Thumb-Sucking: Do’s and Don'ts

Welcome to the Toddlers Made Easy podcast, where you learn how to become the parent every kid wants. I'm Dr. Catherine, a pediatrician with more than 32 years of experience and the mum of four amazing kids. Now, I know you're crazy busy, so let's just dive right in. I'll never forget the time I took my youngest child, who was then five years old, to her first orthodontist appointment. The orthodontist began by speaking to her, not me. I really had to bite my tongue to avoid jumping in and answering for her. When I stopped feeling defensive, I listened to my daughter's answers, and this was really a defining moment for me. I realized my daughter actually had her own life, her own perspective that wasn't just an extension of mine. So how did I have such a profound experience at the orthodontist's office? Well, when the orthodontist asked my daughter if she ever tried to stop sucking her thumb and my daughter answered yes, I was dumbfounded. It never occurred to me that Maddie had her own feelings about thumb sucking. As the orthodontist and my daughter chatted, I discovered that a few months earlier, Maddie had taped her thumb and index finger together. I actually remember the morning she came down for breakfast and her thumb was all taped up. And I remember I got a little irritated with her, and I asked her to take the tape off before she sat down for breakfast. What I didn't do was ask her, why did you tape your thumb up? And if I had, I would have discovered that Maddie was being teased at school and she was being called a baby. She genuinely wanted to stop sucking her thumb now because her thumb sucking was causing her dental problems. And that's why we were at the orthodontist's in the first place. The orthodontist gave her two choices. One, stop sucking your thumb on your own, or two, the orthodontist showed her a device she would need to wear in her mouth that would make thumb sucking almost impossible. The orthodontist had this discussion directly with Maddie. Maddie hated that device, and she chose option one, that she would stop sucking her thumb on her own. And honestly, after leaving the office that day, Maddie never sucked her thumb again. Now, this is actually a true story, but the moral of the story isn't about Maddie and how great it was. She stopped sucking her thumb so easily because it was a great story. But instead, I wanted to share this story, because when a child is motivated to stop, success is so much easier. So let's talk a little bit about thumb sucking. It's super soothing. It really feels good. In fact, when I went for my first prenatal ultrasound with Maddie, who was my fourth child, I saw her sucking her thumb in the womb. And most babies suck their thumb at some point, either in utero or in the newborn stage. Babies love thumb sucking. Dentists, maybe not so much. Babies and toddlers, they're bombarded with new experiences, and being able to soothe themselves when they need to is very comforting. It's a feel good experience. Similar to breastfeeding. Sucking releases relaxing endorphins and it's as calming as a day at the spa. So most kids will stop sucking their thumb around 2 to 4 years of age before their permanent teeth come in. That is, as long as we don't pester our kids to stop sucking their thumb. When we pressure our kids to stop sucking their thumb, well, we may inadvertently be causing more thumb sucking. Also, like my daughter, many kids stop sucking their thumb because of peer pressure. So what are the issues with thumb sucking anyways? Number one, first and most importantly, are the dental problems. And this includes buck teeth and other alignment problems. The more intensely and frequently a toddler sucks on her thumb, the greater the risks of dental issues. And by the way, this is also true for pacifier use. Next, parents can feel embarrassed when an older kid sucks her thumb or his thumb. And lastly, kids can be teased by their peers for looking like a baby. So where does that leave us? If you've taken my course, Toddlers Made Easy, you already know that you can't force a child to change their behavior or actions. For instance, you can't force them to eat broccoli, or you can't force them to go pee in the potty. You can encourage them, but you can't force them. And the same thing goes for thumb sucking. Toddlers suck their thumb when they're bored or falling asleep or upset or when watching tv. It creates that soothing, yummy feeling. So who would want to give it up anyways in the first place? Well, truthfully, unless a youngster is being bullied or made fun of, most toddlers won't want to give it up. But with time, what happens is kids develop other calming and coping skills, and they typically naturally just give up the habit. But you can give them a gentle nudge by coaching from the sidelines if it's needed. So first, let's just pause and take a deep breath for a second and consider this. Have you ever seen an adult sucking his or her thumb? I expect the answer is no. So speak with your dentist and let him or her know that your child is a thumb sucker so you can see whether there's any particular issues with your child based on an oral exam. If there's no concerns, you can hold back and do nothing initially, Especially with young toddlers before