Biting

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 may need to be seen by a doctor. This type of biting 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

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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 a 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

• Generally, 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

Usually a bite from a child is not harmful, and medical care is not needed. Even bites that pierce the skin and bleed are usually minor injuries and need only basic home care. But these types of bites are prone to infection and should be watched closely, especially if the person who was bitten has an immune system problem.

See a doctor if:

• You or your child has a bite that pierced the skin and signs of infection arise.
• You or your child is at high risk for problems from an infection.

The doctor will examine the bite and ask questions about immunizations and how and when the bite occurred. For more information about biting that causes injury, see the topic Animal and Human Bites.

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 signals 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 age 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 age 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.

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.

In addition, parents should model the behavior they would like to see in their child. Avoid angry outbursts and other forms of aggression. Set a good example by showing your child how to deal calmly with everyday frustrations.

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. Usually the injury is still minor and can be treated at home. But these types of bites should be closely watched because they are more prone to infection.

Contact a doctor if a bite pierces the skin and:

• Appears severe.
• Signs of infection develop.
• The person who was bitten has immune system problems, which increases the risk for complications from infection.

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.

Children over the age of 3 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 a 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

Online Resource

Organizations

Related Information

• Animal and Human Bites
• Growth and Development, Ages 1 to 12 Months
• Growth and Development, Ages 12 to 24 Months
• Growth and Development, Ages 2 to 5 Years

References

Citations

1. 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 (2004). Anger, aggression, and biting section of Behavior. In SP Shelov, ed., Caring for Your Baby and Young Child, Birth to Age 5, 4th ed., chap. 17, pp. 525-527. 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, 2nd ed., chap. 29, pp. 136-138. Philadelphia: Lippincott Williams and Wilkins.

• Jerrard D (2007). Bites (mammalian), search date 2005. Online version of BMJ Clinical Evidence. Also available online: 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.

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