanket or toy. Even when the habit lingers past infancy, thumb or finger sucking is rarely something to be concerned about. The majority of children give up such habits on their own by age 2. If children do not stop on their own, the habit should be discouraged after age 4.
Some children prefer sucking a pacifier to a thumb or finger. Pacifier use elicits strong responses from parents and caregivers. Some oppose it because of the way it looks. Some feel that it’s “pacifying” a child with an object. And others believe that using the pacifier can harm the child. But pacifiers do not cause any medical or psychological problems, and like thumb or finger sucking, using a pacifier during the early years of development generally does not permanently alter the position of the teeth or jaw. If a child wants to suck beyond what nursing or bottle-feeding provides, a pacifier will satisfy that need.
Tips for Safe Use of Pacifiers
- Pacifiers should not be used to replace or delay meals; they should only be offered after meals or between feedings. It may be tempting to offer a pacifier to a child when it’s easy for you. However, it is best to let the child decide whether and when to use it.
- Pacifiers should be of one-piece construction made with a firm nontoxic material that can be sterilized. They should have a soft nipple, air holes for ventilation, and have a shield that is wider than the child’s mouth.
- Never tie a pacifier to a child’s crib, or hang pacifiers around their neck or hands. This is very dangerous and could cause strangulation.
- Never dip a pacifier into honey or anything sweet before giving to a child.
- Never put a pacifier in your mouth first before giving to a child.
- Do not let children share each other’s pacifiers.
- Frequently check the pacifier, especially the nipple end, to make sure it has not become brittle and to see whether the rubber has changed color or is torn; discard if the nipple has become sticky, swollen, or cracked
- Never substitute a bottle nipple for a pacifier.
- Pacifiers have a tendency to fall on the ground and children’s hands are often dirty, so make sure to wash pacifiers and children’s hands often with mild soap and rinse with water to limit exposure to germs.
Thumb or Finger Sucking Versus a Pacifier
There are definitely conflicting views on this. Some feel that the pacifier may cause more dental problems, is more unsanitary, and may hinder successful breastfeeding, while others feel that breaking the pacifier habit is easier than with the thumb or finger because a pacifier can be taken away. Studies have shown that children who suck their thumbs or fingers generally have a greater difficulty breaking their habit then do children who use pacifiers.
Should You Be Concerned?
A primary concern is to avoid dental problems that may occur if a child continues thumb, finger or pacifier sucking during the emergence of the adult (permanent) teeth, around age 5. After permanent teeth come in, thumb, finger and pacifier sucking may cause problems with the proper growth of the mouth and alignment of the teeth. According to the American Academy of Pediatric Dentistry, extensive sucking of thumbs, fingers or pacifiers has a tendency to put pressure against and push the front teeth out of alignment causing teeth to protrude. This pressure is likely to cause changes to the roof of the mouth, an open bite (vertical gap between upper and lower front teeth), or overbite (horizontal gap between upper and lower front teeth). It is possible that these conditions will self-correct, especially if the habit ceases before the eruption of the adult teeth.
Conclusively, experts agree that prolonged sucking of thumbs, fingers or pacifiers during and after the eruption of the permanent teeth can hinder proper growth and development of the teeth and gums. Sucking of the thumb or finger or use of a pacifier beyond 6 to 7 years of age can affect the shape of a child’s mouth or teeth, resulting in reparative orthodontia later on. If you notice changes in the roof of the child’s mouth (palate) or in the way the teeth are lining up, then encourage the child’s family to talk with their pediatrician or pediatric dentist.
How to Help a Child Stop the Habit
Children generally forego non-nutritive sucking long before any permanent damage is done. However, some children need to be helped to stop the habit before it will cease. Attempts to steer children away from the habit can backfire if they are not tempered with positive support and guidance. Refrain from harsh words, nagging, teasing, belittling, pulling the finger or pacifier out of a child’s mouth, or punishing the child to stop the behavior. These methods may upset the child, increase anxiety and stress, and worsen the habit.
- Parents and caregivers can assist children with strong emotional support through a variety of methods. Start by gradually weaning children from the habit over time. Explain that they must stop the habit in order for their teeth to come in straight.
- Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to the child.
- Involve older children in choosing the method of stopping. Have a special place for the pacifier that’s out of sight, so that children must ask for it.
- Praise and reward children when they don’t suck their thumb or use the pacifier. Look for times when the children do not have the thumb, finger or pacifier in their mouth, and provide words of encouragement, a pat or hug. Let them know that you are aware of the effort they are making to change the habit and that you appreciate it.
- Star charts, daily rewards and gentle reminders, especially during the daytime hours, are also very helpful.
American Academy of Pediatric Dentistry Fast Facts
Reprinted with the permission of the California Childcare Health Program.
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