Many infants calm and entertain themselves by sucking on a thumb or finger (digit). Children usually give up digit sucking during the toddler or preschool years, but some continue it well beyond early childhood. When digit sucking persists into school years, it can interfere with proper development of the teeth, mouth, and jaw and lead to speech distortion, learning difficulties, and social rejection. The longer the habit continues the harder it is to break. If your child is older than 5 years of age and still sucks a thumb or finger, you can help eliminate the habit:

Choose the right time. To give up digit sucking, your child must be mature enough to understand why you want him to quit and to practice self-control. Most 5-year-olds are mature enough to take on the task of quitting; preschoolers, no matter how bright and articulate, are not. Trying to get a preschooler to give up thumb sucking will likely lead to repeated relapses, frustration, conflict, and resistance. It may even make the habit worse as the child seeks comfort through increased sucking.
Choose a time to break the habit when you and your child are not experiencing excessive stress or change in your lives—such as the arrival of a new sibling, a family move, or starting a new school. Children use digit sucking to relieve stress, and trying to quit during a stressful time increases the chances of failure.

Motivate your child. Before your child can give up digit sucking, she must want to quit. To help get her commitment:

• Let her know that you love her unconditionally and that you want to help her out of concern for her well-being.
• Show her with a mirror what digit sucking is doing to the teeth, and point out calluses or crooked fingers that are related to the habit.
• Discuss any speech problems that may make it hard for others to understand her.
• Talk about the unhealthy aspects of putting a finger or thumb with "germs" on it into the mouth.
• Discuss hurtful comments made by others about the digit sucking.

Introduce reminders, such as a bandage on the finger or thumb, as special "helpers" (never penalties) to let your child know when the finger is trying to "sneak into the mouth." Character bandages work well as daytime reminders. Help your child place the bandage comfortably on the top of the finger or thumb.

Take steps to promote success. To increase the chances of immediate success and encourage your child to persevere:

• Be available (especially during the first two or three days), consistent, patient, and focused on helping the child in a positive way. Don't force her to comply. The habit belongs to her, and she must be willing to cooperate if it is to be eliminated.
• Plan activities to occupy the child's hands (drawing, craft projects, puzzles, games), especially during the first several days when you are trying to break down the hand-to-mouth habit.
• Be aware of situations in which the reminder bandage could come off the thumb or finger (such as handwashing) and offer to help replace it without being critical or intrusive.
• Avoid situations that stimulate digit sucking, such as excessive fatigue, hunger, television watching, and conflict. Most children suck their thumbs unconsciously, especially when watching television. Limit TV time and place a small table in front of your child with toys, crafts, or art materials to occupy her hands while she is watching.
• Offer plenty of empathy, encouragement, and praise for your child's efforts.

A hand puppet made out of a cotton tube sock or glove can be placed on your child's hand as a nighttime reminder. Fasten it securely or sew it to your child's pajama top to prevent it from coming off during sleep. Emphasize to your child that digit sucking that occurs during sleep is not her fault because "that old finger just sneaks in." Explain that if the sucking continues during sleep, the habit won't go away.

Resort to chemical warfare if necessary.   Thumbz and Stops-It are two names (there are other brands also) of OTC thumbsucking remedies available at drug stores.  Basically, these are nasty-tasting compounds in a resin that does not wash off easily when applied to the thumb or finger.  This method might cause some frustration for your child, but studies have shown that it does work most of the time.

Adapted from Contemporary Pediatrics. 18:6, June 2001