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THUMBSUCKING
Thumbs naturally find their way into the mouths of babes and often stay there for years. Thumbsucking is a boon to babies
but bothers onlookers and dentists. So what's a poor thumbsucker to do? Can a baby and her thumb find happiness together without
public censure?
WHEN THUMBSUCKING IS HELPFUL
Some babies are born thumbsuckers. Ultrasound pictures show babies sucking their thumbs in the privacy of the womb. In
many babies, the need to suck is not satisfied by bottle-feeding or breastfeeding alone, and they learn to suck on the ever-
present thumb for comfort. In the early months, even tiny infants discover that one of life's little pleasures is right in
their hands and under their noses. We consider the ability of babies' to use their own body parts for comfort as a sign of
emotional health, not psychological disturbance. In fact, some veteran baby comforters even help their babies find their thumbs
to self-quiet. What's all the fuss about? Whose thumb is it anyway?
Some babies seem unsatisfied after bottle-feeding. They've had enough milk, but not enough sucking. One advantage of the
breast is that it can still be sucked on even after the feeding is over, so baby can get the sucking he needs without over-filling
his tummy. But there are times when the breasts' owner has had enough and a few babies still need pacifying. If you don't
feel you can handle letting baby pacify on your breast, let him suck on your finger, and eventually, if he doesn't discover
them on his own, you can direct his thumb or fingers into his mouth. The seemingly insatiable desire to suck is there for
a reason.
Sucking mellows the fussy baby, helping to organize the otherwise disorganized bio-rhythms of a newborn. Some babies need
more mellowing than others. Our high-need baby was the only one of ours to suck her thumb. We thought it was sweet to see
her snuggled up with her thumb while she slept. She started at three months and quit on her own at five months; a very uneventful
thumb weaning. Martha was careful to breastfeed her frequently so that the thumb did not become a substitute for the breast.
Sucking at the breast is more than eating to a baby or toddler. They learn that the comforting they get helps them relax.
A child who has gotten attached to her thumb will tell you she needs it to help her relax.
WHEN THUMBSUCKING CAN BE HARMFUL
While most mothers, for practical reasons, give infant thumbsucking their thumbs-up approval, some dentists vote thumbs
down. While this harmless habit subsides without concern or intervention in most infants by the age of two, some children
increase their thumbsucking to such frequency and intensity that it becomes a social and dental problem.
Thumbs in push teeth out. In the first two to four years, don't worry about thumb and teeth not getting along. Seldom
does thumbsucking harm teeth in the child under four, and it usually subsides by this age anyway. But habitual thumbsucking
at age three or four or older is a reason to start putting money aside for the orthodontist, especially if the child already
has a hereditary overbite or protruding upper gum. Or, you can start thinking of ways to get that offending thumb out of the
child's mouth and into his pocket. Because of the way the thumb is forced against the inside of the upper front teeth, thumbsucking
can cause overbite (buck teeth) and other dental malocclusions. If neither your child's doctor nor his dentist are worried
about the thumbsucking, you shouldn't worry either.
Oversucked thumbs get sore. Habitual sucking is hard on the skin of the thumb. Spending too much time between the moisture
of the tongue and the pressure of the teeth causes oversucked thumbs to look like one long callus; others crack and bleed.
Some get infected (there is a red, swollen tender area where the thumb nail joins the skin).
Sucking becomes socially unacceptable. Toddlers don't ridicule their thumbsucking peers because thumbsucking is standard
operating procedure for children under two. But the older the sucker the more likely she'll get teased about her thumb-in-mouth
"disease." In most children, the fact is that thumbsucking, like bedwetting, doesn't reflect a psychological disorder.
It's just a habit -- though unsightly to some older children and adults. Don't fret about a happy thumbsucker who is gregarious
and has a good self-image -- this thumb will soon leave the mouth. But some suckers never show an unobstructed view of their
smile; it's as if their nose has grown a fist. They prefer sucking their thumbs to relating to peers. This scene is socially
unacceptable and the thumb and its owner may be teased continually about being a "baby."
THUMBSUCKING: 12 WAYS TO STOP IT
Like most normal but bothersome behaviors, if you did nothing but accept and ignore it the thumb would eventually find
its way into other occupations. But if the habit persists and is harming the child's teeth, try these tips:
1. Satiate sucking needs. Sucking satisfies the need for attachment. A need that is filled goes away; a need that is not
filled stays as a habit. If you have a "sucky baby," let her suck to her heart's content during early infancy. Breastfeed
on cue as long as possible. Let your baby suck your fingers. Allow non-nutritive sucking (sucking on an "empty"
breast, finger or pacifier, collapsible bottle nipple) after the baby's hunger is satisfied. An interesting study confirmed
that babies who get their sucking needs met seldom become habitual thumbsuckers. In 1977 researchers studied fifty children
between ages one and seven who were habitual thumbsuckers, and compared these with children who did not suck their thumb.
