Our three year old still sucks his thumb. Is that a problem?

Is it a problem that our son Luka is still sucking his thumb now that he’s three years old?  It’s mostly at home when he’s being read to or watching tv.  I’ve also seen him doing it at pre-school during circle time.  At the park, I’ve told him he can’t suck because of germs, and he knows that if I catch him doing it I’ll use sanitizer on his hands which he hates. Frankly, I don’t really care since I sucked my thumb as a kid, but we get a lot of negative comments from grandparents and other family members. They say he’ll get teased when he gets older if he doesn’t stop. Should we make him stop?

Sucking is the first way that babies learn to soothe themselves, and almost all babies take pleasure in sucking—that’s why they are willing to nurse or take a bottle.  The sucking instinct is nature’s way of assuring that a baby will demand to be fed.  As babies get older, many will gradually suck less and less except for feeding during the day, but they may continue to suck on a pacifier, thumb or fingers when they are falling asleep or feeling distress. 

Some children, like Luka, develop patterns of comforting themselves by sucking long after they are babies. Sometimes it’s only when they are tired or in the midst of transitions, sometimes it’s almost all the time! When the habit is pacifier sucking,  parents can control access to a pacifier or remove it entirely. You don’t have that choice with a child’s thumb!

Fortunately, there is no evidence that a three-year-old’s thumb sucking is harmful to her.  In fact it’s probably helpful. That’s becausechildren who suck their thumbs have the ability to calm themselves readily, often before they get so unhappy that a parent notices that they are upset. If you expect Luka to give up such a useful way of coping, what will be his substitute?  Will he still be able to quiet himself when he is feeling stressed? Will he still be able to fall asleep independently?  Future teasing should not bea cause for concern. A pre-school age child doesn’t worry about what others think of her now, and she can’t imagine or care what the future might be like.

The only reason to discourage thumb sucking in a three- to five-year-old, or in any child,  is if the degree of sucking is so frequent and of such intensity that it is likely to interfere with permanent tooth development.  This would be highly unusual at this age. If a five- to six-year-old child sucks her thumb with strong suction throughout the day and night, many dentists would advise parents to intervene.  However, since you have noticed already that Luka has many periods when he does not suck his teeth may not be affected at all as he gets older. (If his parents have overbites or needed braces, Luka might still need an orthodontist no matter what you do!)

There are a few things you can do now to help Luka continue to gradually reduce his dependency on his thumb.  The first is to make sure that he is also developing other ways to soothe himself and to accept comfort from others.  Make sure that Luka gets lots of hugs and cuddle time.  Encourage him to practice relaxation in ways that don’t involve his thumb:  stretching and splashing in a bathtub, blowing bubbles, playing with sand or clay, and doing slow deep breathing while you play music.  These aren’t strategies to “fix” the thumb sucking.  This is long term skill building that will be helpful to any child.

Many young children suck when they are bored or when they are in a situation where they have learned to automatically suck their thumbs.  At those times, a child doesn’t need comfort.  He’s just unconsciously doing what he’s used to doing. You can interrupt that type of sucking (or any other unconscious habit) by introducing an activity that is incompatible with the habit.   For example, you may notice that providing Luka with something else to do with his hands--holding a ball, drinking a glass of milk, doing a puzzle--gives her enough distraction for him to forget about sucking. If he tends to suck his thumb when you are driving in the car, you can give him an interesting toy to play with.  Having a conversation or singing a song together may also keep his mouth busy without his thumb.  You aren’t trying to stop the thumb sucking all the time, you are just substituting ways for him to keep his hands busy.

You may hear that children should have their thumbs painted with nasty tasting substances to discourage thumb sucking. Since the hand sanitizer is effective at the park, you may be tempted to use it more often. However, some parents who have taken this path regret it later.  They discover that their child develops another habit that may be less pleasant than the thumb sucking--lip licking and nose picking are common--or that their child becomes more easily distressed without a way to comfort himself.

If a parent reacts with disapproval when a child sucks her thumb, or even worse, nags her to stop, the thumb sucking is likely to increase.  Some children will become defiant and suck more in reaction to comments from parents.  Others will simply hide the thumb sucking and may wind up seeking ways to sneak in extra sucking time.

Comments from adults other than parents or regular caregivers aren’t as likely to cause this kind of rebound effect.  However, children naturally avoid being with people who disapprove of them, so you may want to advise critical family members to keep quiet.

You can also explain to them that pediatric and pediatric dental organizations have all issued statements that thumb sucking does not need to be interrupted at this age, if ever.  If that doesn’t work, you’ll be setting a good example to your child about resisting peer pressure if he hears you say, “We think it’s fine for Luka to suck his thumb, and we don’t see it as a problem.”