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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Thumb Sucking

Babies are born with a sucking reflex, often beginning in the womb that allows them to suckle and nourish themselves. They therefore have a desire to suck, not only to satisfy their most basic needs of hunger and thirst, but as a means of self soothing when falling asleep or during times of anxiety. Thumb sucking also soothes sore gums during teething and allows the infant to derive pleasure from their own body parts and the world around them. Thumb sucking tends to bother parents more than infants and some children tend to suck more than others, with the behaviour continuing well into childhood. There is no particular age at which comforters, such as thumb sucking, should or shouldn't be used and, like bed-wetting, children grow out of them. Babies may also suck on their fingers, hands or items such as pacifiers. This behaviour is known as non-nutritive sucking or sucking for purposes other than feeding. This phenomenon tends to occur in western, industrialized societies, where children are often physically separated from their mothers at an early age. Thumb sucking is uncommon in cultures where mothers are in close physical proximity with their babies during the early years  (Discovery Communications, LLC., 2006-2011; Dr. Stoppard, M., 2005; Kaboose.com; Leary, 1990).

Possible side-effects of long-term thumb sucking:

Prolonged thumb sucking may result in the following dental problems, after the permanent teeth come in;

Malocclusion- in which the child's teeth become improperly aligned. This problem generally resolves when a child stops thumb sucking. However, if thumb sucking continues, orthodontic treatment may be required to rectify the problem.

A second dental problem is the protrusion of the upper two front teeth.  Teeth that protrude are more likely to be damaged in falls or accidents.

Malformations in the growth and formation of the roof of the mouth or upper palate.

There is some evidence that excessive pressure put on baby (primary) teeth through sucking, may result in the premature loss of these teeth before permanent teeth are ready to replace them. This may result in problems such as abnormal tooth spacing.

However, it is often advocated that it is the intensity of the sucking that determines whether or not dental problems will occur. i.e. children who merely rest their thumbs in their mouths are less likely to have problems than their more aggressive sucking counter parts (Kaboose.com; WebMD, LLC., 1995-2011).

Other problems may include;

Speech problems- such as mispronouncing T's and D's, lisping, or thrusting out the tongue when talking.

There are concerns that infants who engage in thumb sucking, are less prone to babble or imitate the sounds around them. Furthermore, when they try talk around a thumb or pacifier, they are less likely to be understood.

Frequent thumb sucking may irritate the skin, due to a combination of enzymes in saliva and constant wetness, resulting in a mild form of dermatitis. This problem is easily rectified with the use of a mild cortisone cream.

Bacteria may be introduced into the mouth through dirty fingers.

Thumb suckers may be teased by their peers (Kaboose.com; WebMD, LLC., 2005-2011).

Thumb or dummy?

Parental opinions on thumb sucking and dummies vary. It is therefore up to you, to decide what your attitude towards them is. In many cases, parents are often relieved if their baby stops crying, since hearing their child cry can be highly distressing and they just want the tears to stop. Both thumb sucking and pacifiers like dummies, have their advantages and disadvantages. Your baby can easily take their thumb out of their mouth, in order to babble, place something else in their mouth or resume crying. Unfortunately the opposite is also true, thumbs are always readily available and habitual thumb sucking may be a difficult behavioral pattern to break. Prolonged thumb sucking may lead to dental problems later in life.  With a dummy, parents can dispense it when they wish, although this is often easier said than done. Many dummies are orthodontically moulded and are considered to be less harmful to dental development than they used to be. On the down side, research has shown that dummies may impede general and linguistic development. Dummies restrict a baby's ability to babble, make them less alert, and prevent them from putting other things in their mouths, which serve as an important way for them to explore their worlds (Collins, 2005).

When does thumb sucking become a problem?

Thumb sucking is normal in babies and young children. Babies have a natural urge to suck, that usually decreases around 6 months of age. But many babies continue to suck as a self-soothing behavior. In some children, thumb sucking may become a habit and a means of comfort for; hunger, fear, restlessness, tiredness or boredom. Most children tend to stop thumb sucking on their own between 3 and 6 years of age. However, children who suck their thumbs frequently or with great intensity, after the age of 4 or 5, or those who continue to thumb suck after the age of 5, run the risk of developing dental and speech problems. In rare cases, thumb sucking over the age of 5, may be related to an emotional problem or disorder, such as anxiety. These children require a thorough medical evaluation. In most cases, children stop sucking their thumbs following simple treatment interventions (WebMD, LLC., 1996-2011).

