Oral Habits – Thumb and finger sucking
It is always hard to write something that is research-based to provide parents with information without scaring everyone. This is intended to provide information on when a habit is considered normal, when it is considered problematic and possible reasons for prolonged sucking behaviours and the potential impacts of this.
Non-nutritive sucking is sucking that is not related to feeding and nutrition. Almost all babies will engage in non-nutritive sucking; they may suck thumbs, fingers, hands, dummies/pacifiers, or other objects such as a comforter. This is expected behaviour. Most children will grow out of this by the age of 2-4, and before this age, we consider this to be normal behaviour. As we know, most children will grow out of the habit. It is recommended not to try to change the habit before this time – often, a wait-and-see-no-pressure approach is the path of least resistance for you and your child.
Why the concern?
Prolonged sucking or oral habits can cause dental issues in dental, jaw and facial development. Consistent pressure on the teeth or palate can cause dental problems such as open bites, overjet and craniofacial abnormalities. The duration and intensity of the sucking will be a factor in if these problems occur.
There is evidence that children who suck their thumbs beyond 3-4 years old are at increased risk of having an impact on speech development.
Prolonged sucking can damage skin integrity on the thumb or digits and increase the risk of infections in some cases.
Possible causes for prolonged oral habits
Understanding the reason for the oral habit will make planning for change easier and the process more efficient.
- Just a plain habit
- Anxiety
- Emotional / Psychological
- Airway obstruction
- Oral dysfunction
How can you help your child?
What not to do
Firstly, there is to be no shame or pressure put on them. Avoid comments like “you are a big boy/girl now”, highlighting the sucking in a public way or constantly telling them to stop. As adults, we must guide our children, not put unintended pressure on them to stop. This can drive the habit and make cessation harder.
We do not suggest using mouth guards, sour-tasting nail polishes, taping gloves or mittens and covering your child’s hands. Some aids in conjunction with a cessation programme are helpful, but not without planning and finding the root cause of the habit.
What can we do?
Observe your child and start to get an idea of times they are more likely to be engaging in these habits. For example, watching TV, in the car, or bed. Identify any other patterns that may go alongside the sucking – hair twirling or pulling, always with a comforter or blanket. Once you have identified things that can be a trigger, try to explore ways to minimise the triggers. Examples:
- When watching TV, try to keep their hands busy with something else – holding your hand, fidget toys, things to squeeze, tactile objects
- Tie hair back
- Keep use of cuddlies and comforters to bedtime only versus access to them all-day
- Comforters do not need to go by a particular age, little ones will drop them when ready unless sucking on them is becoming an issue.
- Car rides try to provide distraction with toys or something to keep hands busy
- Offer oral play toys, chewy foods, cold, crunchy foods and different textures
- If they use the sucking habit to soothe and comfort, then experiment with helping them to regulate in other ways – helping to name and identify emotions and co regulation for example.
- Ensuring you have the time and space to connect with your little ones during this change and the space to commit to helping your little ones especially when it comes to emotional regulation. Helping them through things is so important and whilst it’s easy to encourage the thumb or dummy it’s important they see and learn healthy regulation.
Oral play benefits
If your child is seeking oral stimulation, you can help by providing them with foods they can suck, different textures, chewing and teething toys. The aim of this is to fulfil any oral sensory seeking and try to reduce habits.
Examples:
- Freeze sticks of ice for crunching on
- Silicone straws for chewing
- Food cut into sticks like carrots and cucumbers frozen
- Crunchy foods that require lots of chewing
- Chewy tubes
- Chewlery
These examples try to minimise the habit and help prepare for stopping. Your child will likely suck their thumb or fingers to soothe to sleep, and until age appropriate and you have a plan in place, try not to put too much pressure on stopping for sleeping. Aim to add other sleep associations, such as a solid bedtime routine and good sleep foundations, as this will assist when aiming to stop the habit.
Age will play a significant factor in successfully stopping these habits. Trying to stop while this is still age-appropriate may cause increased stress to parents and children. Once your child is old enough to be a part of the plan and participate, this will improve the chances of successful cessation. Addressing any potential underlying issues and engaging the help of a professional and a Thumb Sucking Cessation Programme will help you as the parent feel like you are working with your child toward a common goal.
Where to seek help?
If you are concerned your child is sucking beyond what is considered age-appropriate, these professionals will be able to help.
Orofacial Myofunctional Therapist
GP and referral to an Ear, Nose and Throat Specialist (ENT)
Paediatric Speech Pathologist
Paediatric Occupational Therapist
Thumb-sucking Cessation professional or programme
I hope this helps to put your mind at ease if your child is sucking their thumb at three years old and provides you with some ideas on how to help reduce habit and direction if and when your family needs help with stopping the habit.
Nic TGSS xx
