Pacifier vs Thumb
Gina DiRenzo-Coffey, M.D.
Boys Town Pediatrics
Is one better than the other?
I really do think it does matter and there are really two big issues. The first is that the thumb does a lot more damage to the palate and to the teeth. The structure of the thumb has a tendency to really push up on the palate, narrow it, and cause the front teeth to buck outward. If you look at kids who suck pacifiers or thumbs long-term, the thumb-suckers have more need for braces or other orthodontic procedures later in life.
The second is it's really cute when a baby sucks the thumb or pacifier, but it's not so cute once they're a preschooler or kindergartner. It's a really hard habit to break. When you have a pacifier, you go cold turkey, you throw them away and they're out of the house and eventually, the problem is resolved.
The problem with the thumb is it's connected to your child. I joke with parents sometimes, you can't chop their thumb off, you get in trouble for that. The reality of it is, to break thumb-sucking is a very hard thing.
How do you encourage the pacifier over the thumb?
Babies are born with an incredible drive to suck, it's necessary for them to get nutrition and a lot of babies use it as a mechanism of soothing. What I typically tell parents is, from the time you bring your baby from the hospital, breastfeeding is established, if they're going for their thumb, pull it out of their mouth and provide the pacifier as a good substitute. Just keep doing that until eventually they accept the pacifier over the thumb.
If it's not just happening and your baby is going to suck their thumb, then they're going to suck their thumb. There isn't much you can do about that. It's a tough situation. It's a benefit on the front end because the sucking of the thumb or pacifier does decrease SIDS and because those babies learn to soothe and settle themselves and become good sleepers. But, ideally if you can avoid it, it's best.
How do you break the habit of thumb-sucking?
They really need to be motivated and want to stop sucking their thumb. If they aren't motivated to do it, it will be very hard to break them of the habit. Behavior modification charts, like a sticker chart, for periods of time gone without sucking their thumb or rewards system, like reading more books at bedtime if they don't suck their thumb. That's a big time when kids suck their thumb, when they're tired, so when you get them into bed and you're sitting and reading books, you tell them, well if you suck your thumb we only read one book, if you don't suck your thumb we'll read three. That somewhat motivates kids because they get more Mom and Dad time and more book time.
When should you wean your child off of a pacifier?
My rule of thumb is after 15 months of age, a baby should only have a pacifier in their crib at naptime and bedtime. It's really important that they not be walking around the house all day with the pacifier in their mouth while they're playing because this is the age where they're learning to talk. If they have the pacifier in their mouth they're going to talk less and they probably will learn to put their tongue in the wrong position and mispronounce words as well.