If your toddler is constantly sucking his thumb or popping a pacifier in his mouth, he’s not alone. These habits are normal, calming and originate from the infant’s genetic need to suck. In fact, thumb-sucking begins in the womb, according to the American Academy of Pediatrics (AAP).

So, how do you break a habit that began before your toddler was born?

“It may cause concern to a parent when thumb-sucking or pacifier use changes the shape of the child’s mouth or teeth or continues after he’s 5 years old,” says Dr. Richard Erwin, a pediatrician with Mary Washington Pediatrics in Fredericksburg. “There are a number of ways to help the child stop thumb-sucking or using a pacifier.”

Give rewards

Many toddlers are more apt to stop these habits when a reward is offered for not sucking their thumb or using a pacifier. For an older child who takes measures to stop using a pacifier or thumb-sucking, showing him you noticed helps reinforce new behavior. As a reward, take him for a walk or read a favorite book. The child can mark each success to stop the habit on a calendar designed just for this purpose.

“Some methods I’ve found helpful are gradually limiting the use of the pacifier, exchanging the pacifier for other calming items, such as a sleep blanket, or trading it in for a reward like a toy at the store,” says Erwin. “The child can ‘pay’ for the reward by turning the pacifier over to the cashier. In addition, when the child has a successful night of not using the pacifier, the ‘pacifier fairy’ can deliver a toy under his pillow as a reward.”

Age-appropriate peer pressure

When children are older, a parent may not have to do anything to halt the habit since peer pressure may keep the thumb out of the mouth.
“My daughter used to suck her thumb, but when she was in kindergarten she eventually stopped,” says Renee Jackson, a Fredericksburg mom of three. “She would sometimes suck her thumb around a few friends until it just stopped altogether.”

Phasing out

The AAP says if a baby feels the need to suck beyond what nursing and bottle feeding offers, a pacifier will work to satisfy that need. Once they become toddlers, they may continue the habit before falling asleep or to soothe them between meals.

“I would advise parents not to use a pacifier in place of a meal or when there’s a delay in the regular meal schedule,” said Erwin, who advises parents to step back and observe their child’s use habits first. “Allow the child to determine whether and when to use a pacifier.”

Whether your child is attached to the pacifier or is a habitual thumb-sucker, there are plenty of ways to get him to stop. Rewarding his successes, providing an alternative activity or making an appointment to talk to the dentist or pediatrician are all ways to curb—and eventually break—the habit for good.

Concerned about thumb-sucking or pacifier use?

Visit your child’s pediatrician or pediatric dentist in the following instances:

  • If thumb-sucking or pacifier use affects the shape of the child’s mouth or teeth. It’s wise to ensure teeth are developing correctly. After permanent teeth come in, sucking may interfere with the proper growth of the mouth and alignment of the teeth, as well as cause changes in the roof of the mouth, according to the American Dental Association (ADA).
  • The ADA advises that the intensity of sucking can determine whether dental problems will occur. If a child rests the thumb in his mouth passively, there’s less of a chance for concern. Aggressive thumb-suckers can develop problems with baby teeth.
  • Talk to the doctor if the child is more than 5 years old and is still sucking his thumb or using a pacifier.

Erwin advises to have a discussion with the pediatrician about how and when to begin weaning the child from the pacifier.