Thumb-Sucking

Treatment Overview

Most children stop sucking their thumbs on their own sometime between ages 3 and 6. They usually do not need treatment.

Children who suck their thumbs may need treatment when they:

• Also pull their hair, especially when they are between 12 months and 24 months of age.
• Continue to suck a thumb often or with great intensity after the age of 4 or 5.
• Ask for help to stop the behavior.
• Develop dental or speech problems as a result of the behavior.
• Feel embarrassed or are ridiculed by other people because of the behavior.

Treatment to stop thumb-sucking works best if the child is involved in the process and wants to quit. Preferred treatments vary among experts. Some believe that any treatment that does not have the child's cooperation is not likely to work and may even make the habit last longer. Others believe that it is sometimes necessary to try to stop thumb-sucking even when the child objects. For more information, see:

Thumb-sucking: Helping your child stop.

It is important to delay treatment for thumb-sucking if a child is facing a stressful time, such as after an injury, loss of a pet, moving, or when the family is having difficulties.

Some parents of thumb-sucking children are unable or unwilling to ignore the behavior even in a child younger than 4. In this case, parents may choose to talk to a health professional about their concerns, rather than focus on treating the thumb-sucking.

Caregivers disagree about whether it is best for infants to suck their thumbs or use pacifiers. One advantage is being able to control when your child uses the pacifier. However, pacifiers may be linked to an increase in ear infections in some children. Prolonged thumb-sucking may cause serious dental problems, although most children stop on their own before entering school. This is largely an issue of preference.

Problem thumb-sucking is most often resolved with home treatment such as offering rewards and praise when the child is not thumb-sucking. When home treatments have not worked, other treatments may be necessary. These include:

• Behavioral therapy. Behavioral therapy helps a child avoid thumb-sucking through various techniques, such as substituting tapping fingers together quietly. Behavioral therapy works best if all people involved in the child's care follow the treatment plan.
• Thumb devices. Thumb devices, such as a thumb post, can be used for children with severe thumb-sucking problems. A thumb device is usually made of nontoxic plastic and is worn over the child's thumb. It is held in place with straps that go around the wrist. A thumb device prevents a child from being able to suck his or her thumb and is worn all day. It is removed after the child has gone 24 hours without trying to suck a thumb. The device is put back if the child starts to suck his or her thumb again. Thumb devices need to be fitted by a health professional.
• Oral devices. Oral devices (such as a palatal arch or crib that fits into the roof of the mouth) interfere with the pleasure a child gets from thumb-sucking. It may take several months for the child to stop sucking the thumb (or fingers) when these devices are used. Once the child stops sucking, parents may choose to continue using the device for several months. This may prevent the child from starting the habit again. Oral devices need to be fitted by a dentist.

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Author:	Amy Fackler, MA Debby Golonka, MPH	Last Updated: October 2, 2006
Medical Review:	Michael J. Sexton, MD - Pediatrics Tom Bailey, MD - Family Medicine
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