THUMBSUCKING

Thumb sucking grows out of a deeply satisfying activity that all children engage in, nursing. Children nurse not only to get fed but for the feelings that are associated with nursing: being cared for and loved. When a child sucks their thumb it may very well recreate that deep feeling of contentment associated with nursing. Sometimes a pacifier can be substituted for a thumb, but often it does not satisfy the child in the same way a thumb does. If a pacifier is chosen, parents will need to keep extras around, as they often get lost. Pacifiers should not be substituted for parental attention when the child is distressed or upset.

Children who are going to suck their thumb usually start before they are weaned. It may also emerge when the child is under stress that might be due to illness, change in routine, a new caretaker, or when they are teething. Most children will give up thumb sucking when they are 3 to 3 1/2 years old. It may reemerge when the child is tired or upset.

Some children will persist beyond four years of age. Frequent and vigorous sucking at this age is not good for developing teeth. If the child is persisting in sucking it may be because it is a "habit" or because they feel a need to recreate the contentment and feelings associated with nursing. Children will also suck their thumb if they are bored or unhappy.

If your child persists in thumb sucking beyond age four years it will be helpful to examine why before any steps are taken. Is your child lacking in attention or interesting activities during the day? Or is it just a habit that feels good and your child has just not demonstrated an inclination to give up something that feels good? If your child is experiencing a lack of attention then the obvious step is to increase daily activity with your child. Twenty to thirty minutes of free play daily is enough for most children. Get down on the floor with your child and allow them to direct you in activities of their choice. Give you child freedom of expression in this activity. Limit rules to addressing destructive and aggressive behavior only.

If your child has developed a habit, using positive consequences to change their habit of thumb sucking will be more effective than negative consequences or punishment. Observe your child and determine when they suck their thumb most often. Explain to them that they can earn tickets or tokens for not sucking their thumb during this time. Give them a ticket or token every 2-3 minutes if they have not sucked their thumb during that period. If they have put their thumb in their mouth during the previous 2-3 minutes remind them that you are unable to give them a token and continue observing for the next 2-3 minutes.

Here is an example of how this would work. Joel sucked his thumb frequently during the day. However, he sucked his thumb most often while watching cartoons in the morning. His father decided to observe him for 30 minutes each morning. Joel's father gave Joel a token every 2 minutes, if Joel had not sucked his thumb. At the end of their first session Joel had earned 10 tickets. His father let him trade the tickets for a sticker. Every day Joel would trade in his tickets for a special treat, if he had at least 10. At the end of two weeks Joel was only sucking his thumb prior to falling asleep. Two weeks after that he had stopped completely.

If your child persists in sucking their thumb after you try to eliminate it using the above suggestions, it may be helpful to consult with a pediatric or behavioral psychologist.