"My 5-Year Old Kid Is About to Enter School and Still Sucks His Thumb"

Parents with pre-school children of 3-4 years of age often come to me in my Outpatient Clinic complaining that their kid is still in the habit of sucking his/her thumb like a baby.

They are usually worried about how long will this habit last, sometimes even asking me if this is going to last forever!

The child in contrast is not worried at all and seems to enjoy sucking his thumb a lot.

Thumb-sucking is a habit disorder, and like other habit disorders that include nail-biting and teeth-grinding, is very self-soothing for the child.

This means that whenever the child is feeling anxious he might suck his thumbs to relieve the anxiety.

There are theories that suggest that this may have a psychological cause as it is more common in children who have faced neglect and loneliness during infancy.

The diagnosis is very evident by the history itself and does not require any kind of tests as such.

How common is this problem and when should you worry?

It occurs in almost all children under 1 year of age, peaks at around 1 and half years of age, and then gradually decreases with age.

If it persists beyond 4 years of age then it can cause problems such as misalignment of teeth, and deformities of thumb & nails.

Complications include open-bite, and chronic inflammation of the thumb known as paronychia- the pictures of which I am sharing below for better understanding.

What the parents should do?

If you are very worried about the situation then you must pay attention to the habit and gather some information before you make your visit to a pediatrician.

• How frequently does the child suck his thumb every day

• How long does the child suck his thumb once he starts

• Are there any situations when the child sucks his thumbs more- for example when he is fearful, or angry, etc

• Can he be diverted away from the habit by engaging in some playful activities.

How to treat the habit of thumb-sucking

Below 4 years of age parents should be reassured and a wait & watch policy is followed as mostly it will resolve by itself.

Above 4 years your doctor may use some of the following methods

1. Simple reminders- may suffice for kids who are very obedient by nature

2. Positive reinforcers- giving a reward such as a sticker if the child does not suck his thumb for a certain amount of time say 2 hours

3. Basic behavioural management- engaging the child in other playful activities and praising the child for substitute behaviours

4. Mechanical devices- placed on the thumb or the mouth (eg- palatal crib)

5. Noxious agents- like pepper and quinine applied on the thumb

Final words

Thumb sucking in pre-school kids might be very embarrassing for the parents but it is self-resolving and requires no treatment in kids below 4 years age.

Above 4 years of age, you must consult a pediatrician as it can lead to deformities of teeth and nails if continued for longer time.

If you have any queries or confusion regarding thumb sucking as a habit, please feel free to comment below.

Regards,

Dr. Zeeshan

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