Habit Cessation: Pacifier, Thumb or Digit(s) Sucking and Tongue Thrusting
This is a tricky subject! A child’s adored habit is challenging to break. The older your child is while continuing their habit, the more dependent a family is on starting an intervention when the child themselves is ready!
The AAP (American Academy of Pediatrics) encourages pacifier removal by age 6 months. The use of a pacifier in the early months is encouraged as a preventive method against SIDS. Since the risk of SIDS greatly decreases starting at 5 months of age, it is encouraged to remove the pacifier to avoid emotional attachments that are challenging to break. Oral habits such as pacifiers, thumb, or digit sucking can also change a child's dental arch development and consequently impact their speech.
Often pacifiers are used to initiate a suckling in preterm babies or newborns struggling with nursing or bottle feeding. There are infant feeding specialists and lactation consultants who are great at advising parents in these situations. Prolonged use of pacifier or digit(s) and tongue thrusting causes alterations in the shape of the roof of the mouth, tongue posture, open bite of the front teeth, an inability for the lips to meet one another for lip closure, and eventual mouth breathing.
All of these lend to abnormal muscle function and tone to our oral motor function and will need retraining of the muscle groups, mostly the tongue, to achieve ideal tone, positioning, and function. Our office is happy to refer to our trusted myofunctional therapists to help families meet all these needs.
Why is Breaking Sucking Habits So Challenging?
So why is breaking a sucking habit so challenging, you ask? Non-nutritive habits such as pacifier or sucking digit(s), provide tremendous endorphin and dopamine releases, providing pleasure and emotional assurance for the child. Previous theories suggested that sensory habits were of a psychological origin, but more recent evidence suggests a neuro-muscular origin. The pacifier or digit touches the roof of the mouth and the sucking pattern that causes the release of these “feel good” endorphins and dopamine hormones. We need ways to separate the digit or pacifier nipple from the palate to disrupt this chemical reaction.
Children can often have a comfy companion during these habits. We suggest that a family be prepared to help a child in breaking the habit through a Habit Elimination Program, often with a myofunctional therapist, through POSITIVE REINFORCEMENTS — this is the key ingredient! Often during these programs, you are including a busy project to keep those little hands busy! A calendar of progress is suggested to mark their successes and reward appropriately. Children respond favorably to positive reinforcement during their habit elimination process.
Find out what your child’s motivation is behind stopping their digit habit! Include a signed contract between one another to do the exercises and motivation between themselves, parents, and your therapist. This support system is hugely effective along with reminders to keep lips closed and “tongue to spot” on the roof of the mouth!
Some families include a verbal cue or hand gesture to encourage cessation if seen in public to avoid embarrassment but gently remind their child. Bedwetting can be seen in children with improper mouth posture/airway concerns with their habits. This therapy helps to address proper oral seal to convert mouth breathing to nasal breathing. Prolonged habits can cause many emotional and self-esteem issues to get to the heart of. Be inspired to be your child’s companion through this voyage and remain a calm emotional support for them. Often your therapist will ask for a phone call daily during the first week to keep motivated. If slip-ups occur, do not become upset with your child, but get them back on track!
Aids to help include:
calendar to mark 21 DAYS OF NO SUCKING!
sock puppet during day/night with same tape mimicking their paper tape
band-aid or digit tape over their preferred fingers (silicone sleeve covers exist as well)
ointments to create a taste aversion with digit
thumb and/or double-digit guards
myo munchee, chewy toys, lip trainers (to help close mouth properly)
If you have any questions related to these topics please contact our team.