Habits

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What causes habits?
Comforters 
Head-banging and rocking
Breath holding
Nose picking
Teeth grinding
Nail biting
Hair pulling
Cough
Masturbation
Tics 

Habits may have an identifiable cause. Sometimes dealing with the underlying reason will bring about a change. Sometimes habits are behaviours that started for one reason, but are continuing even though the reason has now gone.

Sometimes a particular habit is normal for a child of a certain age, and she will naturally grow out of it. Making a child worry about a habit, by continually trying to change it, may make it last longer.

What causes habits?

Some habits start because they are normal behaviours for young children that help them feel calm.

• For example, sucking is very calming for a baby. When a child is older, sucking can still be calming, so sucking on a dummy or a thumb can help a child feel safer in new situations.
• However, many children suck a dummy or their thumb when they are tired, unhappy or bored. It is not necessarily stress, but a habit. Older children may suck a pencil, or later, a cigarette.
• At times of stress, the habitual behaviour may become more obvious.
• A two-year-old who had almost stopped sucking her dummy during the day may want to suck on it much more when a new baby comes into the family.
• When the child is feeling more confident again, she will usually be able to let go of her dummy.

If a child is unable to control a habit by an age at which most children have stopped, this may be a sign that she is experiencing more stress than she is able to manage easily. However, many habits continue even when there is no sign of stress (nail biting is an example of a habit that often goes on, even when everything else seems to be going well for a child).

Starting a new habit may also be triggered by some stress in the child's life.

However, it is very important to remember that many things that cause some stress cannot be changed, and a child's habit may be a way of coping until she is a little more confident.

Comforters

• Young children may suck on a dummy or their thumb, or may want to hold a special piece of blanket or a toy when they need comfort, e.g. at bedtime, or in new situations (sometimes this is a lot of the time when they are about 1-2 years of age). Having a comforter is one of the ways children use to stay calm while learning how to manage without a parent always being there to look after them.
• Often children stop needing their comforters during the daytime by about four years of age, when they feel more secure in the world. They may still want a special toy or blanket to hold when going to sleep.
• It is not helpful to take away children's comforters while they still need them (especially when they are one or two years old) because it can make them more anxious and upset.

Head-banging and rocking

Rhythmic movements such as head-banging (on the side of a cot or bed), rocking, or rolling from side to side for a while before going to sleep (at night and during the day) are very common behaviours that seem to be calming to many young children from about nine months to about four years of age – even though it seems that hitting your head would hurt. Often older babies will also make some rhythmic noise such as humming or chanting.

The child’s development is almost always normal, but if rocking or head-banging happens often during the daytime too, there may be some developmental problem. Sometimes head-banging or rocking may start due to an ear infection, but usually the child is well. A child who is head-banging or rocking more than usual may be stressed, so it is worth considering what could be causing the stress.

Usually children don't harm themselves with head-banging (other than a few bruises) but if head-banging or rocking happen so much that they interfere with your child's play or going to sleep, it needs to be treated seriously. Have a check with your doctor.

What you can do for head-banging

• If your child is head-banging or rocking for only a short time before going to sleep, and the behaviours are not happening during the rest of the day, there is no need to do anything differently.
• If it happens often, lasts longer or has started suddenly, have a check with your doctor to make sure there is no underlying health or developmental problem.
• Even when they bang their heads quite hard, children do not seem to be hurt, or distressed by any pain. Padding of the bed end is probably not needed. Padding or bumpers in cots are usually not recommended because of the small risk of a child getting trapped so that she cannot breathe.
• Reducing the noise by moving the cot away from the wall or tightening screws can help.
• Scolding and punishment never help.
• It is not clear whether going to your child, picking her up and comforting her, patting or rubbing her head is of any help, because they may ‘reward’ the behaviour – but they also distract the child, and may help her go to sleep without the need to rock or bang her head.
• Try some different soothing routines before bedtime, and do not put your child down to sleep until she is really ready to sleep.

Remember, head-banging and rocking will usually stop without any change to the way you put your child to sleep.

Breath holding

Breath holding is common. There are two types: one where the child stops breathing and goes blue (cyanotic); and the other, less common, where the child goes pale (pallid). Breath holding is rare before six months of age, happens more often up to about two years of age, then is usually gone by the age of five years. Breath holding is not caused by any health problems, and does not cause any health problems.

Cyanotic breath holding happens when a child is angry or frustrated.

• She will usually give a short cry, breathe out, stop breathing, become blue very quickly, unconscious and floppy. She may have a few muscle twitches (similar to a fit).
• Within a minute or so she will start breathing again and recover fully.
• Although it is scary to watch, no treatment is needed (you do not need to do mouth-to-mouth resuscitation or splash her with water).
• Make sure that onlookers know what is happening and that they understand she will be alright.
• You should check with your doctor to make sure this is only a breath holding spell.
• When she has recovered, do not give her extra attention, as this 'rewards' a breath holding spell. But also, do not punish her – she is not old enough to understand what is happening.
• Remember that breath holding is scary for you, but it will not hurt your child, and it is important not to always ‘give in’ to a child to avoid it happening.

Pallid breath holding usually happens when a child is hurt or startled.

• Usually she will stop breathing, become pale, floppy and unconscious. She may have a few muscle twitches.
• Again, she will quickly recover without treatment.

