Author: Jomsurang Phothisataya, MD.
Thumb sucking is a behavior found since a baby in the womb when gestational age of 18 weeks, infancy, preschool, and may continue until school age. Mostly after the age of 2-4 years, children gradually stop sucking. However, some babies might continue sucking for a certain period of time which usually occurs only before bed time until the age of 5-6 years. Children younger than 4 years old are not required to get treatment if sucking does not affect any aspect of development because children can develop self-control and stop sucking. It will be a problem only if it causes some impacts on the physical health, development, social interaction and self-esteem regardless of age.
Epidemiology
80 percent of children are born with a sucking habit.
30 45 percent of preschool children are commonly found.
5 20 percent of children older than 5 years have sucking behavior.
Commonly Found: Girls> Boys at a higher socioeconomic status
30 - 55 percent of the children with thumb sucking will get addicted to something (attachment object) such as dolls, blankets, playing with their hair.
Causes
1. Behavior caused by learning (Learned habit / behavior) Infant aged 4 -6 weeks accidentally puts his hand into his mouth and then learns how to suck a thumb. It causes joy, pleasure and enjoyment (Gratification) so that behavior recurs.
2. Children will suck their thumb as to stimulate themselves (Self - stimulation) when feeling tired, alone, abandoned, or they are not stimulated appropriately by caregivers.
3. Kids suck their thumb to soothe themselves (Self - soothing) when hungry, sleepy or sick, as well as physical discomfort or stress and concern such as school attendance, moving to other place or having a sister.
Impacts
1. The most common problems with teeth and oral cavity are abnormal occlusion, mucosal injuries, and facial deformity.
2. Problems with fingers and nails such as infection and deformed fingers
3. Psychological issues include relationship problems, being scoffed by friends or blamed or punished by parents.
Assistance
The goal: To prevent dental complications and psychosocial impacts and self-esteem.
1. Educate parents: such behavior is normal according to age and will disappear when they grow up.
2. Parents need not to teach, warn, blame, or punish the children for their thumb sucking. Do not pay attention with the childrens thumb sucking. When children suck their thumbs, divert their attention to other activities, especially activities that require the use of their hands like picking and carrying things or writing and drawing activities.
3. Admire children when they do not suck their thumb.
4. Do not leave children alone. Find activities to make children fun and joy in order to make them forget thumb sucking. These activities not only help reduce thumb sucking behavior , but also promote the development as well. Activities include movement activities / exercises, clay sculpture, painting, drawing, talking, storytelling and playing. In addition, children may be invited to help with simple tasks and praise them. Doing so will promote the development and build good relationships between parents and children and self-esteem as well.
5. If the thumb sucking is more frequent, find out whether it is caused by mental or physical discomforts, particularly uneasiness of changes such as school transfer, moving to a new home or having a brother/ sister. The children need some mental support in order to adapt themselves to these changed.
6. If a child is older than 4-5 years old and still has thumb sucking behavior so frequent that he is ridiculed, consult an expert.
References
1. Virongrong Aranyanart. Common Behavioral Problems in Young Children. In: Thippawan Hansakunachai, Rawiwan Rungpraiwan, Sureeluk Sujaritpongsa, Weerasak Cholchaiya, Editors. Child Behavior and Development Textbook, Vol. 3 Care of Healthy Child. Bangkok: Beyond Enterprise; BE2556 p.224 25.
2. Ampon Soo-Ampan. Habitual Problems. In:Wanpen Boonprakorb, Ampon Soo-Ampan, Nongpa-nga Limsuwan, Editor. Child Psychiatry for Pediatricians (Revised Version). Bangkok; Chuanpim Printing, BE2538 p.170 78.
3. Blenner S. Thumb sucking. In:Parker S,Zuckerman B,Augustyn M, Editors. Handbook for Developmental and behavioral pediatrics for primary care, 2 nd Edition. Philadelphia: Lippincott Williams & Wilkins; p.348-9
