Thumb Sucking and Children

Specialists agree that a thumb sucker younger than age five shouldn't be pressured to stop. The majority of children give up such habits on their own before they enter kindergarten. Even when the habit lingers past infancy, thumb sucking is rarely something to be concerned about. It does not indicate that a child has emotional problems or that he will still be sucking his finger when he's a teenager.

Nevertheless, about fifteen percent of children will continue thumb sucking past their fifth birthday. This is an age when teasing often starts, causing social difficulties for children once they reach school age.

Thumb sucking also can lead to dental problems. A child who is still sucking his thumb by age five, when permanent teeth start coming in, may develop an abnormal bite. In addition, prolonged thumb sucking can cause minor physical problems, such as chapped lips or cracked skin, calluses, or fingernail infections. If a child older than five or six is still sucking his thumb and is having difficulty stopping, parents ought to think about what they can do to help.

Before insisting that a child go "cold turkey," it is important to observe how deeply entrenched the behavior is. If it happens only at bedtime or in front of family members, it is less serious.

Attempts to steer a child away from thumb sucking can backfire if not tempered with positive support and guidance. Refrain from nagging and reprimands or pulling a finger out of a child's mouth - these can result in a power struggle. The truth is most kids over six really do want to stop but need some extra help.

Many parents have had success with a simple behavioral treatment plan that can be carried out in three phases. First, a one-month moratorium on discussion. If finger sucking is part of a power struggle, not mentioning it may help extinguish the behavior. The next step is to buy a poster board and stickers and make a "progress" chart. Offer a prize at the end of each week the child has refrained from sucking and a larger reward at the end of the month. Breaking a habit is much easier when the child is a willing participant.

Try to engage the child in the process. For example, decide together how many "slip ups" he's allowed each week and have him place stickers on the chart.

It can also be helpful to place a bitter-tasting liquid on the nail (not directly on the finger), especially at night, as a reminder not to suck. Such products are sold over the counter. Mittens, gloves, or a finger-splint may also be worn at night. Surprisingly, children often find it a relief to be able to turn to a program for help.

It is essential to give a child plenty of praise and support while he is tying to change his behavior. For example, an extra cuddle, a special outing, playing a new game together. Be aware of situations that might promote thumb sucking, e.g., television or riding in the car. Use your imagination to guide your child to other means of solace that is more age- appropriate. If this program does not work, don't despair. Breaking a longstanding habit is difficult and some children may need extra help.

Talk to your pediatrician and your child's dentist, who may recommend, especially in the case of an overbite, the insertion of a device in the child's mouth known as a palatal bar that prevents sucking.

With all treatments, a child should be offered strong emotional support. If the problem seems particularly recalcitrant, you may want to seek the advice of a mental health professional.

About the NYU Child Study Center

The New York University Child Study Center is dedicated to increasing the awareness of child and adolescent psychiatric disorders and improving the research necessary to advance the prevention, identification, and treatment of these disorders on a national scale. The Center offers expert psychiatric services for children, adolescents, young adults, and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training utilizing the resources of the New York University School of Medicine. The Child Study Center was founded in 1997 and established as the Department of Child and Adolescent Psychiatry within the NYU School of Medicine in 2006. For more information, please call us at (212) 263-6622 or visit us at www.AboutOurKids.org.