Tuesday, February 1, 2011

Thumbs Up!

Two nights ago Adeleine found her thumb. I'm thrilled! But at the same time, I know it will ignite once again the great thumb sucking debate. Everyone (even strangers!) seems to have an opinion on the thumb vs pacifier. Sometimes people have very strong opinions on how you should raise your kid, grounded in culture, in tradition, in science and some even in myth. In general, this is my advice for new moms who are receiving well-meaning advice from everyone and the mail man: accept it graciously, then do your own research, form your own opinions and go with what your gut tells you. You know what is best for your child (remember the Mother's Instinct?).

I thought I'd share some of the research I've uncovered on thumbs and what I've found from my experience with Liam & Adeleine. Again, this is just our experience, I won't be insulted (in fact I'd be thrilled!) if you totally ignore this, do your own research and go with your gut! But, hey, it's here if you are interested in what goes on in our house...

So, thumbs vs pacifier. Who would have thought a little appendage could get people so riled up? Here are the reasons we are pro-thumb and some links to the research behind it:

Pacifiers can interfere with the cues for feeding.  A wonderful lactation consultant at Mt Sinai in Toronto told us this secret: Babies do three things to indicate they are hungry BEFORE they begin to cry. If you catch them doing any one of these, you can pop a nipple in their mouth before a single tear is shed: opening and closing mouth, sticking out tongue, putting hands in mouth. If a pacifier is in their mouth, you won't see any of these, but eventually you'll hear a cry. Crying is a late-stage or last-resort sign of hunger. People used to marvel at how Liam hardly ever cried. Well, part of that was because he was just an easy going baby (same with Adeleine - yay!), but part of it was also because I never let him get so hungry he would cry. If that kid put one hand in his mouth and began to suck it, on the boob he'd go and have a good meal. 

Pacifiers can interfere with the development of a good latch for breastfeeding. Babies don't usually find their thumbs until about 2 or 3 months. If you are breastfeeding, it is recommended that pacifiers (or other nipples) not be introduced until breastfeeding and a good latch are well established (about 6-8 weeks).  Pacifiers (and bottle nipples) have a completely different shape than a mother's nipple and as a result, require a completely different sucking pattern. This can sometimes make it more difficult to get a good latch, since the baby is not used to opening their mouth as wide and working with their tongue to get the flow going.  Some babies (because they are smart!) discover that bottle feeding is easier (don't have to work as hard!) so they will begin to prefer the bottle over the breast.  This is sometimes referred to as nipple confusion, but it's not the baby who's confused! They know exactly what they want! Who could blame them, fast easy flow vs suck suck suck, if I was tired and hungry I'd go for the bottle too! Dr. Newman (the breastfeeding guru) addresses this in his information article here.  Also there is a great article from La Leche League here
 and KellyMom here.

Thumbs are used for self-soothing, creating independence for the child. Thumbs are always right there, they never get lost and babies can easily find them in the middle of the night. The ability for a child to soothe themselves when they awaken or are anxious is priceless (thank you Adeleine for 10 hours of sleep the other night, I needed that).

Children will naturally grow out of thumb-sucking habit.  No, you can't throw out a thumb. I've never found that saying very nice, I always picture parents holding dismembered thumbs over a garbage can. Anyway, people are convinced that because you can get rid of a pacifier by throwing it away it's better for the kid's teeth. Everyone seems to worry that children will suck their thumb forever, when in reality, few children suck their thumb long enough to do any damage to their teeth or palate. The American Dental Association says thumbsucking will cause problems if they continue after their permanent teeth come in. Most kids stop spontaneously much earlier, between 2 and 4 years old, as they learn other methods for self-soothing.  Liam stopped all on his own at 12 months. Here is an article on thumbsucking from BabyCenter. 

Preemies and Pacifiers
Some of you will wonder why, if I'm so pro-thumb, Adeleine had a pacifier in the NICU.  Well, as for much of what I learned with Liam (my term-baby), it doesn't apply to preemies. Having a preemie is like starting from scratch and re-learning all you thought you knew.
There are a few reasons why Adeleine had a special preemie pacifier in the NICU (and I was never happy about any of them, but hey, I wasn't happy about her being in the NICU at all, so what are you going to do):
Self soothing was impossible. She was swaddled to mimic the comfort of the womb, and while her hands were often at her face it was difficult to move them. Also, her favourite position was on her belly and she didn't have the strength to pull her hands to her mouth since they were often so weighed down with IV's and splints.
She needed to learn to suck. Normally this would have happened in the womb, with free hands floating in a sea of amniotic fluid, easily brought to mouth. Yeah, not the case in the NICU. She needed to work those sucking muscles in order to be able to eat later on.
Pain-management. Amazingly, one of the best ways of treating pain in infants is to give them a soother coated with sucrose. She would have this during difficult procedures like needle sticks or eye exams.

She was never a big sucker on the pacifier in the hospital, since she had a bit of an oral aversion (ok, she HATED the bottle).  So when we got home, the soother went on the dresser and never moved.  Once when she was really crying (she had bad reflux during the first two weeks home) I tried to give it to her. She spit it back at me. That's my girl.

Finally, Dr Sears has a good, well-balanced article on thumbsucking and pacifier use here. He's so reasonable and informed. I love him. 

So that's my thoughts on the topic, I just love the thumb and I'm glad Adeleine found hers.

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