Thumbs Down (One)

As we continue celebrating National Children's Dental Health Month I'd like to discuss an issue that parents are often concerned about.

Babies are born with the urge to suck. It is obviously an important reflex. Just how much they need to suck depends on the child. While some are satisfied with what they get from their feeding times, many have a physiological need for what is called nonnutritive sucking.

Nonnutritive sucking can soothe an anxious baby, help a hungry infant wait to be fed or calm a child who is overtired. "Normal" thumb or pacifier use is what ever your child needs. While both thumbs and pacifiers have their advantages and disadvantages, many pediatricians and dentists strongly prefer pacifier use because a child is not only more likely to give it up on his own, but also more likely to give it up sooner. It is also a much easier habit to break if it doesn't appear to be going away on it's own. After all, you can't really throw away a thumb.

Thumb and pacifier sucking does not necessarily equate to a future need for orthodontics. However, current research shows us it does need to be abandoned before damage is done to the developing terminal plane. In layman's terms this usually means between the ages of three and four. Studies show that most children quit the pacifier habit before the age of three, but the thumb sucking habit often sticks around until the child is four, five or beyond.

Whether it's a thumb or pacifier, once your infant gets hooked an a particular sucking habit their is no changing his or her mind. Therefore, if your baby shows a need for nonnutritive sucking in the first few weeks of life you may want to consistently offer a pacifier to help lean him or her to this direction. Then relax and let them enjoy.

The good news is that nonnutritive sucking decreases around three to four months of age as babies start to explore their world. If you notice your child suddenly or consistently spitting out the pacifier do not try to pop it back in. It is a good sign that he or she is "kicking the habit".

Don't miss these important cues. Pacifiers are often overused by parents as a plug. However, don't force the issue if these cues aren't there. Some children still need the extra sucking time.

By six months of age the physical drive to suck is all but gone, but your baby may still have a psychological need to use the pacifier for comfort. This is not a sign that your baby is unhappy, maladjusted or lacking love, nor does it mean you are a bad parent or that this will lead to other habit-forming behaviors. An otherwise happy and active child who still sucks when tired, stressed or hungry may simply be finding solace in this calming habit.

The key to weaning is,"less is more". If you make it an issue through berating, punishing or pulling it out, the child will only be frustrated and may do it more to assert his or her independence. If you act like you don't care they tend to give it up on their own.

If your child has not given up the pacifier by the age of three you may want to periodically, casually talk about how they are growing up and soon they won't need the pacifier anymore. Avoid negative comments, but make it less and less available such as restricting it to only home use or nap and bedtime. Use distractions or offer other forms of comfort such as hugs or a special toy. You may want to exchange it for a special treat or agree to give it up for a birthday or holiday. Some parents take advantage of the fact that children are constantly losing their pacifiers and "lose it" on purpose. You may also opt to let the child choose to throw it away themselves and reward them for this " big kid behavior".

Whatever route you choose, remember that once it's gone it's gone. Taking a pacifier away and then giving it back when the child cries only sets the stage for confusion and a power struggle.

The following are guidelines for safe pacifier use.

• Don't buy a pacifier with a lip shield that is either so large it blocks the nose or so small it fits inside the lips

• Do purchase a pacifier with a symmetrical nipple and shield shape designed to be used with either side up so that it is always in the correct sucking position for the baby.

• Don't tie a pacifier around the child's neck or attach it to the crib or playpen with a string.

• Don't dip the pacifier in honey or sweet liquids which can lead to cavities, infections or botulism if it's honey and the child is under one year of age.

• Never use a homemade pacifier, two piece model or a bottle nipple for a pacifier as all can pose a choking hazard.

• Always wash a pacifier with soap and water when you first use it and whenever it falls.