Saturday, 28 November 2009

Thumb sucking

Thumb sucking is very common in babies and young children – in fact, it’s thought that around 70 to 90 percent of babies suck their thumbs. Most of them outgrow the habit by around three to five years of age, but some persist in it (around 15 percent of four year olds still suck their thumb).

Young babies suck their thumbs (and often their fingers too) because sucking is a natural instinct and one of your newborn’s first reflexes. Ultrasound scans show babies sucking their thumbs in the uterus! As your baby grows, mouthing objects is how he learns about them – and his thumb and fingers will constantly find their way to his mouth, Plus, it comforts him, providing him with a sense of security if he feels afraid or is restless or bored, and often helping him settle down into sleep.

When it can cause problems
Thumb sucking can be come an issue if your child still does it once his permanent teeth start to come in, which can happen any time from the age of four onwards. The American Dental Association advises that a child can probably suck his thumb until he is four or five years old without damaging his teeth or jaw line but after this, having a hard thumb in his mouth can cause the permanent teeth to be misaligned and grow outwards, and also can interfere with the proper growth of his mouth and the shape of his palate (roof of the mouth) as he gets older.

While it isn’t such an issue with children who just place their thumb in their mouth, those who suck it vigorously are more likely to have problems and may also find it more difficult to discontinue the habit. The longer your child sucks his thumb the more likely he will be to need orthodontic treatment when he’s older.

Thumb sucking also can interfere with speech development if your child is sucking his thumb instead of chattering, and may result in him lisping and mispronouncing certain letters if the shape of his upper palate is affected.

Breaking the habit
As a rule, thumb sucking up to the age of four is normal and should be ignored, especially if your child uses it as a comfort habit when he’s stressed, unwell or tired.

After this age, and also if he appears to be doing it not for comfort but because he’s bored, distraction is the best way to break the habit, so make sure he has plenty to do – craft projects, puzzles and games that keep his hands busy are particularly effective. Praise your child when he doesn’t suck his thumb, rather than scolding him when he does (and don’t ever forcibly remove his thumb from his mouth), and have a reward chart with gold stars he can put on it for every hour and more he goes without sucking his thumb.

If you notice that he does it when nervous or anxious, try to avoid situations that might cause him worry and distress. If he tends to do it while holding his lovey or comfort blanket, or when watching TV, try to break the association by taking way the item or switching off the TV. Nighttime thumb sucking can be hardest to break, but placing a tube sock on his hand may help. It also can help to put a band aid on the thumb he sucks (if this seems to be working, replace it frequently to ensure it’s clean.

With an older child, try using a bitter-tasting non-toxic coating you can paint on to put him off (your pediatrician or pharmacist can recommend one) – but keep an eye on your child to make sure he doesn’t just switch to using the other thumb! An older child is also at an age where he should be able to understand how he might be affecting his teeth by sucking his thumb, so show him how they might be growing outwards and also get your dentist to explain how it can affect his teeth.

If you notice your newborn or young baby is sucking his thumb, consider offering him a pacifier. It is an easier habit to break in the toddler years because you can just take it away, whereas you can’t remove your child’s thumb!

When to seek advice
In some cases, thumb sucking after age five may red flag an emotional problem or anxiety disorder. If your child gets particularly upset when you try to stop him sucking his thumb, displays other nervous behaviors such as hair pulling, or has speech problems because of it, ask your pediatrician for referral to a specialist. You should also seek advice if your child is attending preschool or kindergarten and his teacher reports that he is sucking his thumb in class. Consult your dentist if your child’s permanent teeth are growing in crooked because of the habit.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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