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 you are here: Article 7 Toddler Nail Biting
TODDLER BITES HER NAILS.
Contemporary Pediatrics . Dec 1999 v16 i12 p34.
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Q: An 18-month-old in my practice recently began biting her fingernails. She has not used a pacifier nor has she sucked her thumb or fingers in the past. Mom notes that the nail biting started shortly after she weaned the child. The infant's development is otherwise normal. She tends to bite her nails when she is tired or bored.
Ronda Dennis-Smithart, MD
Oskaloosa, IA
A: Since nail biting is uncommon among toddlers, we don't have much empirical information to guide us. Extrapolating from what we know about nail biting in older children, however, allows us to draw some conclusions.
To determine why the child is biting her nails, it would be helpful to know how frequently and aggressively she engages in this habit and how long she has been doing it. What remedies have the parents tried and what have been the results? Are there circumstances in the child's life that would cause anxiety or stress? Did the child find weaning difficult? Could the child be imitating someone with whom she is in daily contact, such as a parent?
I suggest proposing to the parents the following management strategies:
* Ignore the problem. This probably is best, but also consider praising the child when she does not bite her nails at a time when she might be expected to.
* Find other things for the child to do when she is tired or bored.
* Avoid more vigorous interventions. Punishment, nagging, or painting the fingers with bitter substances is likely to be ineffective at best and counterproductive at worst. Habit reversal techniques, appropriate for older children, are not suitable for a toddler. If infection is present or the skin surrounding the nail is bleeding--a rare situation--temporary use of a protective dressing should be helpful.
William B. Carey, MD
Philadelphia, PA
DR. CAREY is Clinical Professor of Pediatrics, University of Pennsylvania School of Medicine, and Director of Behavioral Pediatrics; Division of General Pediatrics, Children's Hospital of Philadelphia.
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