Childhood Biting

There are many reasons why children bite themselves or others.

• Depending upon the age of the child (birth to 3 years old), biting behaviors may reflect normal (though frustrating) development.
• Toddlers most commonly bite their peers in a response to anger or frustration.
• Socially inappropriate behaviors respond to immediate consequences (such as time-out) and parent/caregiver suggestions for alternative techniques.
• Biting others or self-biting in children over 3 years of age should prompt a visit with the child's pediatrician.

Many behavioral pediatricians report that biting behaviors are a reflection of the developmental and chronological age of the child.

1. Birth to 6 months old: Newborn infants may bite during breastfeeding, either due to neurological immaturity and an overzealous "jaw clench" or occasionally as a learned pattern to slow down the flow of breast milk. A lactation consultant generally can help resolve these issues. While not helping to correct the reason for biting, immediate removal from the breast teaches the infant that his behavior produces an immediate negative result and will also lessen the frequency of his painful behavior.
2. 6-15 months old: Excitement is often the precipitating factor that causes the biting of caregivers of other children in this age range. Biting experiences are generally not painful during this time frame since the child is most often either trying to let off "emotional steam" or attempting to gain attention in a nonverbal way. Such biting is analogous to the "nips" that other animals do when interacting with their littermates.
3. 15-36 months old: Biting behaviors in the toddler age group are a reflection of frustration and anger and are more commonly directed against another child and less frequently against an adult. A firm verbal reprimand (For example, "You are going into 'time-out' because you bit Tommy. We don't bite; it hurts!") is an effective strategy to deal with such socially unacceptable behaviors. Helping the child to express emotions verbally provides an alternative avenue to vent his frustration.
4. Over 3 years old: This age range most commonly bites as a defense mechanism when they are scared (for example, during a schoolyard or sibling fight). This behavior is age inappropriate and counseling is commonly necessary to provide alternative techniques for expressing feelings and self-control.

Developmentally and neurologically healthy children most commonly bite themselves out of frustration coupled with an inability to express emotions by an alternative means. Likewise, such children may bite themselves out of boredom. Generally, such biting behaviors will not purposefully inflict pain or do damage. Working with the child and role-modeling verbal and behavioral ways of expressing his emotions is often helpful. If a toddler demonstrates self-inflicted pain or bodily injury, a consultation with his pediatrician should be arranged. Severe emotional stress or an uncommon neurological condition (such as Lesch-Nyhan syndrome) may be the cause.

Toddlers tend to bite others as a response to anger and/or frustration. Adult supervision should be able to defuse many of the impending situations that might lead to biting behavior (such as when two children want to play with the same toy). Modeling verbal or other more socially accepted behaviors in dealing with frustration and delayed gratification are worthwhile. Time-out and separation from the "crisis zone" are reasonable responses to biting.

Generally, simple soap and water scrubbing followed by the application of an over-the-counter topical antibiotic ointment should suffice. Notification of the parents so they may watch for evidence of infection is important. Children do not contract tetanus from a human bite.

To extinguish an unwanted behavior, the toddler who bites should experience an immediate and proportional response from their parent or caregiver. Time-out serves such a role. Following a time-out, giving the child appropriate verbal expressions or other techniques to deal with their frustrations is important. Parental biting of the child does not teach the child that biting hurts but rather reinforces the biting behavior since it is often done in parental frustration/anger when other techniques have failed.

Nursing newborns who bite often respond well to an evaluation by a lactation specialist. Pre-toddlers' nips are generally a reflection of excitement and are generally considered part of normal childhood development. They occur so quickly that they are difficult to prevent. The biting toddler may require repeated time-outs to realize that biting is not an effective approach to his goal (such as getting Tommy's toy) but rather provides a negative experience (social separation). Children over 3 years old who repeatedly bite others or themselves warrant a consultation with their pediatrician since this behavior may reflect serious emotional or developmental issues.