Kicking the Habit

You’ve seen them doing it. At the mall. During a movie. In the backs of cars. They’re little kids with a big habit.

“I want to suck my thumb,” yells my daughter from her bedroom. She’s 4 1/2 and trying to quit, but--like the 12-step saying goes--she’s struggling one day at a time.

As any parent can tell you, some kids are just born to suck on a thumb, a finger or a pacifier. In fact, many babies start sucking their thumbs in utero, which, according to UCLA professor Mary O’Connor, is a good thing.

“Sucking is a fairly complex motor activity, so it’s important to learn the skill early on,” says O’Connor, a child psychologist and director of UCLA’s infant and preschool evaluation and brief treatment service.

Babies who learn to calm themselves with a thumb or a pacifier are often more advanced at what O’Connor calls “neurological organization”--that is, being able to calm themselves when they’re feeling anxious or tired.

However, what’s useful at 2 can mean social stigma at 5. Bigger kids who still suck their thumb or rely on a pacifier risk being labeled a baby by their playmates and enduring long looks--and occasional comments--from grown-ups. Especially stigmatizing in public are pacifiers.

(A side note for parents in the middle of the thumb versus pacifier debate: O’Connor votes for the thumb. “It’s always handy for the baby. And unlike a pacifier or a binkie, you never have to search the house looking for a thumb.”)

So what should parents do? For some kids, the sucking habit takes care of itself once the child’s permanent teeth arrive. “When the permanent teeth come in, they change the architecture of the mouth so it just doesn’t feel the same to a child trying to suck her thumb,” says Dr. Paul Reggiardo, a Huntington Beach-based pediatric dentist. “It just doesn’t have that same comfortable fit and sometimes that’s enough to break the habit.”

There are also tools. One form of assistance is bitter tasting liquid called Thum designed to be painted on the offending digit. Thum is effective as a reminder but not as a deterrent since all a determined child has to do is lick it off and pop the thumb back into her mouth.

Another gadget available through pediatric dentists is a plastic strip that goes around the thumb and snaps closed at the wrist.

However, unless the child has asked for this kind of assistance, such measures create a battle zone instead of an opportunity for kids to kick the habit on their own.

Pacifiers require the same kid-motivated self-control.

Well-meaning parents who hide their child’s pacifier may find themselves dealing with a resentful child.

“If a child wants to quit, half the battle is won,” O’Connor says. “But parents have to let the child deal with her own ambivalence. You can say, ‘We feel you’re a big girl now and at school you probably don’t want to be sucking your thumb because the other kids aren’t sucking theirs. But if you need to suck your thumb before you go to sleep at night, that’s your decision.’ Then let the child struggle with it. You have to let them do it themselves or they’ll never feel any sense of accomplishment.”

Reggiardo agrees. “If a kid wants to quit, sometimes all that’s needed is a Band-Aid placed around the thumb just as a reminder. Breaking the habit has to come from inside the child.”

Other useful reminders include a piece of tape around the thumb or even letting the child wear a mitten or baseball glove to bed. “If the child consents, you can also put an Ace bandage around the elbow so she can’t get her thumb up to her mouth,” says Dr. Chris Thanos, a Torrance-based pediatric dentist, quickly adding, “but parents shouldn’t do these things unless the child asks for this kind of help.

“Parents also shouldn’t expect results overnight,” Thanos says. “Helping a kid break the habit shouldn’t feel like punishment to the child. Having a good overbite isn’t worth having a traumatized child.”

Although strong, nonstop thumb or pacifier sucking can cause tongue thrust, overbite and other jaw and teeth problems later on (even though some kids still have these problems without ever having sucked their thumb), Reggiardo says parents sometimes run the risk of addressing the habit too early. “My own feeling is that if a child is 6 years old and the permanent teeth are in, it is probably an appropriate time to see if the child is ready to stop.”

O’Connor adds, “If thumb sucking doesn’t seem to interfere with learning and social experiences, we tend not to worry about it.

“If it starts setting a child apart because friends are calling the child a baby or interfering with development because she’s too busy sucking to play or if the habit has grown into a power struggle within the family and really represents something else, that’s when we tend to work with the habit behaviorally,” she says.

Both O’Connor and Reggiardo advise parents to ask themselves why breaking the habit is important to them. “Parents need to ask themselves whether they’ve encouraged

the behavior because they don’t care [whether the child sucks her thumb] or if they’ve encouraged it by giving it so much attention that the child uses thumb sucking as a way to draw a battle line in the home,” O’Connor says.

As for my daughter, she’s been largely thumb-free for eight weeks. Her advice for thumb suckers? “Put an apple in your mouth so your thumb can’t go in.”