those permanent teeth come in. Thumb sucking is a normal developmental activity, and it's more likely to disappear if we just let it fizzle out on its own. The more you pester a young child to stop sucking her thumb, the more likely she'll use it even more. Unfortunately, the very things we do to stop our kids from sucking fingers and thumbs tends to increase the habit. So for kids three or four and under, you can do nothing. Don't tell them to stop. Let the habit just fade out on its own. If you're thinking, okay, did that, my kid still sucks her thumb and she or he's almost five years old, well, that's a different story. So what do we do in this situation? How can we motivate older kids to stop thumb sucking, especially once those permanent teeth are in? Well, the first thing is stay on the same team. So many of the problems we experience with our kids stems from working against them instead of together with them. Have you ever tried to break a habit, let's say nail biting or emotional eating? You probably already know how challenging this can be. Well, your toddler is going to find stopping thumb sucking equally hard. Understanding how hard this is to do will help you support your child. In practical terms, this can look like this. You could say, how can I help you stop sucking your thumb? In other words, you approach the problem together. Or you could say something like, you really love sucking on your thumb, but how can I help you stop it? The other thing is to get curious. Ask your child, have you ever tried to stop sucking your thumb? You know, from earlier in the story, I was shocked when I discovered my daughter had tied her fingers together on her own. The next thing is to have a chat and let your child know about the dental complications of thumb or finger sucking. She most likely has no idea why you want her to stop. Keep the conversation friendly. In fact, consider reading a book about thumb sucking. There's a few nice books for kids. Or make one of your own. The next step is to keep those thumbs busy. Give your child something to keep her hands busy at times when she tends to suck on her thumb. Give her a stuffed animal to hug or do artwork, or a fidget spinner or a stress ball. The idea is to focus on adding something that is soothing or distracting as opposed to taking away her well loved thumb. Here's a little pro tip. If your child is motivated to stop thumb sucking, consider using an elbow Tensor bandage, one with Velcro so there's no pins involved. This will just serve as a reminder. So if your child tries to bring her finger to her mouth, there'll be a little tension there and she'll remember, oh, I'm not supposed to do that. You can also use gloves or mittens on at bedtime, but again, only if your child wants to try this method. And lastly, remember that device I mentioned earlier on the dental device for thumb sucking? Visit your dentist and discuss whether or not this should be considered. We've talked about changing our mindset and talking to our kids and giving them the information and support they need to overcome thumb and finger sucking. But just like toilet training, your toddler has to be ready to give up the thumb. Otherwise behavioral strategies are just not going to work. So let me just tell you what else doesn't work. Using hot sauces or other nauseous or bad tasting substances applied to the thumb. They typically don't work and I haven't found nail polish works either. Punishment, humiliation or other forms of changing your child will also not help. So think about it. If thumb sucking is really soothing and we keep pestering our kids to stop, they're going to want and need that lovely calming feeling even more. Another little point from the pediatrician point of view is that thumb suckers they get calluses. They get dry wrinkly skin or moist and weepy skin from chronic sucking. Remember to use soap and water and you can apply a moisturizer if the skin is really dry and cracked. But put this on at mealtime when the child's hands are busy eating and not sucking on her thumb. Thank you for listening today. Today's takeaways are Number one, your toddler needs to be motivated to give up thumb sucking. Think child led. You can inspire motivation with a non judgmental and no shaming chat regarding the problems with thumb sucking when your child is about three years or older. Number two, don't pressure your kids to give up the thumb when they're young as it may boomerang on you. But keep in touch with your dentist so you know when thumb sucking is bothering his or her teeth. Number three, Stay on the same team and offer support. Oh sweetheart, you really find thumb sucking comforting, but it can cause your teeth to grow and crooked. How can I help you stop sucking on your thumb? And the fourth takeaway today is to please speak with your dentist so you know whether or not your child is experiencing any dental issues related to this habit. I hope you found this episode helpful. If you're struggling with any tricky toddler moments, check out our Toddler Made Easy course. We cover tantrums and whining and sibling fights and picky eating and sharing and not listening and so much more. You'll find the link in the show notes. Have a great week and remember, a tantrum is just a toddler acting his age.