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Thumb sucking in Children

Mr. Basant Kumar Karn
Mrs. Sunita Shah
Nursing Officer
B. P. K.I.H.S, Dharan, Nepal

The sucking instinct in newborns is for survival. Sucking brings food and this food brings comfort.
Some infants begin sucking their thumb while in their mother’s womb. Many babies are born with
calluses from sucking their finger, thumb or wrist. Other babies discover finger or thumb sucking
after birth. This non-nutritive sucking is done for comfort. Babies that are born in countries where
they have constant access to their mother’s breast have very little incidence of thumb sucking. The
infant’s sucking urge is completely satisfied and they do not need to suck their thumbs.

Most children stop sucking their thumb or fingers on their own without parental intervention
somewhere around age one. But, some children continue sucking their thumb long after.

This epidemiological study was conducted upon 4,590 school children to find the prevalence of oral
habits in Mangalore in relation to their age and sex and to find the correlation, if any, between the
habits and the malocclusion status. We noted that 29.7% of the population had habits of which 3.
1% had digit sucking.

Causes of thumb sucking

Thumb-sucking can become a habit in babies and young children who use it to comfort
themselves when they feel hungry, afraid, restless, quiet, sleepy, or bored. In some infants it can
signal fatigue, sleep, hunger, teething and shyness.

The reason why many children continue to suck their thumbs long after toddlerhood has to do with
the psychological needs of the child. Our brain has the ability to produce endorphins, or mood
altering chemicals, in response to smells, sounds, actions or objects. The brain controls our emotions
and feelings in response to these chemicals. Pleasurable activities such as thumb sucking, gambling,
running, eating stimulate the brain to release these endorphins that stimulate a sense of well-being
and pleasure. Thumb sucking triggers a calming, relaxing sensation to occur in the child. An infant
first experience with pleasure which creates a calm feeling is sucking and getting food.

As most infants develop independence they become more mobile and too busy to bother with thumb
sucking and therefore quit. When a child continues to suck their thumb many parents start to use
punishment, negativity, yelling and frustration to try to stop them. This only makes the habit more
entrenched. Many times older children who suck their thumb have to endure pushy comments made
by other children, teachers and complete strangers about this habit that brings them so much
pleasure. They begin to feel ashamed and that they are a bad person because of all the ridicule and
insults they receive.
Thumb-sucking cause problems

The possible effects of thumb sucking for children after the age of three is: Prolonged thumb-
sucking may cause a child to develop dental problems.

1. Reshape the jawbone because their jawbones are still soft and pliable
2. Teeth grow out of aliment and position
3. Narrows dental arches which cause the next problem
4. Upper front teeth will flare out and tip upward
5. Lower teeth will move inward
6. Affect growth of child's palate causing: Poor tongue placement
7. Problems chewing
8. Problems with learning to swallow properly. The tongue plays a major role in
swallowing. For people who don't suck their thumb or finger, their tongue goes up
behind the roof of their mouth as they swallow and this causes a seal. But, when trying to
swallow while sucking the thumb or finger, the tongue is thrust forward, in between the
front teeth. This action makes swallowing difficult and will require re-training to correct
the tongue movement.
9. Problems speaking including mispronouncing Ts and Ds, lisping, and thrusting out the
tongue when talking.
10. Overbite or open bite
11. Make tonsils collapse to cause snoring
12. Excoriation and blisters on the thumb

The skeletal deformities which can develop can lead to insecurities and self-
image problems, particularly in children. In developing countries, children
with habit of thumb sucking have additional risk of Diarrheal disease and
Worm infestation.

How to Stop Thumb Sucking
Parents usually start to worry too early, about how to stop thumb sucking habit
of their children. Usually children stop the habit on their own, by that age. If
they don't, here are some easy ways to get kids to stop thumb sucking.
 Breast feed the child
 Keep the child's hands occupied with a toy, puzzle or other activity.
 Carefully remove your child's thumb from his or her mouth during sleep
 Give the example of his friends that have managed to stop thumb sucking.
 Don't put the child in a state of anxiety or fear.
 If the child has any emotional problems, or is under stress and needs comforting, you may
need to resolve those issues first before your child can successfully stop thumb-sucking.
 Talk about the 'bad' germs that are on our hands and how the child puts them in his or her
mouth while thumb sucking.
 Ask the advice of a pediatric dentist. He will explain to your kid what will happen to the
teeth if the child does not stop sucking its thumb.
 Use a thumb sucking guard. - In difficult cases, your dentist might suggest the use of
special devices to stop thumb sucking, called thumb guards. A thumb guard is a device
with a plastic cover of the thumb that is attached to a child's wrist. The thumb sucking
guard interrupts the process by breaking the vacuum created by sucking, thus removing the
child's pleasure. Treatment with thumb guards usually lasts four weeks and helps children
to stop thumb sucking successfully.
 Have them wear a large shirt with long sleeves. Button it completely on and tie the
arms or rubber band them shut so they can not suck on their thumb.

Guidance For Mother

1. Thumb sucking is not a problem until up to 4 months of Age.
2. Never place polish on an infants nail
3. Breast feeding can prevent and replace thumb sucking behavior
4. Restraining hands for longer period/ duration can hamper growth and development
5. Do not punish the child for thumb sucking rather motivate or reward the child for NOT
sucking the thumb

References:

1. Shetty SR, Munshi AK., J Indian Soc Pedod Prev Dent. 1998 Jun; 16(2):61-6.
2. Dr. John Warren, Journal of the American Dental Association, 2001; 132:1685-1693.
3. Dorthy R Marlow, Barbara A Redding, Text book of Pediatric Nursing, 6th Edition
1998.
4. Aarts C, Hörnell A, Kylberg E, Hofvander Y, Gebre-Medhin M., Breastfeeding
patterns in relation to thumb sucking and pacifier use. Pediatrics. 1999 Oct; 104(4):e50.
5. http://www.pamf.org/children/healthinfo/?A=C&type=info&hwid=hw170183&section=
hw170208 as on 25 December 2007.