Non-nutritive sucking  indicates the sucking of any object that does not have any nutritional value. Most of the time, it is normal part of early development. If this persists, it may then go on to become a learned habit. It is a mechanism by which the child learns to soothe herself. It may occur in 70 to 90 percent of infants. As children become older, the frequency decreases significantly, but by 4-5 years of age, in most children, it is replaced by other coping mechanisms.

Children in an effort to soothe themselves (even the most attentive parent cannot be there for the child all the time), tend to suck on:

• Thumbs
• Other digits
• Pacifiers (if one is offered to the baby)

Pacifiers are marginally better than digital sucking, as they are less likely to persist to the age of 4-5 years and beyond.  If the child uses a pacifier, is less likely to indulge in thumb-sucking or other digits.

Problems associated with Thumb-Sucking

Early cessation of Breast Feeding

Infants who suck at pacifiers are 2-3 times more likely to stop breast-feeding early as compared to those who do not use pacifiers. In contrast, breast-feeding does not cease early in children who indulge in thumb-sucking or other digits.

Increased risk of developing middle ear infections

The risk of middle ear infections increases almost 1.25 times in infants and children sucking on pacifiers. There is no increased risk with digit sucking.

Decreased risk of sudden infant death syndrome or SIDS (An advantage!)

This is the big advantage of using pacifiers. The risk of SIDS is reduced to almost one-third in infants using pacifiers. The American Academy of Pediatrics recommends that caregivers “consider offering a pacifier at nap time and bedtime” after breast-feeding routine has been established (by around one month of age), to prevent SIDS. If pacifiers do get dislodged after the child falls asleep, do not put them back in. Do not offer pacifiers through the day, when the child is awake, just in a bid to quieten an upset child.

Dental Malocclusion

A variety of malocclusive defects can occur due to all types of non-nutritive sucking. Constant pressure of the non-nutritive sucking object on the tender and developing teeth, results in teeth, that are out of alignment. Cosmetic and functional problems may then ensue.

Nail Infections & Skin Infections

Infections are not very common, except in recalcitrant case. The child may develop small abscesses around the nail or in the pulp of the fingers, that may then require minor operations to drain the pus.

Who is more likely to suffer more?

• Non-nutritive sucking across multiple settings (play, sleep, cry, hunger, etc).
• Conscious (Not only when the child is falling asleep).
• Female.
• Older Child.
• Uncooperative in steps taken to break the habit.

How to Break The Habit of Thumb-Sucking?

1. Stop Pointing Out & Nagging: If you find yourself constantly nagging your child, stop it! This only acts as positive reinforcement and makes things more difficult.
2. Identify any stress factors for the child: Could be a noisy environment, domestic quarrels, birth of a sibling etc.
3. Positive Reinforcement: Like all behavioral disorders, positive reinforcement and reward systems work best. Start a “star chart” by giving the child gold stars for every day that they did not indulge in this habit. Once the child accumulates a certain number of stars per week, or a certain number of consecutive stars, reward them with their favorite treat.
4. Negative Reinforcement: No punishments are recommend. Simply put bitter tasting stuff like करेला (bitter gourd) juice on their thumb / digits. Do not use castor oil, as this may cause violent purging. In extremely rare instances, temporary casts were advised to break the habit in the past, but with the advent of dental appliances are no longer recommended.
5. Intra-oral dental appliances – A seal is required between the pacifier / digit and the mouth for effective sucking. Devices have been created to prevent this seal formation. As a result, the child cannot suck effectively. You do need to consult with your pediatric dentist.

Do share with us your own remedies that may have worked with your own child in the comments section below. It will benefit other readers. What will be most interesting will be what you used to coat the child’s digits that caused them to give up on thumb-sucking.

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