The answer is, it’s not your choice. Let’s start by discussing the need for these things in more detail. First and foremost, sucking is comforting and a normal and natural process for all babies. Secondly, there isn’t a rule or recommendation for either. It depends on the child and what they need to soothe. The most important factor is to allow and encourage normal mouthing experiences and give strategies for gradual and healthy development.
It’s also important to know that thumbs, fingers, hands and objects in the mouth are a normal and natural process of learning. Babies and children learn about their mouths, learn to chew, learn to move their tongues, learn to taste and develop their hand-mouth connection by playing with their mouths. These are all positive things. In fact, using different mouth toys as your child grows is incredibly important for eating, speech and dental development. Babies start to explore the lips and the tip of the tongue and gradually move to back of the mouth which helps to move the gag reflex back as the child grows. Please don’t stop your baby from doing this. It is healthy, normal and positive.
No Place for Guilt
I often hear the argument that dummies are better because you can’t throw away a thumb. I see the angle here but it just doesn’t work that way. Some children just prefer dummies and some children will choose a thumb, maybe because they don’t have a dummy available, maybe not. It is a common finding that some babies aren’t interested in dummies and I love when this happens. It is ideal not to use them at all, but it’s very important to know that its ok if you need to. You need your sleep too! It just becomes more important to have a strategy for appropriate elimination. There has been research to support the use of dummies. In fact, they have been shown to reduce the incidence of sudden infant death syndrome (SIDS). They can be used as a tool for a period of time. Think short and useful, not prolonged and excessive. The goal is to try and eliminate the dummy around 10 months of age. If we do it gently and gradually, along with providing the right tools for comfort, then we can do it successfully. The key is replacing with healthier strategies that support optimal development. These things include positive mouth play activities, drinking and swallowing properly, chewing, nasal breathing and the tongue resting in the palate
I haven’t met a single parent of a chronic dummy or thumb sucker who doesn’t want it gone. Easier said than done, right? This information is practically useless when you have a toddler screaming in your face. I don’t think it is fair for professionals to lecture parents when they aren’t the ones trying to get a toddler to sleep at 2am. However, it is important that parents know about the potential for damage. The concern from a dental perspective is the impact they can have on a developing jaws and palate. The roof of the mouth is very soft and prolonged dummy use or excessive force from thumbs or fingers negatively impacts the way the face and jaws grow.
Elimination Takes a Little Bit of Strategy
Ever heard of the dummy fairy? She has a great place for families and can often be very successful. Other parents send it off with the Easter Bunny or Father Christmas. Maybe they give it away to a younger sibling or another child. Lots of children will respond well, maybe shed a few tears, but after a few days they’re on their way to successful elimination.
Thumb and finger sucking is certainly a large focus for our practice. We work with many ages in regards to persistent oral habits and we work towards normalising oral function. Normal function is when the lips are closed at rest, breathing is nasal and the tongue is resting on the roof of the mouth. Lingual-palatal rest posture (ie tongue up) is the key here. Your child is likely using their dummy or thumb because their tongue is not providing the right stimulation. Behind the upper front teeth is an area called the incisive papilla. This area has nerve endings which, when stimulated by the tongue, leads to release of relaxing chemicals like serotonin and dopamine. If the tongue is not resting up, then children (and some adults too) find ways to compensate, ie the thumb.
Chewing is comforting too. If we consider ourselves as adults for a minute, who of us have been involved in emotional eating from time to time? Chewing is satisfying, chewing promotes brain function. Chewing is a positive oral stimulus and actually positive for normal growth and development. Successful sucking elimination can be helped by substituting with chewing, biting and proper swallowing activities.
For Those Who Are Strong Willed
This might indicate a wider issue worth exploring. There are occasional instances where persistent night time sucking is a symptom of an airway issue. If a child has an airway obstruction such as enlarged tonsils or adenoids, it is possible that a thumb or dummy could be helping your child breathe and maintain a patent airway. This is not all cases but one at least worth considering if you’re struggling with elimination. Interestingly, tonsil and adenoid enlargement doesn’t necessarily mean infection or pain and this can go unnoticed. It doesn’t matter what age we are, we are driven by the need to breathe. If there is an airway issue linked to the habit that is helping your child breathe, their attachment will be stronger than ever. These cases may need to see an Ear, Nose and Throat Specialist or Sleep Specialist for more information. Other red flags to consider in these instances might include snoring, mouth breathing, constant snotty nose, chewing on clothes or collars, excessive drooling, delayed speech, difficulties with swallowing.
We have different approaches depending on the age but we will always start with an airway assessment to rule out any medical concerns. Depending on the child’s age, we start to implement activities that help develop healthy movement away from sucking toward more mature drinking, swallowing, chewing and of course, nasal breathing. Older children who are already moving in more mature ways sometimes need a focused strategy and we have this too. We have a structured thumb sucking cessation program for our kiddos who are over 5 years. Please know there is professional help out there and you don’t have to do it alone.