February 1, 2024

Thumb Sucking: When to Worry

For the first two years of life, thumb sucking should not be a cause for worry. However, problems can occur when thumb sucking persists past age two.

Is your child a thumb sucker? Rest assured that most thumb sucking behaviors are normal. Infants can turn to thumbs or pacifiers as a great way to self-sooth. For the first two years of life, thumb sucking should not be a cause for worry. However, problems can occur when thumb sucking persists past age two.

The following issues can arise from thumb sucking past the age of two:

  • Oral musculature malformation could be a potential side effect of persistent thumb sucking.
  • Incorrect tongue placement and teeth can form into an open bite.
  • Tongue thrust is another potentially harmful side effect of thumb sucking.
  • Common sounds affected by incorrect tongue placement are /s,z,t,d,n,l/.
  • Tongue thrust is a normal part of a pediatric swallowing pattern but should be replaced gradually by a mature swallow. Thumb sucking may affect the maturation of tongue patterns during swallowing.

If you suspect any of these problems, a family dentist can help to determine if the use of the pacifier or thumb is causing structural problems in the teeth or closing of the mouth.

What can you do about thumb sucking?

  • Try and determine when, where and why your child is in need of soothing.
  • Search for the root of the behavior i.e. Is she tired? Is she upset? Does she only suck when holding a certain stuffed animal?
  • Exchange thumbs for a small sensory object or sugar free gum (if the child is old enough).
  • EXPLAIN to your child that thumb sucking can be harmful to her body.
  • Praise praise praise your child when she chooses not to suck her thumb.
  • Give your child praise frequently, randomly, and in small increments for being “thumb free”.
  • Expect to take one step forward and two steps back when weaning thumb sucking!

Download our Guide for Families

We know that choosing a local ABA facility can be a hard decision. We’ve created an informational guide to help you understand more about the questions you should be asking while meeting with different providers.

Although we talk about our services here, our highest goal is for you to feel comfortable and knowledgeable about picking a provider that is the best fit for your needs. You are making a decision that will impact the entire trajectory of your child’s life!
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The cover of the NSPT Guide for Families, which helps families to figure out the questions to ask when picking an ABA provider.

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Our infant daughter was in physical therapy with Anna Zahn for about five months.  Anna was consistent, patient, and wonderful with our daughter.  Anna was also clear in her communications with us as parents which helped us understand our daughter's progress and needs, as well as how we could help our daughter at home.  While we are proud that our daughter graduated PT, we will miss Anna's warmth and kindness.

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I cannot say enough nice things about the staff! My son worked with Khadija as his ABA therapist and is finishing up this week with his OT, Sabrina. They were really instrumental in helping us navigate a new diagnosis. Both were so easy to approach with questions. From Leeann at the front desk to the RBTs (Alex, Rabbia, Molly, and many others), we always felt so welcomed. It seems like the staff genuinely enjoy their jobs, consistently offering feedback and suggestions on how to help my son.

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We have been working with the amazing team at NSPT for many years. They have been essential in understanding and supporting our child. I recommend their services to anyone looking for their specific type of support.Posted to

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NSPT is fantastic! All of the staff are wonderful, accomodating, and make you feel welcome and comfortable. Alan is fantastic - he has helped our family tremendously and has such patience and purpose in everything he does.

Alex Ehrhardt

North Shore Pediatric Therapy has been amazing.  They have done a great job adjusting to the specific needs of my autistic child.

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