Clinical Reference Systems: Pediatric Advisor 10.0
Biting
Description
Biting another child is one of the more unacceptable,
aggressive behaviors in our society. The parent of the
child who has been bitten is usually upset and worried about
the risk of infection. If biting happens in a day care
setting, the other parents may want the biter to be
expelled. If it happens in someone else's home, the child
is often told never to return. Adults tend to forget that
some biting behavior in a group of toddlers is to be
expected.
Causes
Children usually discover biting by chance when they are
about 1 year old and teething. Most children first learn to
bite by biting their parents in a playful manner. It is
important to try to interrupt this primitive behavior at
this early stage. The biting often continues because the
parents initially think it is cute and the child considers
it a game to get attention.
Later, children may bite when they are frustrated and want
something from another child. At an age when children have
minimal verbal skills, biting becomes a primitive form of
communication. Only after a child is 2 or 3 years old does
biting become a deliberate way to express anger and
intimidate others.
Recommendations
- Establish a rule: "We never bite people."
Give your child a reason for the rule, namely that
biting hurts.
Other reasons (that won't interest a young child) are
that bites can lead to infection or scarring.
- Suggest a safe alternative behavior.
Tell your child that if he wants something he should
come to you and ask for help or point to it. He should
not bite the person who has it. If your child bites
when he is angry, tell him, "If you are mad, come to me
and tell me before you bite anyone."
If your child is at the chewing age (usually less than
18 months), help him choose a toy that he can bite
rather than tell him that he cannot bite anything. A
firm toy or teething ring will do. Encourage him to
carry his "chewy" with him for a few days.
- Interrupt biting with a sharp "No."
Be sure to use an unfriendly voice and look your child
straight in the eye. Try to interrupt her when she
looks as if she might bite someone before she actually
does it. Especially close supervision of your child may
be necessary until you are sure she will no longer bite
people.
- Give your child a time-out when he bites people.
Send him to a boring place for approximately one minute
per year of age.
If he tries to bite you while you are holding him, say
"No." Always put him down immediately and walk away (a
form of time-out). If time-out does not work, take away
a favorite toy for the rest of the day.
- Never bite your child for biting someone else.
Biting back will make your child upset that you hurt her
and may teach her that it is okay to bite if you are
bigger. Also do not wash your child's mouth out with
soap, pinch or pop her cheek, or slap her mouth. In
fact, if your child tends to be aggressive, avoid
physical punishment in general (for example, spanking).
Also eliminate "love-bites" because your child will not
understand how they are different from painful biting.
- Praise your child for not biting.
Praise your child especially when he is in situations in
which he used to bite or when he is with children whom
he used to bite. Remind your child gently not to bite
before before you embark on a high-risk visit. Then if
he doesn't bite, praise him afterward for good behavior.
- Biting in child care settings.
Biting behavior is common in child care settings. The
preceding approach should be used by day care staff to
eliminate the behavior in their setting. Provide
careful supervision and quickly place the biting child
in time-out, even when he acts like he might bite
someone. In general biting is harmless since most bites
by younger children don't puncture the skin. Calling
the parent at work is pointless since the problem should
be dealt with immediately by whomever witnesses it.
Prevention
The best time to stop biting behavior from becoming a habit
is when the biting first starts. Be sure that no one laughs
when your child bites and that no one, including older
siblings, treats biting as a game. Also never give in to
your child's demands because of biting. Make sure that day
care providers understand your approach and are willing to
follow it.
Call Your Child's Physician Immediately If:
- Biting causes a puncture or a cut that completely breaks
the skin.
Call Your Child's Physician During Office Hours If:
- Biting behavior lasts for more than 4 weeks after you
have begun using the approach outlined here.
- Your child bites or hurts himself.
- Your child has several other behavioral problems.
- You have other questions or concerns.
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