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Five-Year-Old Still Sucking Thumb
Q: My daughter is five years old and she has sucked her thumb ever since I can remember. When she gets up in the morning, the thumb is still in her mouth. She does not suck it all day, unless she is lying down for a nap. I am concerned about what this is doing to her teeth and if I should try a stronger approach with her to stop other than just talking with her about it. Some mornings when she gets up, the thumb is just a wrinkly stump. I have asked my doctor, and he said that it was most likely a calming thing for her to help her sleep. But when is too old to suck your thumb?
A: Contrary to what most people think, in general it is not particularly harmful to a child's teeth to suck the thumb. As your physician suggested, sucking is a calming mechanism that many babies develop during infancy. Preschool children continue to use it as a comforting mechanism, particularly in preparation for sleep. Most children give up their thumb-sucking spontaneously at around age six or seven, usually due to peer pressure because they are in school. There are, however, some children who are like your daughter: they don't suck their thumb much during the day and just do it at night. Unfortunately, this also means that for her, sucking her thumb is how she has learned how to fall asleep, and in order for her to give this up she needs to learn a different way to fall asleep on her own.
In general, it is very difficult to get a child to stop sucking her thumb if she does not want to stop. If she is interested in stopping, then there are a number of things that you can do to help her with it. There are a few preparations that you can buy in the drugstore that are specifically made for thumb-sucking and nail-biting. You paint it on the thumb and it has a bitter taste, thus acting as a deterrent to sucking the thumb. Putting a mitten or other covering on the hand at bedtime may help. A sticker chart reward system would also be useful for a child this age: She gets a sticker on the calendar each night she falls asleep without the thumb in her mouth. When she accumulates three stickers she gets a special treat (an activity or a toy, not food); when she gets to six she gets another treat. When she gets to twelve she gets a final "big treat." By this point she will have learned how to fall asleep without sucking her thumb, and you can stop.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.