The studies showed that thumbsuckers tended to be bottle- fed rather than breastfed. The later the child was weaned, the less
likely he was to suck his thumb. The thumbsucking children tended to have been fed on schedule rather than on cue. And 96
percent of the thumbsuckers had been left to fall asleep alone after being fed. But not one of the non-thumbsuckers was left
alone to fall asleep. Researchers theorize that during sleep persons return to primitive reflexes, such as sucking and hand-to-mouth
actions. In our own pediatric practice we have noticed that babies who are nursed down to sleep and not weaned until they
are ready are much less likely to become habitual thumbsuckers. Consider breastfeeding as a suck of prevention for habitual
thumbsucking.
2. Offer early alternatives to sucking. If you are blessed with a baby with a strong sucking drive, instead of always
automatically pacifying him by sucking, try alternatives: rocking, massage, playing animated games, and singing. The earlier
baby learns that there are other ways to find comfort in addition to the breast, bottle, thumb, or pacifier, the more he will
seek alternatives to oral gratification later.
3. Keep thumbs busy. Bored little thumbs often seek their friend, the mouth, when there is nothing better to do. Busy
the bored child. When you see the thumb heading toward the mouth, distract and redirect the child into an activity that keeps
both hands busy.
4. Keep life calm. As your toddler gets older he will use his thumb to help himself relax. This is good. You then do what
you can to keep peaceful yourself, and that will flow over into a peaceful atmosphere in the home. Model relaxing ways and
your child will learn from you; such as quiet times, long walks, music, and slow, deep breathing when you feel anxious.
5. Show and tell. If your child is old enough for thumbsucking to bother his teeth, he is old enough to understand why
this habit harms his teeth. In front of a mirror let your child rub his index finger over the protruding upper teeth and put
his fingertip into the gap between the upper and lower teeth during a bite. Imitate a buck teeth appearance (like Bugs Bunny),
showing your child what can happen to thumbsucked teeth. Also, point out to your child that her sucked thumb does not look
as nice as her other one.
6. Time your intervention. With thumbsucking, wait to intervene until your child is in a receptive mood. Trying to step
between thumb and mouth when your child is not in a cooperative mood is likely to result in a power struggle. Your interference
will be regarded as a threat to her independence.
7. Offer reminders. In the thumbsucker over four, try an adhesive bandage or tape on the thumb. A glove can remind and
dissuade the nighttime thumbsucker. For the intensive night sucker who uses his thumb on his teeth like a crowbar, I've suggested
a tongue-depressor taped to the thumb as a splint to keep the thumb from bending. If your child is older, talk with him about
using a product that gets painted on the thumb and gives a stinging reminder when thumb meets lips. Encourage the child to
paint it on himself; it's his thumb and his habit.
8. Suggest a competing habit. With the child over four you can use the principle of a competing habit. Show your child
how to fold his arms, squeeze his thumb, or some other gesture that he enjoys instead of sucking his thumb. A trick that I've
used successfully in my office is the game of hide the thumb: "As soon as you feel like sucking your thumb, wrap your
fingers over your thumb into a fist." If it's a bedtime habit, suggest hiding the thumb under the pillow.
9. Negotiate a milestone. If your child seems to be eager to meet goals you could give her a target date -- "When
you have your fourth birthday you can say goodbye to sucking your thumb!" Don't hold your breath, though. On the big
day she may smile sweetly at you and say "I've changed my mind." Remember to smile sweetly back.
10. Consult your child's dentist. When your compulsive thumbsucker is four years of age, and her teeth are starting to
reflect the harmful habit, a dentist can fit a palatal appliance that keeps the thumb from pushing on the teeth.
11. Relate with people instead of the thumb. If you see your child withdrawing from group play and interacting with his
thumb instead of other children, consider the possibility that your child may need a social boost. Rather than attack the
thumbsucking, delve into the underlying self-esteem problem that may hamper his social interaction. If you need some help
in this department, consult a professional.
12. Chart-a-thumb. Once peer pressure begins, the child over ages six or seven may want to stop thumb-sucking for her
own reasons. Offer to help her design a chart that she can use on her own to mark down the number of times she sucks every
day. She'll be motivated to see the number get smaller and smaller. You do not have to watch her, or remind her, or check
up on her charting.
THUMBS VERSUS PACIFIERS
Which are better, thumbs or pacifiers? Babies would vote for thumbs. They are always available, taste familiar, don't
get lost in the night, and don't fall on the floor. Dentists would vote for pacifiers. Children don't use them like crowbars
against their upper teeth, and they can be "lost"; permanently. Even for those who dislike the way "these things"
obstruct the view of a baby's face, it's hard not to like the quieting effect of the silicone plug. All babies suck their
thumbs at some time. Most outgrow it, and if their sucking needs are appropriately met in early infancy, they seldom carry
the thumb-sucking habit into childhood.
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