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| |    Thumb-Sucking: When to Be Concerned? by Dr. Benjamin Spock reviewed and revised by Robert Needlman, M.D., F.A.A.P. One baby never nurses more than 15 minutes at a time and yet never puts a thumb in her mouth. Another who always nurses for 20 minutes or more thumb-sucks excessively. A few begin to thumb-suck in the delivery room, and they keep at it. We now know that some babies suck their thumbs while they're still in the uterus and some are even born with sucking blisters on their hands or arms. (These are not harmful, and go away in time without treatment). Should you worry? You don't need to worry when babies suck for a few minutes right before feedings. They are probably doing this only because they're hungry. It's when babies try to suck their thumbs as soon as their feeding is over, or when they suck a lot between feedings, that you have to think of ways to satisfy the sucking craving. If your baby girl begins to try to suck her thumb or finger or hand, I think it's preferable not to stop her directly but to try to give her more opportunity to suck at the breast or the bottle or the pacifier. If your baby hasn't been a confirmed thumb-sucker from birth, the most effective method by far to prevent the habit is the ample use of the pacifier in the first 3 months. Also, think about the number of times you feed her, and how long each feeding takes. With a thumb-sucker, it's better to go slowly in omitting feedings. It's not just the length of each feeding but also the number or frequency of feedings in the 24 hours that determines whether a baby satisfies the sucking instinct. So if a baby is still thumb-sucking even though you have made each breast- or bottle-feeding last as long as possible, it is sensible to go slowly in dropping other feedings. For example, if a 3-month-old baby seems willing to sleep through the late evening feeding at the parents' bedtime but is doing a good deal of thumb-sucking, I would suggest waiting a while longer before dropping the late evening feeding - perhaps a couple of months, provided the baby is still willing to drink when awakened. When to address thumb-sucking The time to pay attention to thumb-sucking is when babies first try to do it, not when they finally succeed. I make this point because lots of babies haven't much control over their arms for the first few months of their lives. You see such babies struggling to get their hands up and searching around with their mouths. If by good luck they get their fists to their mouths, they suck them vigorously as long as their hands happen to stay there. These babies, just as much as the skillful thumb-suckers, are showing a need to suck longer at the breast or bottle. The very young baby needs help most, because the sucking need is strongest in the first 3 months. From then on it tapers off. In most babies it's usually gone by 6 or 7 months. The thumb-sucking that persists after 6 months is a comforting device, not an expression of sucking need. For a thumb-sucking child who is 6 years or older, consult a dentist or orthodontist.
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