Thumb Sucking and Pacifier Use in Toddlers

Many parents dread the day they need to put the pacifier away or discourage thumb- sucking. Certainly all children need to be able to soothe themselves and oral habits are just one of the many ways they are able to accomplish this. When should you extinguish this behavior and how do you accomplish this without turning your life upside down?

Regardless of the oral habit, one needs to consider frequency (how often throughout the day they do they use their oral habit), intensity (do they create a significant amount of pressure in their mouth when they suck?) and duration (do they aggressively suck all night or does their thumb/pacifier fall out shortly after they fall asleep?). Before the age of two years, parents should be mindful of beginning to wean their toddler from both pacifiers and thumb sucking. Both of these oral habits can cause some long term problems for children.

  1. Prolonged use can interfere with dentition and result in an open bite.

  2. It can interfere with development of a mature swallow pattern- a reverse or tongue thrust swallow pattern persists which results in additional atypical pressure on dentition and also creates articulation problems later on (i.e. lisp etc.)

  3. It interferes with development of more refined tongue muscle movement and coordination which can also interfere with later articulation development.

  4. It can interfere with your child’s resting mouth posture; your child may develop a weak and pronounced lower lip with a more taut upper lip and begin to exhibit oral breathing instead of nose breathing patterns at rest.

  5. Your child’s expressive language ability may be slowed- they simplify and shorten their expressive speech to accommodate being understood with a pacifier or thumb in their mouth.

  6. Social stigmas related to an older child with oral habits- they may be perceived as less mature, shy or insecure by others.

Resource: Marshalla, Pamela. “How to Stop Thumb sucking and other Oral Habits”, Marshalla Speech and Language, 2004

Extinguishing oral habits can be very difficult for both the child and everyone else around them. It takes patience and time. Many parents postpone this process simply because they know it will cause turmoil for everyone in their household. A few tips to facilitate the process are:

  1. Try to do it when there is some stability in your routine for a period of at least a couple of weeks. Do not try to do it right before a trip or a move.

  2. Talk to your child about when it is a good time to use the pacifier or thumb- start by identifying some times during the day as designated quiet time for using it. During “off” times, plan activities that will keep your child’s hands busy (play-dough) versus more passive activities where they may be more inclined to want their thumb/pacifier.

  3. Sometimes putting a colorful band-aid on thumb as a reminder for an older child helps. Having the child wear a glove during the night can also help. Using lotions or sprays on their hands may discourage it because of the bad taste (there are products developed specifically for this).

  4. Plan a celebration and let your child help in the planning for the day when the thumb sucking or pacifier is officially done.

  5. Let your child decorate a special box for disposal or permanent storage of the pacifiers. Having a designated special place for them versus throwing them in the garbage is helpful, after all this was a cherished possession of your child’s.

What to do when it’s gone on too long…consult with your child’s dentist to determine the impact on dentition and bite and get follow up recommendations. If your preschool child appears to push his/her tongue forward when he/she swallows or eats, they should be evaluated for tongue thrust by a Speech and Language Pathologist. Elimination of the oral habits and tongue thrust pattern is necessary to correct dental and bite patterns as well as some articulation errors.

Lowry Speech Therapy (303) 360-0727