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Early Childhood Concerns: Counseling on Sleep Issues, Thumb-Sucking, Picky Eating, School Readiness, and Oral Health

Carl Bryce, MD
Theron Liddell, PhD
Geoffrey Gideon, DO

American Family Physician. 2025;111(1):31-36.

Author disclosure: No relevant financial relationships.

This clinical content conforms to AAFP criteria for CME.

Common early childhood concerns and behaviors include sleep issues, thumb-sucking, pacifier use, picky eating, school readiness, and oral health. Family physicians must recognize when these indicate an underlying disorder and offer constructive and evidence-based strategies to support healthy child development and family well-being. Behavioral interventions and education to address sleep issues can alleviate stress and decrease fatigue for the whole family. Thumb-sucking and pacifier use have dental and social consequences if they persist beyond 3 years of age. Eating problems in childhood are common; in most cases, reassurance and trying new foods can improve picky eating. Readiness to begin school depends on child, family, and societal factors, and needs an individualized approach that emphasizes inclusion while ensuring person-centered success. Reading and participation in early childhood educational programs improve literacy and classroom preparation. Oral health is an important part of childhood well-being; preventive care, including fluoridation, should begin when the first tooth has erupted.

CARL BRYCE, MD, FAAFP, is program director at the Abrazo Family Medicine Residency, Phoenix, Arizona, and a clinical assistant professor in the Department of Family Medicine at Midwestern University Arizona College of Osteopathic Medicine in Glendale.

THERON LIDDELL, PhD, is director of behavioral sciences and a core faculty member at the Abrazo Family Medicine Residency, and a clinical assistant professor in the Department of Family Medicine at Midwestern University Arizona College of Osteopathic Medicine.

GEOFFREY GIDEON, DO, is a resident physician at the Abrazo Family Medicine Residency.

Address correspondence to Carl Bryce, MD, FAAFP, at carl.bryce@abrazohealth.com.

Author disclosure: No relevant financial relationships.

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