Right Parenting - Thumb-sucking and Nail-biting

Even a baby inside mother’s womb starts sucking its thumb after completing twenty-nine weeks. So there is nothing unnatural about this habit. This so-called non-nutritive sucking is as a result of a normal biological drive resulting from pleasurable stimulation of lips and mouth that the baby associates with pleasant feelings like satiety or being held.

Persistence of this habit often indicates underlying anxiety, emotional stress or frustration in the child.

When is it significant?

Since a majority of children till the age of four years suck thumbs at least occasionally, clinically it is considered significant only after that age. In most children who are thumb-suckers beyond the age of four years, this habit is annoying but not otherwise bothersome. But in some children where the duration, frequency and intensity of thumb-sucking are more, adverse long-term effects are possible.

What are the long-term effects of this habit?

Severe habit of thumb- sucking could lead to problems in teeth, facial structure and obviously in thumb. Dental mal-alignment, disturbances in jaw- bones and joints, disturbed placement and function of lips and/or tongue or injuries to soft tissues in mouth are probable effects on teeth and face. The thumb that is being sucked vigorously could become bent or deformed. Thumb soreness, callosities (thickened skin), irritant eczema and acute or chronic nail infections (e.g. herpetic whitlow) are also possible.

Psychosocial effects of thumb-sucking are much more damaging. In one study of school children, thumb-suckers were found to be unpopular and were considered less intelligent and attractive by peers. Add to this the stress of having to endure the taunts and reprimands by parents, teachers and schoolmates!

How to manage thumb-sucking?

In a majority of cases just assuring the child of parental love and support is enough. Parents should try and ignore the habit without making it a major issue as in most it usually subsides on its own. One should make an effort to identify and remove any underlying cause of anxiety or stress. Child’s own efforts in tackling this habit should receive encouragement. Parental scolding and negative attitude make the problem worse. That’s why a prominent pediatrician had once opined, “The danger of thumb sucking is not in the habit itself but in what parents do about it!”

Further treatment is needed only in children over four years of age, who are showing adverse effects of habit. Physical barriers like mittens, socks or bandages; orthodontic appliances; aversive taste formula applications and in some cases psychotherapy are the treatment modalities available.

Aversive (bitter or sour) tasted formula application coupled with a reward system taking the child into full confidence has a very good success rate.

Is nail-biting any different?

Actually nail-biting and thumb-sucking are quite similar as regards the cause, effects and treatment. Here too, one has to understand the self-limited, essentially benign nature of the condition and identify and remove the underlying emotional stress.

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