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Thumbs up for dummies? The National, 03.02.3009

From the cradle to the playground, thumb sucking and dummies are a source of comfort and controversy, writes Jo Wadham.

It’s four in the morning. You’ve been pacing the room for what seems like hours, trying to calm your newborn baby. Your sanity is hanging by a thread. Suddenly, out of the corner of your eye, you spy the dummy your mother gave you. You sterilise it and pop it in your baby’s screaming mouth. Five minutes later, he is asleep. It’s a miracle! Or have you just signed up for years of judgemental looks and orthodontic nightmares?

Dummy (or pacifier in America) sucking arouses strong emotions – both for and against. Thumb sucking is often portrayed as natural, but dummies are sometimes considered an altogether more sinister way to “shut up” children. Mothers of thumb suckers would note that at least their children stopped sucking when they played. Research had also suggested that dummy sucking increased the risk of recurrent ear infections, interfered with the establishment of breast-feeding in the early weeks and could affect speech development.

Yet a review by the American Academy of Paediatrics in 2007 found that the overall risk of Sudden Infant Death Syndrome (“cot death”) is reduced by 50 per cent in dummy users. Subsequently, the UK-based Foundation for the Study of Infant Deaths recommended dummy use to parents of newborns (although not forcing them on a reluctant baby), suggesting dummies are used from birth or after one month for breast-fed babies.

And how those mothers of dummy suckers must laugh when the time comes to stop sucking and consider the teeth coming through. It is hard for mothers of thumb suckers to stop their children sucking when the very thing they love is less than a metre away from them.

Christina Ullberg knows this challenge only too well. Ullberg’s son, Tommy, now nearly five years old, was a content newborn, so she had no need for dummies. At five months, he discovered his fingers, and Ullberg says, “he looked so peaceful; I just left him to it”. By the time he had turned four “he had his fingers in his mouth all the time – at school, even during rugby practice.”

Ullberg tried everything. The Stop’n Grow paint-on varnish was easy to apply but it didn’t last, “he worked out the nasty taste was the varnish and as soon as I painted it on, he washed it off”. Next she tried another anti-nail biting formula: varnish with a chilli taste. Unfortunately, he seemed to like the flavour. At her wits’ end, Christina went to the dentist who suggested fitting Tommy with a brace. The brace is lightweight and unobtrusive: it makes it uncomfortable for Tommy to put his fingers in his mouth; and it prevents his sucking creating a vacuum behind his front teeth which can put pressure on his jaw and damage it.

Christina was apprehensive about the brace, but was keen not to saddle Tommy with years of orthodontic work, or even surgery. “At first I thought it was a bit drastic, but he has taken to it straight away. He hasn’t even tried to suck his fingers since,” she says, and the brace will stay until Christina and the dentist are sure the habit has been broken, which could be up to six months.

For dental practitioners though, thumbs and dummies are both bad news for children’s mouths. “Children should have stopped sucking thumbs or pacifiers by the time they are five, because this is when the permanent teeth come in” explains Dr Grace Eid, a specialist paediatric dentist with the Advanced American Dental Centre in Abu Dhabi. When sucking, the teeth and bone move, says Eid. “If the child stops before the age of five, the bone is still growing so it can be auto-corrective to a certain limit, but if not there will be skeletal and dental alteration.”

The first step to correct this is counselling. “We talk to the child to see if there is anything they are particularly worried about,” says Eid, “They seek reassurance in the thumb sucking.” But ultimately, she adds, the child has to take the decision to stop.

Becky Forrest, the mother to Alex, nine, Rowan, six, and Cesaire, four, started using dummies with Alex when he still in the maternity unit. After a toe-curling day of non-stop feeding, Becky sent her husband off to buy one. A more rested and happy mother when she left the hospital, Becky only let Alex use the dummy at night. He stopped using it at two and a half- “Thanks to a strict childminder!” laughs Becky.

When Rowan was born, the couple decided to use a dummy again. But when Becky tried to wean Rowan off the dummy, he started to suck his thumb instead.  Eventually peer pressure made him stop. “I think there is a time with dummies when children do happily give them up because they look babyish.”

Ironically, with her third child, Becky had decided not to give him a dummy after his initial rejection of it as a newborn. But when, aged three weeks, he was diagnosed with meningitis and admitted to hospital, the doctors told her to give him a dummy “so he wouldn’t lose the sucking action”. She persevered and he eventually took it. Now, aged four, she is struggling to get him to give it up.

Excessive dummy use has been criticised for inhibiting speech development. Sarah Booth, a senior speech language therapist at the Rashid Paediatric Therapy Centre in Dubai explains: “Prolonged and frequent use of dummies does have a detrimental impact on children’s communication development.”

This issue is more about missed opportunities to interact and communicate, than a lack of muscle tone or deformed palates. From the age of about six months, children start babbling, exploring how their tongues and lips can make different sounds and learn about communication and social interaction. As Booth points out, “Children can’t initiate a conversation with a dummy stuck in their mouths”.

Booth suggests that, from the age of six months, dummy use should be restricted to “specific purposes at specific times”. Using it for comfort at night or naptimes or at times of distress is fine, but keeping the dummy in for prolonged periods during the day should be avoided.

The benefits of a content child and rested mother are obvious, but the key seems to be regulating this comfort sucking, confining it to sleep times and above all stopping it by the time the child is five.  If you need motivation, watch the 2005 film, Thumbsucker, starring Tilda Swinton, Keanu Reeves and Vince Vaughan, about a 16-year-old boy struggling to give up his habit. I think I’d rather deal with a stroppy five year old.

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