Thumbs, Fingers, and Pacifiers

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All babies are born with the need to
suck. This is important because babies need the sucking reflex to eat and drink.
Sucking for some babies also can have a soothing and calming effect. However,
when does sucking become a problem? Read on for information from the American
Academy of Pediatrics about pacifiers, when pacifier use and thumb and finger
sucking could become a problem, and how to help your child stop pacifier use or
thumb or finger sucking.

What do I need to know before offering a pacifier?

If your baby wants to suck beyond what nursing
or bottle-feeding provides, a pacifier may satisfy that need. Before offering a
pacifier, keep the following tips in mind:

  • Offer a pacifier at nap time and
    bedtime. This helps to reduce the risk of sudden infant death syndrome
    (SIDS). If you are breastfeeding, wait until breastfeeding is going well
    before offering a pacifier. This usually takes about 3 to 4 weeks.

  • Do not use a pacifier to replace or
    delay meals. Only offer it when you are sure your baby is not

  • Do not force your baby to take the
    pacifier if he doesn’t want it.

  • Never tie a pacifier to your
    child’s crib or around your child’s neck or hand. This is
    very dangerous and could cause serious injury or even death.

  • Be prepared for night waking. If your
    child depends on a pacifier to fall asleep at night, he may wake up when
    the pacifier falls out. If you child is too young to put it back in his
    mouth or can’t find or reach it if it has fallen out of the crib,
    you may need to wake up and get it for him.

What should I keep in mind when shopping for a pacifier?

  • Pacifiers come in different sizes. You
    will also find a variety of nipple shapes, from squarish
    “orthodontic” versions to the standard bottle type. Try
    different kinds until you find the one your baby prefers.

  • Look for a 1-piece model that has a soft
    nipple (some models can break into 2 pieces).

  • The shield should be at least
    11/2 inches across so a baby cannot put the
    entire paci­fier into her mouth. Also, the shield should be made
    of firm plastic with airholes.

  • Make sure the pacifier is
    dishwasher-safe. Follow the instructions on the pacifier and boil it or
    run it through the dishwasher before your baby uses it. Be sure to
    squeeze the water out of the nipple with clean hands; otherwise, the hot
    water inside might burn your baby’s mouth. Clean it this way
    frequently until your baby is 6 months old so that your infant is not
    exposed to germs. After that you can just wash it with soap and rinse it
    in clear water.

  • Buy some extras. Pacifiers have a way of
    getting lost or falling on the floor or street when you need them

  • Do not use the nipple from a baby bottle
    as a pacifier. If the baby sucks hard, the nipple may pop out of the
    ring and choke her.

  • Pacifiers fall apart over time. Some
    manufacturers have expiration dates for pacifiers. Do not keep pacifiers
    past that time. Inspect them every once in a while to see whether the
    rubber has changed color or has torn. If so, replace them.

When do pacifier use and thumb and finger sucking become a problem?

If your child sucks strongly on a pacifier or
his thumb or fingers beyond 2 to 4 years of age, this behavior may affect the
shape of his mouth or how his teeth are lining up. If your child stops sucking
on a pacifier or his thumb or fingers before his permanent front teeth come in,
there’s a good chance his bite will correct itself. However, if the bite
does not correct itself and the upper adult teeth are sticking out, orthodontic
treatment may be needed to realign the teeth and help prevent broken front

How can I help my child stop her pacifier use or thumb- or finger-sucking

As a first step in dealing with your
child’s sucking habits, ignore them! Most often, they will stop on their
own. Harsh words, teasing, or punishment may upset your child and is not an
effective way to get rid of habits. Instead, try the following:

  • Praise and reward your child when she
    does not suck her thumb or use the pacifier. Star charts, daily rewards,
    and gentle reminders, especially during the day, are also very

  • If your child uses sucking to relieve
    boredom, keep her hands busy or distract her with things she finds

  • If you see changes in the roof of your
    child’s mouth (palate) or in the way the teeth are lining up,
    talk with your pediatrician or pediatric dentist. There are devices that
    can be put in the mouth that make it uncomfortable to suck on a finger
    or thumb.

  • No matter what method you try, be sure
    to explain it to your child. If it makes your child afraid or tense,
    stop it at once.

The good news is that most children stop their
sucking habits before they get very far in school. This is because of peer
pressure. While your child might still use sucking as a way of going to sleep or
calming down when upset, this is usually done in private and is not harmful.
Putting too much pressure on your child to stop may cause more harm than good.
Be assured your child will eventually stop the habit on her own.