The Pediatric Insider

© 2011 Roy Benaroch, MD

For November, I’m concentrating my writing chops on National Novel Writing Month. Fun! So I’m re-running revised versions of some classic posts. And by classic, I mean “old.” This one was originally from May, 2008. Can you believe it? It’s been over three years, and I haven’t raised prices on the blog even once! What value! Enjoy!

Annette posted: “I have a 4 year old who is still sucking her thumb. At what age do I start discouraging thumbsucking and what is the best way to do it?”

Thumbsucking and other oral habits can hard to break. Many adults find it very difficult to stop biting their nails, so it’s not surprising that in young children this is such a persistent habit.

At age four, your child is probably perfectly happy to continue sucking her thumb. She doesn’t see anything wrong with it. So methods to stop thumbsucking at this age are often doomed to failure. You can try to set a rule, but she’ll break it as soon as your back is turned—often unintentionally, out of habit. Until the child really wants to stop sucking, there’s just about nothing you can do that’s going to be effective.

Starting at about 5 or 6, many kids are ready to accept the idea that thumbsucking isn’t good, and that they ought to stop. You can have the “germ talk” with them about the germs on their hands that make them sick, and they’ll also notice by then that the other kids on the playground don’t suck their thumbs. Someone (hopefully not a parent) is likely to call them a baby if they keep sucking. So it’s a time that can be ripe for some gentle reminders. What you’re trying to convey is “I know you want to stop, but I also know it’s hard to remember. Let’s come up with some ways to help you remember you want to quit.”

Some reminders include:

  • A positive-reinforcement chart (earn a sticker for every day with no thumbsucking—three stickers ears a trip for ice cream!)
  • A thumb-covering glove. An example of this is at, or you can probably make one yourself. Something similar could be made for finger-suckers. It won’t stop a thumb from going in the mouth, but it will remind the child that she doesn’t want to put it there.
  • Nasty-tasting stuff you put on the thumb. I’m not really a big fan of this—it seems too much like a punishment, and I think it will increase anxiety and therefore thumbsucking. But it has worked for some people.

I also don’t like the dental “rake” appliance that sometimes is installed in a child’s mouth to poke a sucked thumb. Ouch.

Parents should keep thumbsucking in perspective. The child isn’t smoking or drinking, and though it’s not great for their teeth I’m not really convinced it’s a terrible thing for a preschooler to do. Once your child is 5 or 6, you can try to take a more active role in discouraging further thumbsucking, but your best chance of success will occur when then child decides she wants to quit.

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9 Comments on “Thumbsucking”

  1. Sheri Flink Says:

    another great article, Dr. Roy. Can I assume this same advice goes for binky’s? My 4 year old (your patient) still needs a binky to sleep. He is trying, even says he’ll stop when he’s 5, and we’ve tried the countdown chart but he just can’t shake it. The reward chart works for all other behaviors, just not this habit.


  2. Dr. Roy Says:

    Sheri, It’s often (not always!) easier to stop a binky (which, after all, is easier to throw away than a thumb!). But I’d follow the same general advice. You can wait a bit longer, until your son and you are on the same side of the battle, when he decides he’d like to quit. Then you can support “his decision”, which is usually more effective than enforcing your own.


  3. S Says:

    My infant son has just started sucking his hand; he’s very hard to settle, so i don’t particularly mind that he’s developing this self-soothing strategy. At what point does thumbsucking begin to interfere with normal development of the upper jaw? I’ve known a few kids (teenagers, when i was also a teen) with a very abnormal-looking mouth shape as though the jaws had developed to accommodate a thumb, though i don’t know for a fact whether any were thumbsuckers (except one who was still doing it as a teen).


  4. Dr. Roy Says:

    S, I’ve talked with several ped destists and orthodontists, and there isn’t an exact or clear answer on this. Clearly, the way toddlers and young children use their mouth and teeth affects the way that teeth and jaws grow– there’s even evidence that the modern world’s starchy, soft, processed diet is responsible for a lot of crowded teeth that end up in braces. But there isn’t an exact age at which one can say this is exactly when permanent problems start. How much tooth-shifting may depend on other things too, like how often, how hard, and at what angle the sucking occurs.

    For what it’s worth, the consensus of what I’ve heard and read is that thumbsucking and pacifiers don’t seem to cause permanent or difficult-to-fix issues until past age four, and even then only if it’s frequent and pervasive.


  5. Awesome Mom Says:

    How would one prevent a baby from starting to thumb suck? Is that even possible? Two of my boys are hard core thumb suckers and with my baby girl I want to discourage developing the habit but she seems very intent on getting her hand to her mouth to suck on it.


  6. Dr. Roy Says:

    Awesome, I will tell you that I know of no practical or effective way to prevent babies from sucking their thumbs. If they want to do it, they’re going to do it. I’ve seen babies with socks duct taped to up above their elbows– they’ll spend hours at night, awake, wiggling that sock off, and in the morning they’re happily sucking their half-unwrapped thumb.

    Has anyone else figured out a way to prevent it? If so, post here and share your wisdom! I’m happy to learn.


  7. andrea Says:

    Have your heard of Thumbuddy To Love to help kids stop thumb sucking. google it. Great product that comes with fitting thumb puppet, story book and success chart.


  8. Roswell Mom Says:

    Our 4 kids are now ages 25 to 15. Three have had braces, and the only one who does not need them/has pretty straight teeth, is . . . our sumb-thucker.

    He quit around age 3 and a half, but at 19 is always putting things in his mouth (hoodie strings, pencils, credit cards . . . not cigarettes fortunately).

    Go figure!


  9. Teri Says:

    As the parent of a child who really loved sucking his thumb, I know how hard it is for some kids to stop – even when they want to.

    When my son was 7, our orthodontist told us that he was going to need an expander within the year and had to stop sucking his thumb before it could go on. I wasn’t willing to make my son suffer with any of the products on the market used to MAKE kids stop thumb sucking: plastic sheathes, neoprene thumb sleeves and bitter tasting ointments just to name a few. I also didn’t want him to feel bad about needing to stop sucking his thumb. So we talked about it – a lot. He wanted to stop, he just couldn’t. He would suck his thumb unconsciously during the day and all night in his sleep. First we tried using a regular knit glove, but he would pull it off in the night because his hand would get too hot. I had him sleep in my bed and spent all night pulling his thumb out of his mouth. Clearly, we needed another solution: Thumb-Thing. By eliminating all of the fingers but the thumb, his hand stayed cool and he would wear it all night. During the day he would put it on while we watched a movie or read a book, or anytime he thought he might suck his thumb. I didn’t have to do anything but make sure his Thumb-Things were clean. He never forgot to put it on at night, and instead of feeling bad about himself, he was proud.

    Wishing you and your little one all the best!
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