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Nail Biting: Why Kids Do it and How to Help them Stop
Nail biting is one of the most common habits, affecting one-third to one-half of children and teens. While many children eventually stop biting their nails, some continue into adulthood. Here are some answers to your basic questions about nail biting.

Why do children bite their nails?
There are several reasons. The reflex for babies to put their hands in their mouth is natural, since this is how they comfort themselves. When older children continue to put their hands in their mouths—to suck their thumbs or bite their nails— this is usually for comfort, to relieve stress or boredom, or simply from habit. Nail biting is also commonly found in families. Children may inherit the tendency from their parents, and they may learn the behavior from watching their parents or older siblings. Children most often bite their nails when their hands are not engaged—for example, while watching TV, reading, sitting in class or riding in the car.

Is nail biting harmful for children?
Nail biting is not a highly dangerous habit. It is mildly unsanitary. When children put their hands in their mouths after touching surfaces such as doorknobs, playing outdoors, handling animals and going to the bathroom, they can catch illnesses such as colds, diarrhea and pinworms. Biting at the sides of the nails can lead to hangnails, or small flaps of open skin, which are susceptible to skin infections. Chewing on the fingers makes the skin at the tips soft and sensitive to pain. It also makes the nails and fingers scarred and less attractive. Nail biting can also chip the front teeth.

How can I help my child stop nail biting?
In order to help your child, try to understand why he does it. All children experience anxiety now and again, but are there extra stresses on your child, such as too many extracurricular activities, a new school, a recent move, a divorce or the death of a pet? Carefully observe when your child bites his nails. Remember, it's very difficult for adults and children to stop bad habits. Your child will only stop if he wants to. Try to be supportive and avoid scolding your child, which could cause more stress and lead to more nail biting. Here are more some tips:

1. Try to reduce stress: Talk with your child about the things she might be worried or scared about. Consider cutting back on extra pastimes and encourage relaxing activities, such as playing with a pet.

2. Empathize with your child: Tell her about a habit that you've tried to break, such as nail biting, thumb sucking, hair twirling or smoking. Discuss how embarrassing or difficult it was for you, what motivated you stop and the process you went through. If you currently struggle with a bad habit, consider making an agreement with your child that you will both work on stopping together.

3. Explain why it's best for her to stop biting her nails. Explain that it will help her be healthier, have stronger teeth and nicer hands. Have the doctor and dentist give her the same messages.

4. Keep your child's nails trimmed and clean. Frequently offer to clip and file your child's nails so he won't need to chew them. Always carry a nail file with you, just in case. Encourage your child to wash his hands after playing outdoors, handling animals and going to the bathroom.

5. Use positive reinforcement. Explain to your child that you know it might be hard to give up biting her nails, but you're confident she can do it. Get a book to read with her about a child who successfully stops biting her nails. Provide comfort when she needs it and praise her for not biting. Offer rewards, such as stickers on a calendar for each day she doesn't bite her nails, which she can trade in for something she really wants.

6. Try distraction. When your child usually bites his nails, try engaging him in other activities, particularly those that use his hands. These could be drawing, putting together puzzles, crocheting or knitting or playing with small hand toys, worry beads, pipe cleaners, balls or smooth stones. You can also try engaging his mouth by talking, telling stories, singing or giving him sugarless gum to chew.

7. Use reminders on her fingers. If she bites her nails at predictable times, like when she's watching TV or sitting in the car, you can put cotton gloves on her hands at those times. It's also safe to use an over-the-counter, non-toxic, bitter tasting nail coating. Apply it to her nails every morning and evening. For girls, the promise of manicures can often be a good incentive to avoid nail biting.

Above all, try to be encouraging and patient. These strategies can work if you're consistent and give them time. If none of them does, if your child is showing extreme anxiety or distress, or is biting her nails so badly that they're bleeding, talk with your doctor about consulting a mental health professional.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician