Thumb Sucking Q & A

My baby sucks their thumb, should I be worried? Will they do this forever?

It's totally normal and safe for your child to suck their thumb! In the early infancy days, any way your baby can soothe themself is desirable. It is important for babies and children to develop self-soothing skills that don’t rely on a caregiver. I typically encourage parents to offer a variety of pacifiers to their infant before giving up or throwing in the towel on pacifier success. Sometimes it takes a little bit of work to find the right fit, and deal with those early days of the pacifier popping out. Sucking pacifiers/ thumb is shown to decrease the risk of SIDS, and sucking is an age appropriate self soothing tool. My main reason for pushing the pacifier over the thumb is that it is easier to extinguish when the time comes.

As your child is growing, putting objects and fingers in their mouth is a natural way to explore, integrate, and understand their world. Additionally, some children use thumb sucking as a comfort source, just as some may use stuffed animals or a blanket.

According to the American Dental Association, children often stop this behavior on their own between the ages of two and four. They may increase or return to this behavior when stressed, anxious, or to self-soothe when going to bed.

My baby sucks their middle and ring fingers instead of their thumb. Is this normal?

Yes! Many children suck other fingers, or a combination of fingers. It often ends up being whatever fingers they find comfortable early on and can become a habit from a very young age!

Why does my baby suck on their thumb?

Thumb sucking can be beneficial to development and calming! All babies are born with the “sucking” reflex; a natural biological instinct to suck. This reflex is vital, as it gives rise to later behaviors such as breast and bottle feeding, essential skills for a healthy baby. It is suggested that sucking should therefore be encouraged as it is a reflexive method for an infant to calm down and gain control when they are upset. Sucking is an effective way to soothe an infant through key developmental challenges such as separation from a parent.

Does thumb sucking cause any problems?

Will they have to get braces? Will it cause speech issues?

Thumb sucking is not a major cause for concern unless it exists when adult teeth are preparing to emerge. There are a few factors which contribute to how much of an impact thumb sucking can have on dentition / speech and language.

These are:

• Frequency
  • How often is the child thumb sucking?
    • Only in the crib? All day long?
• Duration
  • While falling asleep? Or sucking hard throughout sleep cycles?
• Pressure
  • How much pressure is exerted against the teeth and bones?

Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

For most children, the use of a pacifier and/or thumb sucking occurs during the early years and is a relatively short-term practice. When of short duration, they typically do not have a significant effect on the development of the oral musculature, dentition, or on speech development and production. However; more intense thumb sucking over many years may result in a myofunctional condition.

This can cause a frontal tongue posture. This pattern could result in a frontal lisp (thip for ship) or a tongue thrust. A persistent tongue thrust swallow pattern beyond age 9 can impact dentition and alignment of teeth. An orthodontist is able to treat tongue thrust with a device in the mouth, or may refer to a myofunctional therapist or SLP with experience in helping children to decrease use of tongue thrust.

It is important to note that not all children with frontal tongue positioning end up with speech production issues. Studies show that there is not an strong correlation. It is important to consult with a pediatric dentist or SLP to find out the impact your child’s thumb sucking is having on their development.

Are there any pros to my baby sucking their thumb?

Having an excellent self regulation and self soothing skill is a major pro of thumb sucking! Your child can also always access their thumb, rather than needing assistance to put a pacifier in at a young age.

When should I encourage my child to stop sucking their thumb?

Are there specific developmental windows or ages in which it will be easier to help them stop?

We definitely want to be sure this habit is eliminated well before adult teeth to begin to emerge. Experts in the field agree that by 4 years of age children should stop sucking their thumb or a pacifier. As far as a best time, this will depend on the child. A child’s sensory processing abilities, coping skills, and level of understanding are not one size fits all. I personally have children that are very shy / anxious in social situations, and we have held onto the pacifiers longer than I would have imagined we would. It’s important to assess your own child’s needs, and discuss with their dentist.

How can I help my child stop sucking their thumb?

This is unfortunately not a simple answer! I'm afraid it can be a very tough habit to break sometimes, and there may be a lot of trial and error to see what works. Some of these strategies may help though:

• In simple terms, explain to the child why it's important to stop.
  • Kids can understand a lot more than we know.
    • The book “Thumbs Up Brown Bear” by Michael Dahl is a cute conversation starter.
• Thumb guards are a possibility and come in a variety of different options.
• There are also many different bad-tasting polishes on the market that can act as a deterrent to sucking one's thumb.
• For younger children, redirecting the behavior towards a safer oral fidget may help.
• Replacement self soothing options:
  • fidget toys, poppers, special lovies or stuffies.
• As a last resort, dentists can also put in a built-in device in the roof of the mouth (something they can discuss while at the dentist). Some people may see this (and the nail polish) as cruel, but I doubt the same people have personally been in this situation as a parent who has tried everything else!
• Pam Marshalla's book How to Stop Thumbsucking can offer further guidance.

In my experience, some children only suck their thumb while holding their favorite special stuffed animal or blanket. It would be traumatic to eliminate a preferred soothing item, but it can help to temporarily limit use of this object while trying to extinguish the thumb sucking. I have encouraged families to leave the object on the dresser at bedtime or somewhere the child can see it during this time. The child will understand that he/she can have it when they no longer suck their thumb.

Sources:

• Kathleen Fahey, Ph.D., CCC-SLP
• American Dental Association
• Pam Marshalls Pam Marshalla, MA, CCC-SLP
• ARK Therapeutic