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Thumb-Sucking & Pacifiers, Ages 3 to 6

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Should I be worried that my 3-year-old won't go anywhere without his pacifier?

No, but it's probably not too early to begin encouraging your child to be less dependent on it. Most children stop using pacifiers between the ages of 2 and 4, but many stop well before that. You can always force your child to do without his "binky" by taking it away. But you're much better off persuading him that giving up his pacifier is a good idea.

One way to do that is by raising the subject of dental care in general. By the age of 3, most children have all of their baby teeth, and they're beginning to discover things like regular brushing and flossing. So work a little dental education into your bedtime routine: As you help your child to brush, show him what his pacifier is doing -- how it puts pressure against his front teeth and could cause them to protrude. Point out his baby teeth, and talk about how important it is for them to remain straight so that they can hold a place "open" for the permanent teeth to come. Persuade your child that his teeth are important, and he just may decide to leave that "binky" behind.

When should thumb-sucking stop?

According to the American Dental Association, your child can safely suck a thumb or pacifier until age 4 without damaging his teeth or jawline. But you'll want to help your child give up thumb-sucking when his permanent teeth erupt, at age 6 or 7, or he could end up with an overbite. Another reason for him to give up sucking is that he'll start kindergarten around age 5 or 6; children who suck their thumbs often get teased by their peers.

It's important to remember that thumb-sucking at this age is normal, unless your child is sucking too much or starts to suck because he is especially anxious or stressed. Forcing your child to stop thumb-sucking too early can do more harm than good by taking away a habit he uses to comfort himself. Peer pressure is usually what helps a kid turn the corner; he sees that he's the only one still sucking his thumb and develops the will to stop.

How can I help my child stop sucking his thumb?

For starters, talk to your child in a low-key way about the need to stop sucking. Involve him by seeking his opinion on why he does it and how he can stop. These strategies may also help:

  • Help your child stop sucking during the day. Thumb-sucking during naps and at night usually is involuntary. Once daytime sucking is under control, you can start to deal with nighttime sucking.
  • Find a "helper" that will remind your child not to suck. This can be anything from a bandage on his thumb or a funny sticker on his thumbnail to a colorful mitten or even a baseball glove. Make sure that the "helper" is something that your child likes, not a punishment. Also, let him apply the sticker or put on the mitten himself.
  • Praise your child whenever you notice that he isn't sucking his thumb. Put a chart on his door, and give him a star for every day he goes without his thumb or a pacifier. Reward him with a special trip to the park, an extra story at bedtime, or some other treat.

How can I stop my child from nighttime thumb-sucking?

It's not easy. Your child is least able to discipline himself as he drifts off to sleep; he may not even realize that he's popped his thumb into his mouth. And if you're asleep yourself, you aren't in a position to tell him to take it out.

Generally, nighttime sucking will cease once your child stops sucking during the day. However, your child may be one of those who continues to suck at night and needs help to quit, or your dentist may tell you that your child's nighttime habit is harming his permanent teeth.

If so, you and your child need a helpful reminder, such as a glove, mitten, or elastic bandage wrapped around his arm (not too tightly). Try to work these aids into your child's bedtime ritual. Have him choose a special mitten for each night, or tell him a story about a child who wears a magic glove. If you use an elastic bandage, wrap it around his arm from a few inches below to a few inches above the elbow. Apply the bandage while the elbow is straight; whenever your child starts to bring his thumb toward his mouth, the pressure at his elbow will increase and remind him to stop. Give your child a choice of these options, and make sure he helps you at bedtime as you put them on.


Further Resources

National Library of Medicine
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000676.htm

References

Frances L. Ilg, M.D., Louise Bates Ames, Ph.D, and Sidney M. Baker, M.D. Child Behavior: The classic child care manual from the Gesell Institute of Human Development. Harper Paperbacks.

Journal of the American Dental Association. Thumb sucking and Pacifier Use. http://www.ada.org/sections/scienceAndResearch/pdfs/patient_77.pdf

American Academy of Pediatric Dentistry. Thumb, Finger and Pacifier Habits. http://www.aapd.org/publications/brochures/tfphabits.asp

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