Before we go into the 'nuts and bolts' of thumb and finger sucking, it is important for parents to know there is no need to panic if your child has this habit.
There will come a time when it is important for your child to stop doing it. To support them through this process, it is important to understand why children suck their fingers and thumbs at different stages of their development, and what it indicates about their state of being. This helps differentiate when it is good for them to do it, and when it becomes a problem. The more steady, observant and understanding you are, the greater the support you offer your child.
The first years of thumb and finger sucking.
It is innate and absolutely natural for children to suck on their thumb or fingers, from the time they are newborn babies until they reach the ages of two or three. In fact it is such an innate activity for children that it is not unusual to see the thumb or finger in a babies mouth on their ultrasound images, as shown below.
From birth through to the age of 2, it is not just fingers and thumbs that get sucked on and chewed. Everything that can go into the babies mouth does, including their own feet, clothing, soil, furniture, toys, pot plants and things we would rather not think about. This is a natural and important developmental stage and should never be discouraged.
Thumb and finger sucking have a profoundly calming effect on children and it can be a very effective way for them to learn to independently settle themselves down.
The child's heart rate and breathing rate are positively affected by this activity, and the sucking process regulates the movement of muscles of the digestive system (peristalsis) supporting digestion and elimination.
As children approach the age of three, you often see the habit naturally reducing and being replaced as the child engages more with world and develops other methods of settling themselves.
Actions to be taken
None. Simply observe your child and become familiar with the ways and times they settle themselves. Pay attention to the things around them and occurrences that create the need for them to self-soothe. You will learn a lot about the little human being you are raising with these simple observations.
As their parent, allow your child to suck their thumb at this is stage. Do not make the assumption that it is a problem or that it will become a problem.
Ages 2 to 5
For many children between the ages 2 and 5, the tendency naturally falls away until thumb sucking disappears.
If this is not the case for your child and they are showing no signs of letting it go pay attention to whether the thumb and finger sucking are:
Are happening constantly throughout the day, and not just a tool that the child uses occasionally to relax themselves,
Preventing the child from developing other methods of settling themselves, such as play or cuddling a toy,
Happening so often that they are preventing the child from develop their babbling and speaking patterns,
Are distorting the shape of the child's jaw and teeth, or have created an opening between the teeth that allows the tongue to sit forward,
And secondary to the previous point, making the child develop a lisp.
Understanding why and how often your child has the habit are the keys to what needs to be done.
Actions to be taken
If you know your child is using thumb sucking less and less of their own accord, nothing need be done. Let them take their time, no one else's (especially well meaning relatives and friends with opinions).
If however your 4 year old is thumb sucking at the same frequency as when they were 2, if they are not developing other ways to calm themselves, if they are not talking because they do not want to let go of their thumb, or if there is distortion of the shape of their jaw, then a considered response from you is required.
If you have not already done so, now is the time to hone your observation skills. Pay attention to your child as a whole and complete being . . . and do not just focus on the behaviour that you want to stop.
As carefully and as unemotionally as possible, observe your child and how they are handling themselves in life. Is it possible that they are experiencing anxiety, fear and tension? Do not impose a diagnosis on them, just be as open and honest as possible. As much as we do not want to believe it, our children are exquisitely sensitive to everything around them and they do experience anxiety, even at this young age. This is the most important step because this is the key to discovering what is driving the habit.
This is an opportunity for you to talk to your child about how they are feeling, to ask what is bothering them and most importantly, listen to their responses. Give them time to open up to you, especially if these conversations are new for the child.
Watch your child's movements when they are sucking their thumb or fingers. Are they even aware that they are doing it? Or has the movement become unconsciously ingrained into their body?
Again, this is an opportunity to talk to your child and support them to build their self-awareness. Ask questions about how they are feeling when they do the movement, rather than deliver instructions.
Frustrated, punishment based approaches do not work - ever. Neither do guilt and embarrassment based tactics. If your child is thumb sucking as a way of managing their anxiety, then punishment, guilt and embarrassment only feed the cause and give more energy to the habit.
Nagging does not work. It does not support true and lasting change for anyone at any time in their life. All it does is place intense focus on the problem and overlooks the whole being of the child. This takes self discipline for mum and dad especially as their child gets older and worry about the cost of potential orthodontic treatment kicks in.
Noxious tasting solutions, painted on the thumbs and fingers completely fails to address the root cause of thumb sucking. This is a purely symptomatic approach, therefore sure to fail the child (even if it kills off the habit). A child who is seeking to comfort themselves will often put up with the foul taste because the need for comfort is often greater than the awful flavour. The important question is, why do they need comforting?
Rewards can work, for example a certain number of 'thumb-free' days might result in a gift. But do not use this as a way of avoiding exploration of the deeper issues. Anxiety cannot be rewarded away.
Talk to your dentist if you are concerned about the impacts of thumb and finger sucking on the shape of your child's jaw and the position of their teeth.
Also talk to your GP or paediatrician about your child's habit - they are a great resource.
And consult with a behavioural therapist if you feel your child needs emotional support.
Focus on the most important thing: your child and their overall wellbeing.
Ages 5 and older
If your child is still sucking their thumb or fingers at this age it is likely that this has developed into a very entrenched pattern. There is still no reason to panic. By the time they get to school they will be far more willing to give it up due to the nature of the peer pressure they will experience. Peer pressure can be utterly demoralising and feed any anxiety the child already experiences. So now, more than ever, you child needs to know that you are their ally in tackling the habit.
At this age, you and your child can communicate more clearly. Ask them how you can support them to draw out what they need. They often have far greater understanding and wisdom than we give them credit for.
From a dental perspective, persistent thumb sucking until this age is very likely to result in changes to the child's bite, causing a gap to develop between the front teeth.
Even though orthodontic correction is likely to be needed, you would perhaps be amazed to know that even at this age, the mouth will start to self-correct to some degree if the habit can be gently and sustainably removed.
To do this your child needs your support, just as we all need support when we have a habit we really want to (or need to) give up.
Call on all of the professional resources you need, for example dentists, doctors and behavioural specialists.
And always ensure that the child knows you are on their side.
