Behavior

Thumb Sucking

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Thumb Sucking, Thumb-Sucking, Thumbsucking, Non-Nutritive Sucking

  • See Also
  1. Pacifier
  • Definitions
  1. Non-Nutritive Sucking
    1. Non-Nutritive Sucking refers to Thumb Sucking and Pacifier use
    2. Normal developmental process that allows infants to self-soothe
    3. Spontaneous resolution in most children by age 2 to 4 months
  • Physiology
  1. Thumb Sucking is an innate reflex
  2. Self-soothing method in infants
  1. Thumb Sucking extinguishes by 2-4 years spontaneously in most children
  • Management
  1. Behavioral methods to extinguish persistent Thumb Sucking
    1. Praise and reward children when they do not thumb suck
    2. Help find alternative soothing methods for children (e.g. stuffed animals)
    3. Reminders to not suck thumb (e.g. bandage on thumb)
    4. Involve older children in stopping Thumb Sucking (e.g. reward system)
    5. Bad tasting solution applied to thumb (e.g. Thum Liquid)
  2. Advanced measures for persistent Thumb Sucking beyond age 3 years
    1. Pediatric dentist referral
    2. Preventive orthodontics for custom appliances
  • Complications
  1. Persistent Thumb Sucking beyond 4 years can interfere with dental development
    1. Permanent Teeth start to erupt at this time
    2. Pediatric dentist referral is recommended
  2. Tooth alignment and mouth shape may be altered
    1. Dental malocclusion with overbite or crossbite may occur
  3. Nail Abnormalities
    1. Koilonychia
    2. Paronychia
  • Resources
  1. ADA Mouth Healthy
    1. http://www.mouthhealthy.org/en/az-topics/t/thumbsucking
  • References
  1. Bryce (2025) Am Fam Physician 111(1): 31-6 [PubMed]
  2. Nasir (2015) Am Fam Physician 92(4): 274-8 [PubMed]