We were all thumbs, or, what to do about thumbsucking

Q. My baby used to love her pacifier, but now she’s found her thumb and there’s no looking back. Should I worry about the problems we’ll have breaking her of this habit in the future?

You’ve certainly asked the right person - I had a thumb-sucker myself. (Notice the emphasis on “had.”)

Sucking is one of the most common ways babies and toddlers comfort and settle themselves. Many – like my daughter, Olivia, for instance – start in the womb. According to Cary lactation consultant Cindi Freeman, “Sucking is a normal and necessary biological activity for young children that can last well beyond their weaning from the breast and bottle.”  And sucking on a thumb has several advantages over a pacifier. For one, thumbs are always handy and are under the child’s own control. There’s no crawling around on the floor in the dark looking for a lost paci, no need for constant re-plugging during the night, and no concern about increased ear infections. (According to a study in Pediatrics, pacifiers may cause 40% more ear infections, or acute otitis media.)

There’s something so sweet and endearing about seeing a baby drifting of to sleep with thumb in mouth. But when they get to be preschoolers, it’s not so cute. Knowing a surplus of germs was going straight into my daughter’s mouth several times daily was, well, hard to swallow. When she turned four we decided to take action.

We consulted her older brother’s orthodontist in Raleigh, Dr. Herbert Land, who, it turned out, was quite accomplished at helping to end thumb sucking. “We love thumb-suckers,” said Allison Williams, who formerly worked as Dr. Land’s new patient coordinator. “We recommend that children stop sucking their thumbs between the ages of 4 and 6 years old, but they must stop before permanent teeth erupt.”

Thumb sucking after permanent teeth erupt may result in protruding front teeth, an irregular bite or cross-bite, warping of the jaw, facial asymmetry, speech problems and mouth breathing, Williams said.

Together, Olivia and Dr. Land came up with a star chart and plan of attack that included wearing socks on her hands at night. Like many children, Olivia’s weakness was when she was sleepy. Hence, the socks.

Let me say for the record, I wish I had my daughter’s willpower. She was done with the thumb within days. She proudly marched into Dr. Land’s office when her chart as filled and got the reward she earned.

We tend to hear the horror stories about thumb-suckers who continue the habit well into their teen years or beyond. And though it’s true that you can’t take away a thumb the way you can a pacifier, many children stop on their own once they find new ways to calm and comfort themselves.

If your child is still happily sucking away around four or so years of age and you want to help eliminate the habit, keep in mind that nagging and punishing won’t help. Instead, consider modifying the behavior with the guidance of a respected orthodontist or pediatric dentist who’s been successful helping children give up thumb sucking. As with any behavior modification program, the key to success is consistency.