What is thumb- or finger-sucking?

Thumb-sucking is normal in babies and young children. They have a natural urge to suck that starts in their first few months of life or even before birth. Babies may also suck on their fingers or hands, or items such as pacifiers.

Many babies suck their thumbs to soothe themselves. Thumb-sucking can become a habit when it's used for comfort. They may comfort themselves when they feel hungry, afraid, restless, or sleepy.

Most children who suck their thumbs stop on their own between ages 3 and 6 years old. Long-term thumb-sucking (after age 4 or 5) may cause dental problems. It can make a child's teeth uneven or push the teeth outward and can affect the roof of the mouth. Thumb-sucking also may cause speech problems, including lisping and thrusting out the tongue when talking.

Babies have a natural urge to suck. They may suck on their thumb, other fingers, or hands.

Thumb-sucking usually doesn't need treatment before preschool age. If home treatment after age 4 doesn't help, talk to your child's doctor about trying behavioral therapy, thumb devices, or devices for the mouth. These things can help if your child's sucking causes a callus on their thumb or if they ask for help to stop.

Home treatment to help a child stop sucking their thumb usually is not tried until age 4. Even then, most doctors recommend treatment only if the thumb-sucking is frequent or intense. Below are some steps you can take when your child is around age 4, and some stronger measures for when your child can take a more active role in quitting.

Early steps

• Give your child activities they can do with their hands to distract them.
• Put away items such as blankets that your child associates with thumb-sucking. At first, put the items away for short periods of time throughout the day. As your child learns other ways of self-comfort, gradually increase the amount of time these items are not available.

Later steps

• Calmly talk to your child about the harmful effects of thumb-sucking.
• Put gloves on your child's hands or wrap the thumb with an adhesive bandage or a cloth. Explain that the glove, bandage, or cloth is not a punishment but is only there as a reminder to not thumb-suck.
• Use a reward system, such as putting stickers on a calendar to record each day that your child does not suck their thumb. After an agreed-upon number of days, celebrate your child's success.
• Ask your doctor about using a nontoxic, bitter-tasting nail coating that makes your child's thumb taste bad. Follow the instructions carefully. This treatment is most successful when it is combined with a reward system.

Things to remember

• Do not remove the thumb from the child's mouth while they are awake. You can remove it after the child is asleep.
• Stay neutral and calm when talking about your child's thumb-sucking habit. Do not punish or shame your child for thumb-sucking.
• Do not allow other people to make fun of your child.

Thumb-sucking is normal in babies and young children. Most babies and toddlers suck their thumbs. They may also suck on their fingers, hands, or items such as pacifiers. Most children stop thumb-sucking on their own between ages 3 and 6 years.

Some children have a more difficult time than others giving up thumb-sucking. It is important to use positive reinforcement during this process.

If your child is insecure, has any emotional problems, or is under stress and needs comforting, you may need to resolve those issues first before your child will succeed at stopping thumb-sucking.

If your child continues thumb-sucking, you may want to speak to a pediatrician or dentist to learn about devices (such as a thumb guard) that can be tried to prevent thumb-sucking.

Many parents of a thumb-sucking infant question whether they should substitute a pacifier for the thumb. So far, research does not show that one is preferable over the other. Also, although parents can encourage a child to suck a pacifier rather than a thumb, they can't control which the child will prefer.

The advantages and disadvantages of pacifier use and thumb-sucking aren't always entirely clear. So there are some general issues for parents to think about.

The advantages of using a pacifier include being able to control when your child is allowed to use it and being able to take the pacifier away when it is no longer appropriate. A pacifier at naps and at bedtime may reduce the risk of sudden infant death syndrome (SIDS). But a young child who uses a pacifier may be more likely to get ear infections.

An advantage of thumb-sucking is that it may not interfere with breastfeeding. And children usually stop on their own between the ages of 3 to 6. But if thumb-sucking is a habit past age 4, the child may develop dental problems. Also, it may be more difficult for a child to stop thumb-sucking than using a pacifier.

Talk to your doctor about how long you should wait before you introduce a pacifier to a breastfeeding infant.

Keep in mind that there is no reason to encourage thumb-sucking or pacifier use in infants who do not show a need. The sucking instinct in these infants is satisfied through breast- or bottle-feeding.