Nose picking

Nose picking is something that most children do (and many adults too!) and something that parents often find difficult and frustrating to deal with.

• Children usually pick their nose to remove dried mucus that is irritating them, or because their nose is itchy.
• There are no health problems from nose picking, except occasional nose bleeds or sometimes spread of germs from the nose to other parts of the body (such as with school sores).
• Most children stop doing it, at least in public, as they grow older and learn that it is not something that is approved of. Sometimes it may continue, either because of continued irritation or because of other stresses in a child's life.

What you can do about nose picking

• Continually focusing on it or getting cross with your child is likely to make her anxious and make it worse.
• Gentle reminders should help your child to remember gradually that it is not OK to do in public.
• Teach your child how to use a tissue to clean her nose, and make sure there is always a tissue handy.
• Using petroleum jelly to soften the mucus will help if your child's nose is uncomfortable.
• Parents can feel embarrassed if their children do this in public. A quick request for the child to hold something for you can sometimes avoid this, or, if the child is older, a secret signal between the two of you to remind her that she is doing it.

Teeth grinding

Almost everyone grinds their teeth or clenches their jaw at night at some time, and a few have problems such as:

• damage to teeth surfaces, causing sensitive teeth
• tight muscles causing headaches.

About 50% of babies grind their teeth when they are teething. This will probably stop happening before the child is two years old. It can happen more often when children and adults are stressed.

What you can do about teeth grinding

• Because this happens during sleep, the behaviour cannot be changed by rewards or punishments.
• Do not criticise your child or wake her up to stop her doing it. This is likely to make it worse.
• Make sure that bedtime routines are relaxing, so that your child goes to sleep feeling relaxed.
• Think about what is happening in your child's world and try to remove any stresses that could be worrying your child.
• If it continues or is severe, have a check with your dentist. If the teeth are being damaged or an older child is having headaches, a type of mouth guard may be recommended.

Nail biting

Many children and adults bite their nails. It usually starts in the toddler years and often continues into adolescence and adulthood (about one in five university students still bite their nails). If it is severe, it can cause bleeding and infection, but generally it does not cause any health problems. Children with flaky nails seem to be more likely to bite them.

What you can do about nail biting

• Stopping nail biting can be very hard. Continually reminding and criticising your child is likely to make it worse.
• Sometimes putting mittens on your child at night may help.
• Giving the child something else to do with her hands when relaxing or watching TV may help.
• Give your child encouragement and praise for small successes.
• Giving special nail care for older children, e.g. manicures and nail varnish, may sometimes help.
• Some people find that bitter paint on nails helps, but this can be very unpleasant for a child, and often does not work.
• Try to remove any stresses that could be worrying your child, if this is possible.
• Try to help your child not to feel ashamed if she has tried to stop but occasionally forgets and bites her nails.

Hair pulling

Some children pull, twist, stroke or twirl their hair when they are tired or need some comfort. They may suck their thumb at the same time. Sometimes older children continue this behaviour and it can cause obvious bald spots.

What you can do about hair pulling

• If there is hair loss, have a check with your doctor to make sure it is not being caused by any health problem.
• For children under three or so it is best to ignore it, as they will usually ‘grow out of it’ about the time they give up other comfort activities such as the dummy.
• Drawing attention to it and criticising your child is likely to make it worse. It makes the child worried about it and then she will need the comfort it gives even more.
• Try to remove any stresses that could be worrying your child.
• For older children, special hair care and attention to attractive hair styles may help (short hair is harder to pull out than long hair).
• When you notice it happening, do something else such as gentle scalp massage to help your child to relax.

Cough

• A cough that lasts for many weeks is likely to be due to a physical problem such as asthma, post nasal drip or rhinitis (hay fever).
• Sometimes a cough that starts with a cold or other physical cause can develop into a habit.
• Habit coughs are different from an ordinary cough; they may occur as a single cough, quieter or louder, or more obvious.
• Have your child checked by a doctor to make sure there is no lingering physical problem.
• Try not to draw attention to the cough, because this is likely to make it worse.
• Look for causes of stress in your child's life and try to deal with these.
• If your child is old enough, encourage her to talk about any worries. Just knowing that someone is listening and understands often helps.

Masturbation

In early childhood, touching the genitals and masturbation is part of learning about the body, and finding out what feels good. By early school years children have generally learnt that masturbation is done in private.

Tics

Tics are muscle spasms that cause jerky movements, such as blinking, twitching of the face or jerky movements of the arm or shoulder, that seem out of the child's control.

• The movement may start because of discomfort, e.g. blinking a lot may be caused by eyesight problems, and nose twitching may be caused by an allergy.
• A child can usually stop a tic for a short time if asked, but it sometimes comes back when she is not concentrating on stopping it.
• Sometimes tics are caused by health problems such as Tourette syndrome.
• Tics may be triggered by stress in the child's life, e.g. learning difficulties, family problems.
• Tics can be very distressing to a child, and some children with tics are made more unhappy by being teased.
• If there is no underlying health problem, it is important to try to deal with any stress in the child's life.
• Relaxation exercises may help.
• If the tic is very distressing for your child, and it does not go away after a few weeks, seek help from a health counsellor.

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