Topic Overview
Is it normal for a child to bite?
Most children
younger than age 3 bite someone else at least once. Most children stop biting
on their own. Biting that happens past age 3 or occurs frequently at any age
may need treatment. Biting is not always intentional, and it rarely causes
serious injury to another person or poses any health risks.
Why do children bite?
Children bite for different
reasons, depending on their age.
- Between 5 and 7 months of age,
children usually bite other people when they feel discomfort around their
mouths or when they are in pain caused by
teething. Most often they bite their caregivers.
Sometimes a young baby bites his or her mother during breast-feeding. Children
of this age learn not to bite as they see and hear the reaction of the person
they have bitten.
- Between 8 and 14 months of age, children usually bite other people when they are excited. Most
often they bite a caregiver or another child close to them. A firm "no" usually
stops these children from biting again.
- Between 15 and 36 months of age, children may bite other people when they are
frustrated or want power or control over another person. Usually they bite
other children. Less frequently they bite their caregivers. Children of this
age usually stop biting as they learn that biting is not acceptable
behavior.
- After age 3, children usually bite
when they feel powerless or scared, such as when they are losing a fight or
think that they are going to be hurt by another person. Children older than 3
who frequently bite other people need to see a doctor. Biting at this age may be a sign that a child has problems with expressing feelings or
self-control.
When is my child most likely to bite another child?
Biting occurs in a variety of situations, most often when many
children are together. In the United States, human bites are a common cause of
injury at day care centers.1 Most biting can be
prevented with proper supervision that includes helping children express their
feelings appropriately.
A child of any age who frequently bites
other children may need special arrangements for day care. Parents may be asked
to transfer their child out of a center when biting becomes a continual
problem. The child may need to attend a child care center with staff who are
skilled in dealing with children who bite.
Can biting be a sign of a more serious problem?
Biting in young children usually does not lead to behavior problems at a
later age. But children who persistently bite and show other aggressive
behaviors, especially if they are older than age 3, may have other health or
emotional issues. These children should be seen by a doctor.
Frequently Asked Questions
Learning about biting: | |
Seeing a doctor: | |
Ongoing concerns: | |
Symptoms
Most infants and young children
bite occasionally. Usually a bite is harmless and may
not even leave a mark. Infants most often bite in response to new sensations in
the mouth, such as may occur when
teething. Young children may bite out of frustration
because they cannot yet translate their emotions into words.
In
rare cases,
biting can be a symptom of a behavioral problem that
should be evaluated by a doctor.
Exams and Tests
Talk to your doctor if you suspect that
your child's
biting is becoming a problem. Your doctor will want to
know details about your child's
biting and other behavior. He or she might ask
questions about what is usually happening when the biting occurs, how you or
other caregivers react, and what a typical day is like for your child.
Questions about situations where your child has bitten someone
- Is your child more likely to bite an adult or
a child?
- Does your child seem angry or frustrated when he or she
bites?
- How many people are usually around when your child
bites?
- Is there a certain place or situation in which your child
seems most likely to bite?
Questions about the discipline of your child
- In general, what are your thoughts on
disciplining your child?
- How do you respond to your child when he
or she bites?
- How does your child respond after being disciplined
when he or she has bitten someone?
Question about daily behavior and environment
- Is your child frequently around other
children? If so, is it usually in small or large groups?
- Are there
any significant changes in your child's life, such as a recent move or the
birth of another child?
- Does your child have any other recent
behavior that concerns you?
- How do others in your home express
anger?
- Do you have any concerns about how others may be treating
your child?
Treatment Overview
In most cases, a
doctor can help when your child has problems with biting others. Biting that
injures someone or biting that continues after age 3 are signs that a child
needs help controlling strong emotions. A doctor can assist parents and
children with techniques that help a child express his or her feelings more
appropriately. For example, your doctor can direct you to a class on parenting
or on normal growth and development of children. These programs and other
measures can help you understand why your child bites and how you can best
respond.
Parents may need additional help if they are
concerned about losing control over their actions when
they are disciplining their child for biting. Anger management courses or
counseling can help parents who feel overwhelmed in
this way.
Not all incidents of biting can be prevented. But
biting can be reduced by looking for things in your child's life that may lead
to this behavior. Usually these relate to your child's age.
- Give
babies who may be teething soft toys or teething rings
specifically designed to safely ease this discomfort. Biting or chewing on a
clean, frozen washcloth can also help. For more information, see the topic
Teething.
- Tell
children ages 8 to 14 months that biting hurts other
people. Exaggerate the pain if your child bites you, and say, "No! We do not
bite!" or something similar.
- Help
children ages 15 to 36 months use words to express
their feelings. Also, learn to recognize the signs that your child is about to
bite. You may be able to stop biting before it happens by distracting or
redirecting your child. Don't try to reason with young children or have lengthy
discussions about biting. Use simple and direct language.
When to call a doctor after a bite
Usually a
bite from a child is not harmful, and medical care is
not needed. Call your doctor if the bite has pierced (broken) your child's skin. The doctor will check your child's immunization status, ask questions about how and when the bite occurred, and decide if your child needs antibiotics to help prevent infection.
For
more information about biting that causes injury, see the topic
Animal and Human Bites.
Home Treatment
How to help prevent biting
Positive reinforcement
helps to prevent your child from
biting. Praise your child when he or she shows
behaviors you want to encourage, such as sharing, being kind, showing empathy,
or being patient.
