Why toddlers bite at daycare, and what helps

Biting is a normal phase for many toddlers, even though it's upsetting to see. Nemours KidsHealth calls it very common in early childhood, slightly more common in boys, and most frequent between the first and second birthdays.

It should stop by about age 3 or 4, and KidsHealth notes that biting tends to lessen as language improves.

Most biting has an ordinary cause. ZERO TO THREE and KidsHealth describe the same common ones:

• Teething and mouthing: Teething can make a child want to chew, and toddlers still explore objects with their mouths.
• Not enough words yet: By 18 months, the CDC's milestone list expects a child to try three or more words besides mama or dada (CDC). By age 2, it expects two-word phrases (CDC). Until the words come, a bite can stand in for anger, excitement or wanting to play.
• Big feelings and little self-control: The AAP notes that toddlers and preschoolers may not have the self-control to express anger calmly yet, so they may hit or bite in frustration.
• Too much going on: Noise, bright lights and busy play can overwhelm a toddler. Being overtired or needing more time to run around can do the same.
• Experimenting: Some toddlers bite to see what happens, including the reaction they get.

The right response depends on the cause. A teether helps a child with sore gums, while a child who bites over toys needs help with words and sharing.

A good program cares for the bitten child first, responds briefly and calmly to the child who bit, and then works on preventing the next bite:

1. Comfort and first aid: Staff wash the bite with soap and water (the AAP suggests 5 minutes, then a rinse under running water) and may use a cold pack for pain or bruising. Public health guidance tells staff to wear gloves while they do it (Hennepin County Public Health).
2. A short, calm message: ZERO TO THREE suggests a brief, firm statement that biting hurts, in a matter-of-fact voice rather than an angry one. Then attention turns to the child who was hurt. It notes that shaming and harsh punishment don't reduce biting, and that taking away active play time can make it worse.
3. Shadowing: Teachers stay close to a child who has been biting so they can step in early. They watch for patterns, like what happened just before or a tired morning, and offer a teether, a crunchy snack or words instead.
4. Telling both families: In Ohio, a child care center must give the parent a written incident/injury report (form DCY 01299) on the day a child is hurt and needs first aid (Ohio Adm.Code 5180:2-12-16). Public health guidance says to inform the parents of both children but not to share the names of the children involved, to protect their privacy.

Consistency helps most, so use the same calm words and expectations at home and at daycare. These steps come from ZERO TO THREE, the AAP and KidsHealth:

• Use the classroom's words: Ask your child's teacher what phrase they use after a bite, and use the same one at home.
• Never bite back: KidsHealth warns against biting or hitting a child to show how it feels, and the AAP points out that children copy the way adults handle anger.
• Name feelings: Put words to what your child seems to feel, such as mad, tired or excited, and praise them when they use words instead of biting. The AAP recommends teaching young children to express anger with words.
• Offer something safe to chew: A teether or a cold washcloth can soothe sore gums.
• Protect sleep and active play: Being overtired is a common trigger, so keep naps and bedtime steady and make time to run and climb every day.
• Share the hard days: ZERO TO THREE suggests telling other caregivers when your child slept poorly so they can shadow your child that day.
• Read a picture book about biting and talk about how each character feels.

Many toddler bites don't break the skin and need only washing and a cold pack. The AAP's symptom guide says a bite that doesn't break the skin can't become infected, and most minor bites heal in 5 to 7 days.

• Call your child's doctor now if a bite breaks the skin or is a puncture on the hand or face. Also call for signs of infection: redness, red streaks, pus or a fever.
• Go to the emergency room if bleeding doesn't stop after 10 minutes of direct pressure.
• Call 911 for major bleeding that can't be stopped.

Hennepin County Public Health calls the risk of hepatitis B, hepatitis C or HIV from a bite extremely low. It still advises seeing a health care provider when a bite breaks the skin.

Talk with your pediatrician if biting goes on past about age 3 or 4, happens a lot, is getting worse instead of better, or comes with other upsetting behavior (KidsHealth).

• The AAP also suggests calling if your child seems unusually aggressive for more than a few weeks or hurts other children or adults. Being sent home or left out of play because of it is another warning sign.
• If your child's talking seems behind, bring it up. The CDC recommends talking with your doctor and asking about developmental screening when a child misses milestones or loses skills (CDC), and ZERO TO THREE suggests considering a speech-language assessment.

At All Around Children, toddlers (18 to 36 months) are in classrooms with 1 teacher for every 7 children. Families get daily updates through a parent app, which is an easy place to mention a rough night or a new tooth.