When should you quit?
The bottle
should be the first thing to give up, between 12 and 18 months. Continuing to
give a bottle at bedtime increases the child’s risk for ear infections and
dental problems. Your toddler should be drinking 16oz-24oz (2-3 cups) of milk
per day. Less than 16oz does not give them enough calcium and vitamin D, but
too much milk can cause iron deficiency anemia and fill up your child,
preventing them from eating other nutritious things.
The pacifier
is usually the next thing to give up, between 1 and 3 years old. It is
important to stop in order to prevent ear infections and poor teeth/ jaw
alignment. The pacifier has also been blamed in some for lisps, and delayed
language development (the child may use it as an excuse to not speak properly).
Thumb
sucking is the hardest to stop, and most pediatricians recommend no
intervention until age 4, since most kids will stop sucking their thumb on
their own before then.
Sleeping
solely in the child’s own bed is a very personal decision, as there is nothing
medically wrong with sharing the bed with a toddler (unlike in infancy, when
you must be careful of how you co-sleep to prevent SIDS). However, teaching
them to sleep on their own is a way to help children learn to self-comfort, as
well as providing the whole family with better sleep.
How Do We Stop?
Some tip for breaking any habit:
(1) Decide if you want to stop the
behavior completely all at once (“cold turkey”), or wean it off gradually
(usually by limiting the activity to bed time).
(2) Do not turn it into a confrontation
with the child. Let them know you are here to help them stop the habit, and why
you want them to stop.
(3) Have them come up with alternative
methods of self-soothing with you. Ask them, “What can you do instead?” Guide
them to choosing something that is reasonable.
(4) Point out that their older siblings,
friends, even characters that they like, do not use a pacifier/ suck their
thumb/etc… and let them know “big kids” don’t do it. Example while watching
Dora The Explorer, “Wow, look what a big girl Dora is! She and Boots have all
these adventures and she doesn’t suck her thumb, even when Swiper comes.” Point
out how much your child has changed/ grown in other ways, and let them know how
proud you are of them.
(5) Do not prohibit them from
self-soothing in high anxiety situations, or when there is a big change (such
as a new sibling being born or a parent going on a business trip).
(6) Make sure they are aware they are
doing it (by pointing it out in a helpful, positive way), and distract them
with something else to do.
(7) Give them an acceptable substitute,
such as a blanky/lovey, small stuffed animal, special new cup, or small cloth
square to keep in their pocket (this last item can be rubbed by the child with
fingers in pocket, especially when substituting for thumb-sucking or nail
biting). Make sure the child is involved in choosing the new item, and knows
why. If you decide on a lovey that your child gets attached to, make sure you
have 3 identical ones in rotation, so one can always be in the wash, one in
use, and one back-up.
(8) Reward charts can be helpful for
children who are age 3 and above (the older, the better). This is a sheet with
calendar spaces for 2 to 4 weeks, with the last space with a pre-determined
prize, such as a trip to a special place (e.g. Disneyland), or special new toy.
The child puts a sticker or X in the space every day that they don’t do the
habit, in some cases only consecutive days of not doing the habit are allowed
to be charted.
The bottle is the most important thing to give
up, for your child’s health. At 12-18 months transition to a sippy cup, then around 21 months transition to a regular cup for meals and snacks (sippy and straw cups
are fine to use when going out). Start by holding the cup for the child, and teaching
them to hold it themselves with very small amounts of water in it (to reduce
spills/ clean up). You can also give gradually less milk in the bottle until
there is none (e.g. decrease the amount of milk in it by 2oz each day).
The pacifier is usually a difficult transition
because of age, and the new toddler’s desire for independence. In addition to
the general tips above, you can also try the following: (1) Give it away to a baby (not the child’s new sibling, since that can lead
to jealousy), or a favorite character (such as on a trip to Disneyland). Make
sure the child participates in the giving away ceremony. (2) Have the pacifier sewn into a stuffed animal (like at one of the Build a
Bear workshops), then the child can sleep with the stuffed animal. (3) Cut a hole in the pacifier, so the sucking action stops working. (4) Make a necklace out of the pacifiers, and hang it on their crib. Let the
child know if they don’t use the pacifiers for a certain amount of time they
get a pre-determined reward. This works well with older children, with a reward
chart.
[Photo of my son while still happily sucking his pacifier at 9 months old (c) ]
Thumb sucking is the hardest habit to break, since
you can’t take away their fingers. For this reason, and since most toddlers
stop thumb sucking on their own, it is recommended to wait until the child is 4
years old before intervening. Peer pressure at that age also helps them try to
stop (at least in public), and they respond better to reasoning. First try all
of the above tips in the general section, especially pointing out when they do
it, distracting them, giving them a substitute, and reward charts. In addition,
you can provide a barrier by tying socks or mittens on their hands (there is no
need to spend money on the fancy devices that do the same thing). Some girls
respond to having a manicure. Other children are better reminded to stop by
placing bandaids on the thumbs. I think bitter nail polish should only be used
as a last resort, since this seems like a punishment to me, and I try to keep
the experience positive, letting the child know that their parent is there to
help them. The key at this age is that they need to want to stop, which means a
lot of discussion in the house about why it is important to stop.
Bedtime is usually a big struggle with
toddlers, so each family needs to decide for themselves how they want to handle
it (pick and choose your battles). If the parents want the bed to themselves,
or simply want the toddler to sleep on his own, the younger you start with
sleep training, the easier it is. If your toddler is getting up in the middle
of the night and coming to your bed, you can firmly, but simply, bring them
back to bed each time. A music box or sleep sheep (white-noise maker) that they
associate with going to sleep can really help (be sure to use this at regular
bedtime and naptime as well). Another option is allowing them to sleep in your
room, but not in your bed, so they feel close to the parent, but not
comfortable. You can put a simple mattress down on the floor, or even just a
blanket. This minimizes the parents waking up, which can be a big help to
everyone. Another option which some people recommend, but which I never use,
because it just seems cruel and unsafe, is to put a baby gate or lock on the
child’s bedroom door, so that they cannot open it and leave their room at
night. Whatever method you choose, or even if you choose to let the child sleep
in your bed, just try to provide minimal attention when they wake up, since you
do not want to reward them for getting up in the middle of the night, and
everyone needs a good night sleep.
