In our society thumb sucking is often considered to be quite a problem. Except for the very rare child who causes real deformity of his/her teeth by sucking very hard and for many years, it is difficult to see why thumb sucking should be taken so seriously by so many people.

In the first year of life, all children do a great deal of sucking and mouthing objects other than foods. Watch a 9 month old child at play and you will see that each new toy quickly finds its way into the mouth for sampling of taste and texture before he goes on to play with it. A baby uses his/her mouth the same way he/she uses his/her hands and his/her eyes, to find out about things.

Actually, using his/her mouth came first. A newborn baby is adept at finding the breast and is sucking long before he/she uses his/her hands and his/her eyes. Throughout his first year he has a strong urge to suck. Most of this urge will be satisfied at feeding time, but frequently there is a strong desire to suck “left over” after feeding is completed. For these infants pacifiers or thumbs are perfectly appropriate. Pacifier use is recommended by the American Academy of Pediatrics (and this office) during infancy, as it has been shown to be a factor in reducing Sudden Infant Death Syndrome (S.I.D.S.).

A few babies stop sucking their thumbs in a few months, but most continue until the beginning of the second year. Some of them gradually stop completely. A few cut down and suck their thumbs only at special times such as bedtime or when they are tired. Some don’t stop at all, but continue until they are five or six years of age.

It is not wise, and very seldom effective, to tie or cover the baby’s hands, to put splints around the elbows, or to paint the fingers with bitter tasting medicines to stop thumb sucking. These punishing measures hardly ever work and you make the child more eager than ever to suck his/her fingers. He or she might stop temporarily, but will go back to sucking with more determination than ever before.

Pacifiers, on the other hand, should be discontinued by one year of age. A pacifier can be discontinued without the child switching to thumb sucking. Pacifiers are recommended for infants, but become a major source of contagious illness in toddlers, especially those in daycare. Prolonged pacifier use has also been shown to increase the incidence of ear infections.

Don’t worry that thumb sucking will cause permanent deformity to the teeth. If a great deal of sucking occurs after the age of two, the upper teeth may be pushed out and the bottom teeth in, depending upon the position of the thumb in the mouth. The structure of the jaw is not altered, however, and the permanent teeth, which begin to come in after the age of six years, will come in straight. Thumb sucking or finger sucking after the permanent teeth have erupted may cause permanent deformity requiring orthodontic care.