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Sunday, February 15, 2009

Thumbsucking and Pacifier Use - When to Call It Quits:

With close to 90% of children either sucking their thumb or using a pacifier, it is almost a child's rite of passage to engage in one of these behaviors. Most children outgrow these habits on their own without any parental intervention at all. By 4 years of age, only 12% of children are still sucking their thumbs and even fewer, a mere 4%, are using a pacifier.

Despite the fact that all children will eventually give up sucking their thumb or using a binkie, there is a fear that a child will do permanent damage to his mouth and teeth by continuing this habit past infancy. But at what age do you truly have to worry about the consequences of thumbsucking and binkie use?
According to the American Dental Association (ADA), children should stop non-nutritive sucking prior to the eruption of their permanent teeth. They state that most children discontinue thumbsucking and pacifier use between 2 and 4 years of age. The ADA also points out that how aggressively a child sucks will have more of an impact on whether dental damage occurs, than how long a child continues these behaviors. For this reason, if a child is passively putting his fingers in his mouth at a time of stress but not aggressively sucking, he will probably do very little damage to his mouth.

Most children will begin to discontinue these behaviors on their own due to social peer pressure when they start to have regular interaction with other children. The American Academy of Pediatrics (AAP) does not suggest intervening with these behaviors until at least 4 years of age. But that does not mean that you cannot encourage alternative self-soothing behaviors at an earlier age.

Understanding why children continue with these habits will allow you to better work with your child to develop other coping methods to replace their thumb or binkie. Sucking is a natural infant reflex. Babies are often seen sucking their thumb or fingers inutero. For some children, the sucking reflex becomes a habit when they repeatedly use sucking to soothe themselves in times of stress or boredom.

For older children, simply being aware of when they engage in this habit can go a long way in helping to break it. When a situation arises in which your child would normally turn to his thumb or binkie, even just acknowledging to him that you know he is scared or feeling shy can help to relieve some of his stress. You can assist your child by helping him find alternative methods to self-soothe or relieve boredom. By prompting him to use these methods, you will help him to learn adult ways to cope with these situations.

It is often easier to discontinue pacifier use than thumbsucking. Making a small whole in the tip will deflate the binkie. Since a deflated binkie no longer gives the same sensation when sucked, it quickly looses allure.

For thumb sucking, placing a glove over the hand can help especially if your child tends to suck his thumb through the night. There are also over-the-counter, bitter tasting substances that can be applied to the nail to deter sucking. Before using either of these methods, it should be explained to the child that he is not being punished but rather that you are working together to break the habit. Lastly there are appliances that can be placed in the child's mouth that can make thumbsucking uncomfortable and may be necessary if structural changes are occurring.

Discuss with your pediatrician or dentist if you notice any changes to your child's teeth or to the roof of his mouth. But keep in mind these changes are rare and most children will break the habit on their own when they are ready. It is important to remember to be patient. As with any habit -- breaking it takes time.