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

1. 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.

2. 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.

3. 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 he/she will no longer bite people.

4. Give your child a time-out when he/she bites people.

   Send him/her to a boring place for approximately one minute per year of age.

   If he/she tries to bite you while you are holding him/her, say "No." Always put him/her 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.

5. Never bite your child for biting someone else.

   Biting back will make your child upset that you hurt him/her and may teach him/her that it is okay to bite if you're bigger. Also, do not wash your child's mouth out with soap, pinch or pop his/her cheek, or slap his/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.

6. Praise your child for not biting.

   Praise your child especially when he/she is in situations in which he used to bite or when he is with children whom he/she used to bite. Remind your child gently not to bite before you embark on a high-risk visit. Then if he/she doesn't bite, praise him afterward for good behavior.

7. 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/she acts like he/she 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 Pediatrician Immediately If:

• Biting causes a puncture or a cut that completely breaks the skin.

Call Your Child's Pediatrician During Office Hours If:

• Biting behavior lasts for more than four weeks after you have begun using the approach outlined here.
• Your child bites or hurts himself/herself.
• Your child has several other behavioral problems.
• You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.

Copyright 1999 Clinical Reference Systems