Ask: When to worry about thumb-sucking?

Posted by Brian Eichner on January 29, 2013 

Dr. Brian Eichner offers tips on when to worry about thumb-sucking and how to encourage your toddler to kick the habit.

Q: My daughter is 3 years old and still sucks her thumb. Is this normal? At what point do I need to worry? What can I do to stop this?

A: Thumb-sucking is a habit that is very common and leads to a lot of angst among parents (perhaps partially because many parents do not realize how common it is and are unduly embarrassed!). In fact, 80 percent of infants and young toddlers utilize thumb-sucking as a means of self-soothing. One in three preschool children and one out of five school-aged children still suck their thumbs, so you are not alone.

As with most behaviors, thumb-sucking is not a big deal until it interferes with other aspects of your child’s life. For instance, it is rarely a problem that needs medical intervention before the age of four; after 4 years old, there is a risk of dental malocclusion, overbite, TMJ problems and, rarely, impaired facial growth. Another reason that it can become problematic is the risk of accidental poisoning – as your child comes in contact with toxic substances, she may ingest toxins if her fingers are going into her mouth. Socially, it becomes a problem when it leads to impaired interactions with either peers or family members.

As is generally the case with concerning early childhood behaviors, the best way to extinguish the habit is to not make a big deal about it. Rather than chastise your daughter while she sucks her thumb, reward her when you notice that she is not sucking her thumb. Some children suck their thumbs out of boredom, so try to find other things to occupy her hands, such as a favorite toy or stuffed animal. Because many children suck their thumb as a way to soothe or calm themselves when upset, teasing or belittling them when they do it can actually make things worse.

In some cases, it is quite difficult to get children to stop sucking their thumbs. For these children, if it’s becoming a dental or social issue, other interventions may be needed. These include putting bitter substances on the thumb, splinting the thumb (as a reminder, not a punishment), and, occasionally, oral appliances from a pediatric dentist.

Long story short, this behavior is common, is still normal for another year and likely will go away on its own, so try not to make a big deal about it. If it becomes a problem, utilize some of the tips above or ask your pediatrician. Good luck!

If you have a question about your child's health or happiness, ask Dr. Eichner or any of our experts by sending email to mom2mom@newsobserver.com.


Brian Eichner is a general pediatrician and assistant professor of Pediatrics at Duke Children's Primary Care-Roxboro Street in Durham. He enjoys providing care for children who are healthy as well as those with complex medical conditions. Dr. Eichner also serves as the medical director of the Duke Pediatric Diagnostic Clinic. He and his wife have lived in the Triangle since 2006.

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