Growth and Development: Helping Your Child Build Self-Esteem
When you see your child behaving well, reward him or her
for that behavior. A reward does not need to be candy, toys, or other treats. A
reward can be as simple as telling the child how well he or she is doing and
that you appreciate cooperation or a good-natured response to a problem or
frustration. For example, say "Great job! You used your words when you were
angry." An enthusiastic pat on the back or a hug when the child is behaving
well helps the child associate nonaggressive behavior with good things. The
child will gradually realize that it feels better to get positive attention for
being good than it does to get negative attention for biting or other
aggressive behavior.
Also, model the
behavior you would like to see in your child. Avoid angry outbursts and other
forms of aggression. Set a good example by showing your child how to deal
calmly with everyday frustrations. Tell your child "Next time you feel like biting someone, remember that I can help you stop before you start."
How to help a child who has been bitten
When one
child bites another, first take care of the child who was bitten and give
emotional support:
- Move the child away from the
situation.
- Comfort the child within sight of the child who bit him
or her.
- Help the child express his or her feelings about being
bitten, such as by saying, "It's okay to cry. Being bitten
hurts."
- Do not say, "Johnny was bad to bite
you."
Examine the area where the child was bitten. Most bites
from children are not harmful and leave little, if any, evidence. A tooth mark
on the skin or slight bruising may appear, which usually does not require
medical attention. Tender loving care and an ice pack on the bite are most
often all that is needed.
In rare cases, a bite from a child will
pierce the skin and bleed. If this happens, call your child's doctor.
For more information on treating bites, see the topic
Animal and Human Bites.
How to respond to a child who bites
When your
child bites, let him or her know that biting is not acceptable. React to the
biting incident in a dramatic way (but without violence or aggression). If you
were the one bitten, overreact to the pain. If your child bit someone else,
react with a firm voice and stern facial expression. Say, "No! We do not bite."
Many children are as shocked and upset as the person who has been bitten,
because they may not be aware that biting hurts.
Suggest other ways for your child to express feelings.
For example, say, "Use your words to tell Susan you are angry at her for taking
your truck."
When a child bites, do not:
- Bite the child back to show how it feels to be
bitten.
- Wash out the child's mouth with soap.
- Pinch,
slap, or use other physical punishment.
Starting at age 2, children who continue to bite may benefit
from time-out. Time-out removes the child from the
situation, allows him or her time to calm down, and teaches the child that
biting is not acceptable behavior. Time-out works best for children who
understand why it is being used.
Biting that occurs in a child care center
When one
child bites another in a child care center, the director may ask to meet with
the parents of both children. If biting keeps happening, measures that can be
tried include:
- Shortening your child's day at the
center.
- Watching your child closely to identify when he or she is
most likely to bite. Some activities may frustrate your child. Replacing
frustrating activities with less challenging activities may be all that is
needed to stop a child from biting.
- Staying on a consistent
routine.
If these measures do not stop your child's biting, you
may want to or you may be asked to move your child to another child care
setting. A smaller center or one with staff who are skilled in handling
children who bite may be a better situation for a child with an ongoing biting
problem.
Contact your doctor if:
- You have not been able to stop your child's
biting using the above techniques.
- You have difficulty handling
your reaction to your child's biting.
- Your child's biting is
disrupting his or her life.
- You need suggestions for treating
biting.
Other Places To Get Help
Organizations
|
HealthyChildren.org |
| 141 Northwest Point Boulevard |
| Elk Grove Village, IL 60007 |
| Phone: |
(847) 434-4000 |
| Web Address: | www.healthychildren.org |
| |
This American Academy of Pediatrics website has information for parents about childhood issues, from before the child is born to young adulthood. You'll find information on child growth and development, immunizations, safety, health issues, behavior, and much more. |
|
| KidsHealth for Parents, Children, and
Teens |
| 10140 Centurion Parkway North |
| Jacksonville, FL 32256 |
| Phone: | (904) 697-4100 |
| Fax: | (904) 697-4125 |
| Web Address: | www.kidshealth.org |
| |
This Web site is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This Web site
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly e-mails about your area of interest. |
|
References
Citations
- Ginsburg CM (2007). Animal and human bites. In RM
Kliegman et al., eds., Nelson Textbook of Pediatrics,
18th ed., chap. 712, pp. 2928–2932. Philadelphia: Saunders
Elsevier.
Other Works Consulted
- American Academy of Pediatrics (2009). Anger, aggression, and biting section of Behavior. In SP Shelov et al., eds., Caring for Your Baby and Young Child, Birth to Age 5, 5th ed., pp. 565–570. New York: Bantam.
- Brazelton TB (2006). Eighteen months. In
Touchpoints, Birth to Three: Your Child's Emotional and Behavioral Development, 2nd ed., chap. 11, pp. 164–178. Cambridge, MA:
Da Capo Press.
- Committee on Psychosocial Aspects of Child and
Family Health, American Academy of Pediatrics (1998, reaffirmed 2004). Guidance
for effective discipline. Pediatrics, 101(4):
723–728.
- Howard B (2005). Biting others. In S Parker et al.,
eds., Developmental and Behavioral Pediatrics: A Handbook for Primary Care, 2nd ed.,
pp. 136–138. Philadelphia: Lippincott Williams and
Wilkins.
- Jerrard D (2007). Bites (mammalian), search date August 2005.
Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Sonnett FM, et al. (2006). Mammalian bites and
bite-related infections. In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 200–204. Philadelphia: Saunders
Elsevier.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Susan C. Kim, MD - Pediatrics |
|---|
| Specialist Medical Reviewer | Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics |
|---|
| Last Revised | April 8, 2010 |
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