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| |    Thumb-Sucking: Getting Your Child To Stop by Dr. Benjamin Spock reviewed by Robert Needlman, M.D., F.A.A.P. The mainstays of treatment are:
When the child wants to stop If your child truly wants to stop, then you can help by giving encouragement, drawing a chart to mark progress, or by offering rewards and praise. A bitter substance (Stop-zit, Thum, or another over-the counter brand,) can serve as a reminder. Some children use an elastic bandage wrapped around their elbows that pinches a bit when they bring their thumb up toward their face. These techniques are described more fully below. It's OK to remind a child, but be careful that you don't get into a power struggle over thumb-sucking. You are sure to lose. If your child is still sucking her thumb when her adult teeth come in (at about age 6), there is a risk of developing buck-teeth and other orthodontic problems. At that point, most parents will turn to their dentist for help. A small metal rod installed behind the top front teeth makes thumb-sucking much less pleasant, and can prevent the need for more expensive orthodontic work later on. See: Thumb-sucking: Negative Effects Below, we discuss some treatments we would NOT recommend. Why not use restraints? Why not tie baby's arms down to keep him from thumb-sucking? This would cause him a great deal of frustration, which could produce new problems. Furthermore, it usually doesn't cure the baby who is thumb-sucking a lot, because it doesn't respond to his need for more sucking. We have all heard of despairing parents who use elbow splints or put bad-tasting liquid on the baby's thumbs, not just for days but for months. And the day they take off the restraint or stop the liquid on the thumb, the thumb pops back in the mouth. To be sure, some parents say they have had good results from using such methods. But in most of these cases, the thumb-sucking was very mild. Many babies do a little thumb-sucking off and on. They get over it quickly, whether you do anything or not. I think that restraints and bad-tasting liquid only make the confirmed thumb-sucker do it more in the long run. Why not use deterrents? Elbow splints, mitts, and bad-tasting stuff on the thumb only make the child miserable. They won't stop the habit any more often in older children than they do in small babies. I think that they tend to prolong the habit. The same applies to scolding a child or pulling his thumb out of his mouth. You often hear the recommendation that you give children a toy when you see them thumb-sucking. It certainly is sound to have enough interesting things around for them to play with so that they won't be bored. But if every time their thumb goes in the mouth you jump toward them and poke an old toy into their hands, they'll soon catch on. If a child is motivated to stop, and can see the splint or bitter stuff painted on his thumb as a helpful reminder, then it makes sense to use these things. You can suggest them, but it does no good to force the issue. What about bribing? Another word for "bribe" is "reward." Everyone works for rewards. (Some people make the distinction that a "bribe" is simply a reward to do something that is wrong; if you think this way, you might prefer "reward" to "bribe.") If your child is one of the rare ones who is still thumb-sucking at the age of 5 years, and you are beginning to worry about what it will do to the permanent teeth when they come in, you will have a fair chance of succeeding if the bribe is a good one. A girl of 4 or 5 years who wants to get over her thumb-sucking may be helped by having her fingernails painted like a woman's. But practically no child of 2 or 3 has the willpower to deny an instinct for the sake of reward. You're apt to make a fuss and get nowhere. So if your child is thumb-sucking, see to it that his life is good. In the long run it will help him if you remind him that someday he will be grown-up enough to stop. This friendly encouragement makes him want to stop as soon as he is able. But don't nag him.
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