My daughter’s habit at bedtime has become a worry for us

Q. We have a four-and-a-half year old daughter who is lively, intelligent and friendly and she gets on great with her little sister. Sometimes she can be a little nervous at times or want things done a particular way, though this is nothing unusual. The concern I have is around masturbation. She plays with herself down there constantly. I know a certain amount of this is normal for a little girl, but that hand is in there a lot. She does it, not always, but frequently, to help her go to sleep. I have told her that while it’s okay, it’s not polite to do that in company, so she does tend to do it in private now, but the frequency is freaking me out a little. I walk into my innocent little daughter’s bedroom and she’s doing this. It affects my ability to lie down beside her and read her a story. I’m embarrassed. Her genitalia are often sore from the friction and we have to apply Sudocreme. So I don’t know what to do. Is this normal? Is it something normal that a lot of kids use as a coping mechanism but has got out of hand because of something in her environment? Is it something that I’m doing? Is something – or someone – stressing her out that much? I am really worried about this and it’s probably transmitting to her.

A. Though parents are surprised by this, masturbation in young children, both boys and girls, is quite normal. Generally, it is very innocent and young children touch themselves as a source of pleasure or comfort, without any particular sexual connotations. Before the age of two or so, children are likely to touch themselves without inhibition and it is only at the age of three or four that they begin to become aware of the social stigma surrounding this behaviour.

Parents are normally embarrassed about it and often confused as to how best to respond. Traditionally, children who display this behaviour were given out to or punished, but modern parents are rightly worried about giving their children a negative message about sexuality and want to avoid giving them any “hang ups” about sex as they grow older. From a clinical perspective, masturbation is only thought to be a problem if it is over-frequent, compulsive or done in public.

I think you have handled it very well so far by giving your daughter the message that while it is okay to touch herself, it is something she should only do in private. She seems to have taken on board your message by doing it less in public and more in her room. As she grows older you would expect her to fully understand the private message so as a parent you will less frequently encounter her doing it.

Though many three and four year olds touch themselves regularly, they often do this much less as when they reach six or seven years old. Childhood sexuality can become latent in middle childhood, before it takes on a new force at puberty when the hormones take over.

A lot of parents worry that masturbation in a four year old could be a sign of abuse. However, unless you have other specific concerns or reasons to suspect something, and you are pretty sure your daughter is well protected, then this is unlikely to be the case and her touching herself is more likely to be a sign of innocent childhood sexuality. You may wish to consult with your GP to check whether there are any medical causes for the redness in her genitalia such as thrush etc.

Children touching themselves can become a habit and some children can use it as coping mechanism if they are stressed or worried about something, in a similar way that a child might use other coping behaviours such as sucking their thumb or rocking etc. For some children it can become a relaxing strategy they use to get to sleep at night.

To deal with it, I would suggest you continue to give her the message to do it in private. This includes any time you are with her, for example, when you are lying with her before you sleeps. It is not okay for her to touch herself when you are talking to her or when another person is with her. If she starts to do it, even absent mindedly, you should gently ask her to stop. It can be useful to develop a “positive code word” with her to remind her. For example, rather than saying, “Don’t be doing that”, you can say, “Hands away now. . . Mammy is here to read a story”. Picking a gentle and positive though firm tone will help her not feel bad about what you are asking and she will quickly get used to the fact that this is a private behaviour. The more relaxed and matter of fact you are the more easily she will be able to change.

If you are worried that she is doing it too frequently, then you can have a little chat with her about doing it less or only at bedtime and then try and give her alternative strategies or soothing rituals – such as cuddling a teddy, distracting herself by getting up and doing something etc.

In a similar way to changing any habit that is not acceptable in public (such as picking one’s nose etc), you can use a simple reward chart to motivate and remind your daughter to keep the rule and remember not to do it in public, though this may only be necessary if she continues to do it when older.

If you remain worried about your daughter, or you feel there are other issues that cause you concern, do make contact with a professional such as your GP or another child mental health professional.

Dr. John Sharry, Irish Times, August 2010. John writes in The Irish Times Health+ every Tuesday.