Consult your doctor if:

  • Your child also pulls out their hair, especially between 12 and 24 months.
  • Thumb sucking continues with frequency and intensity after the age of 4 or 5.
  • Your child asks for help to stop the behaviour.
  • Speech or dental problems develop as a result of the behaviour.
  • Your child is being teased or is experiencing shame or embarrassment about their behaviour.
  • Most children do not require medical intervention for thumb sucking and the behaviour tends to resolve naturally. It is recommended that thumb sucking is ignored in preschool children and younger. However, if your child is an aggressive thumb sucker and you notice changes in their baby (primary) teeth, consult your dentist. Most children cease sucking by the time their permanent front teeth erupt (ADA, 1995-2011; WebMD, LLC., 1996-2011).

How to treat problem thumb sucking:

It is often recommended that parents ignore thumb sucking in children of preschool age or younger. In most cases children will stop sucking their thumb on their own. If thumb sucking persists, treatment can be carried out at home and usually involves parents setting rules and providing distractions.

Talk to your child openly about the effects of thumb sucking. This may help increase their determination to stop thumb sucking. Most 5 years olds are mature enough to take on the task of quitting, are able to understand why you want them to stop and are able to practice self control. Let your child know that you love them unconditionally and that you want to help them break their habit due to concern for their well being. In contrast, attempting to discourage preschoolers from digit sucking is likely to be met with resistance, conflict and frustration. In some cases, it may even reinforce the habit because some children seek comfort in thumb sucking.

Choose a time to break the habit when your child is not experiencing stress or any major life changes, such as moving house, the birth of a new sibling or starting a new school. Children often use thumb sucking as a means of alleviating fear and anxiety, and trying to quit during a stressful time increases their chances of relapse or failure.

Start off by encouraging your child to stop thumb sucking at easier times, such as when you're in public and move on to the more challenging ones where the habit is more deeply ingrained, such as before bedtime. Offer your child double rewards for their abstinence during more difficult moments.

Extra oral methods:

Put gloves on your child's hands or adhesive bandages over their thumbs. Explain to your child that the glove or bandage is not a punishment but rather a special reminder to let them know that their finger is trying to 'sneak into their mouth'. Character bandages work well as daytime reminders.

Show your child in the mirror what sucking is doing to their teeth.

Develop a reward system, for example you could give your child a star or sticker on a chart for every day that they abstain from thumb sucking. After an agreed upon amount of stars, your child gets a reward.

Apply a bitter tasting, non-toxic nail coating to your child's thumb nail each morning, before bed and whenever you see them sucking their thumb during the day. Ensure that your child knows, this is not a punishment and merely a tool to help them break the habit (Discovery Communications, LLC, 2006-2011; Medindia, 1997-2011; WebMD, LLC, 1996-2011).

How to help your child:

If your child is engaging in thumb sucking due to the pain associated with teething, provide them with a cool teething ring as an alternative to ease their discomfort.

Avoid scolding your child for thumb sucking behaviour, rather provide them with positive reinforcement and praise for not sucking.

In older children, allow them to become involved in choosing the method for stopping and allow them to think that it is their idea. Nagging is not productive for either of you. Point out how much your child has grown and changed in their pathway to maturation. For example, not requiring the use of diapers or a high chair anymore. Tell your child that you are proud of them for giving these things up and ask them if there is anything else they are willing to give up. If they don't suggest it themselves, recommend thumb sucking.

If your child would like to give up thumb sucking, share one of your own experiences with them of giving up a particularly difficult habit. Decide on a secret signal between the two of you and when your child subconsciously places her thumb in her mouth, use this signal to draw her attention to the fact that she is engaging in this behaviour. The aim of this technique is to remove any shame your child might be feeling surrounding their behaviour and simultaneously helps make breaking the habit fun.

Allow your dentist to explain the possible repercussions to their teeth due to vigorous sucking and gently encourage them to stop their sucking behaviour.

Explain the unhealthy aspects of putting a digit with 'germs' on it into your mouth.

Use distraction techniques that require your child to use both hands, when you notice their thumb in their mouth. For example, holding a stuffed animal in each arm or allowing them to hold the book while you read a story. This may be particularly helpful before nap or bedtime, because many children use thumb sucking as a means of falling asleep. Planning activities that occupy your child's hands, will help break the hand-to-mouth habit.

Peer pressure may be a powerful motivational tool in getting your child to stop sucking their thumb.

Avoid situations that may stimulate sucking, such as fatigue, hunger, television watching or conflict. Provide your child with appropriate, structured feeding and sleeping routines, to avoid over-tiredness and hunger. Ensure that their bedtime routine is comforting and calming. For example, read a bedtime story or give them a gentle massage. Stimulate your child by providing a variety of interesting objects to explore, in order to alleviate boredom. Create times for quality parent-child interactions to counteract stress. Most children suck unconsciously, limit TV time and place a small table with arts, crafts or toys in front of your child while she is watching.

Offer empathy, support and praise for your child's efforts (ADA, 1995-2011; Babyzone.com; Kaboose.com).