By Ashli N. Collins, MD
One of the most surprising calls I have received in my pediatric career came from a hysterical mom who was obviously crying and at her wits end. “I don't know what we are going to do, it is just terrible. … Please help us. … At this point, I am getting fairly concerned that I will have to call 911 to get medical assistance for the child and the parent. Little Billy is getting expelled from daycare from biting too many children and we need help. Can I bring him in and you talk to him and make him stop!”
Well, Little Billy is 15 months old and not really into lengthy conversations about what is right and wrong. Just as this mom struggled with her biting child, many parents find themselves segregated into two distinct groups — parents of those who bite and parents of those who have been bitten.
Many forms of aggression develop in our youngsters but biting certainly receives the most attention. The marks left behind from a bite are long lasting and with the possibility of causing an infection with a deep bite the action certainly causes alarm. Understanding why kids bite, hit, slap, pinch, scratch, shove may help parents cope but in the end, this childhood behavior is common and needs to be dealt with in a calm, rational manner. Daycare workers especially struggle with this as they have parents upset that their child was on the receiving end while other parents are upset that their child “wasn't watched well enough” to have controlled the behavior.
Biting is very common. The instinct to do it generally begins in the first year of life as the teething process is taking place. Boys are more likely to bite than girls. As children get older (past 2 years) it seems to be more prevalent in children whose parents use physical punishment for discipline. When biting begins it is often done in a playful way with parents. For my nephew, if you stood him on your lap, allowing him to rock back and forth holding his hands, he would eventually nuzzle your neck and do a Mike Tyson and chop down! The surprise would then cause a startled look, a yelp and thus great delight for my nephew to see what a response he received. There begins the problem.
First, they are teething and it feels good. They are used to chewing on everything and Freud would say they are very orally fixated. The second reason is attention. The responses given by the bitten show the biter attention — although negative. A yell, a shriek or a look of surprise are all fun responses for the biter to see. It's kind of like the thrill the “monsters” in a Haunted House get as people pass through. The third reason kids will bite is aggression. Good old fashioned, ‘you have want I want and I'm mad so I'm going to bite you' frustration. Under the age of 2, verbal skills are lacking and they just can't get their point across. Kids in this age group are not going to bargain or trade or discuss why they want the toy. They want it, Susie is playing with it and won't give it to me, so I'll bite her, she'll drop it and life will be good. As kids get older, biting becomes more deliberate and used as part of a tantrum or while losing a fight.
Handling biting is difficult. From bite number one it is key to tell the child plainly and calmly, “No, we don't bite people.” You can elaborate and tell the child that biting hurts or can cause an infection but that doesn't usually interest them. Close supervision while around other children is imperative. Biters tend to have a typical stance before they move in for the bite with mouth open and gazing at their prey. At this point, intervene with a stern “no” as you see that mouth hovering to redirect them before they make their move. Time out for biting people is helpful for some. If your biter always bites while you are holding him/her, as soon as they do, put them down and walk away for a moment. Biting them back is not recommended as it just enforces the thought that if you're bigger, you can bite.
Biting in daycare settings is especially difficult because there are more children to monitor. Hopefully the workers are following the above steps but it is wise as the parent of the biter to meet with the staff to ensure they are carefully handling the situation. Reiterate with them what you do at home for similar episodes so that consistency is in place. Hopefully staff will also let the parents of those being bitten know that they are working hard to eliminate the problem.
Typically by age 3, or as verbal skills improve biting tends to lessen. If biting continues or if the child is inflicting harm on themselves or seems to have other behavior issues, talk to your pediatrician.
