Some parents struggle with ending pacifier use and thumb-sucking in children, poll suggests

Pacifiers and thumb-sucking can help soothe babies and ease them to sleep but some parents struggle with knowing when and how to stop these habits, a new national poll suggests.

About half of parents say their child currently or previously used a pacifier while a quarter say their child sucked their thumb or fingers, according to the University of Michigan Health C.S. Mott Children's Hospital National Poll on Children's Health.

Experts point to many benefits of pacifier use and thumb-sucking, with the American Academy of Pediatrics recommending offering pacifiers during sleep to help reduce the risk of sudden infant death syndrome, or SIDS.

But some parents polled feel they waited too long to stop the behaviors.

For newborns, sucking is a natural reflex that they use for feeding and can help them calm themselves as they adjust to stressors in their environment."

Susan Woolford, M.D., pediatrician at U-M Health C.S. Mott Children's Hospital and co-director of the Mott Poll

"Pacifiers and thumb-sucking can be lifesaving by reducing the risk of SIDS but their use should be short-lived, as the benefits of these self-soothing techniques decrease as babies get older. Prolonged thumb-sucking or pacifier use may impact dental health and possibly speech development."

To reduce potential long-term effects-such as misalignment of teeth or changes to the shape of the mouth-some experts recommend phasing out these habits as early as six months of age.

When and how to end pacifier use or thumb-sucking

Parents say their children most commonly turned to pacifiers or thumb-sucking at bedtime, naptime, or when stressed or fussy. Yet the habits extended into other moments as well: one in 10 pacifier users and nearly a quarter of thumb-suckers relied on the habit while watching TV or videos. About 18% of parents say their child used the pacifier almost constantly.

"These self-soothing behaviors are a natural part of early development," Woolford said. "But when they persist beyond the toddler years or start interfering with daily routines, it can signal a child is seeking comfort in the absence of other coping tools."

More than half of parents believe the ideal age to stop thumb-sucking or pacifier use is before two years old. While many children quit these behaviors on their own, parents may sometimes need to intervene, Woolford says.

Parents report a variety of strategies to break the habits. Common methods to reduce pacifier use include limiting it to bedtime, hiding or "losing" the pacifier, telling the child they're too old for one, or removing it when the child is distracted. One in 10 parents say they even cut a hole in the pacifier's nipple to make it less appealing.

Among parents of thumb-suckers, 18% gave their child a stuffed animal to hold instead while one in 11 applied deterrents like hot sauce, Vaseline, or mittens to discourage the behavior.

Woolford recommends parents adjust strategies to stop pacifier use or thumb-sucking based on the child's age, temperament, and how and when they use the pacifier. Some children can be convinced that they are getting too big for the pacifier, perhaps by reading a book or watching a video about the topic, she says, while other children may be motivated by stickers or other small rewards.

She adds that some children may need to be phased out of pacifiers, starting with limiting use to certain situations. But others may be able to make a clean break, perhaps by having the "pacifier fairy" take it away, so the child knows it's no longer there.

Substituting a stuffed animal or soft doll may also provide an alternate self-soothing option for the child, she says.

"As children get older, parents should encourage them to rely less on pacifiers and thumb-sucking for comfort and develop other strategies to self soothe," Woolford said.

"Parents should recognize that this may be an emotional transition for their child, and approach it with kindness and patience."