Is your baby exhibiting some strange behavior, like pulling their hair? Perhaps even eating it? Or has your toddler entered a phase where they pull the hair of others?
Babies and toddlers are strange little people, there’s no hiding that fact. But it can be frustrating to see our babies doing things we don’t expect. Still, hair pulling is quite normal, and there’s no need to feel like a failed mother — it happens to most of us!
However, understanding why it happens and recognizing what to do and how to act in these situations is crucial.
Why Is My Baby/Toddler Pulling Their Own Hair?
As a veteran mom, I’ve seen my fair share of strange behavior — pulling at things, smelling things, tasting things — the list goes on. When it comes to your toddler or baby pulling out their own hair, there are a few causes.
We’ll start with the first and, probably, the most obvious.
For babies, hair pulling is generally something they do simply because they can. For them, the world is new and exciting, even hair pulling! They love to explore and see what happens when they do this or that.
Just because your baby is pulling their hair doesn’t necessarily mean that there’s something wrong. But if you do feel worried, you can observe their behavior for a week or two and then let your pediatrician know.
If you see that the hair pulling is hurting them, try redirecting their attention. Give them a toy that they love, or move their hand to another area.
There was a case study that demonstrated this “curiosity” in the Journal of Developmental Pediatrics. The interest in hair improved with gentle distraction techniques (1).
2. Self-Soothing Mechanism
Sometimes babies and toddlers use hair pulling as a self-soothing mechanism. Some babies fall asleep easily when they stroke their head or rub their nose; this could be the same thing. Other babies can even find it soothing twisting their mom’s hair.
Babies doing this are likely to grow out of the habit as they become older.
3. Trichotillomania or Baby Trich
Trichotillomania (TTM) is a disorder where the affected feel an urge to pull out hair from the body. It typically results in bald patches, depending on the severity (2).
This disorder generally has an onset between the ages of nine and 13, but can occur in children as young as 18 months old.
When this condition occurs in children under the age of four, doctors refer to it as “baby trich.” Fortunately, when this disorder affects younger toddlers, it is usually short term.
While adults suffering from this disorder usually do it intentionally, young children often don’t realize what they’re doing. They might not even remember it later in life.
Trichotillomania is different from the “bald patches” that form on the back of the head from the infant lying on his/her back. It occurs due to the back of the head rubbing against flat surfaces during sleep, diaper changes, playmat time, etc. In clinical practice, I find that hair begins to regrow by 7 to 8 months old when the infant spends more time in an upright position (3).
Editor's Note:Dr. Leah Alexander, MD, FAAP
Symptoms of Baby Trich
Usually, with this disorder, sufferers show both emotional and physical symptoms. However, mental and emotional signs can be tricky to spot in toddlers, since many do it unintentionally. Still, there are some ways you can detect it.
Your toddler might:
- Constantly be tugging or twisting their hair.
- Pulling hair repeatedly in one place over a period of time, where a bald spot might appear. This could also include eyelashes or brows.
- Exhibit an urge, that they might try to resist, right before they begin pulling.
Why Does Baby Trich Occur?
Doctors are still unsure about this, although some studies suggest that lack of parent-infant interaction, low pain threshold, or parental aggression could be some of the triggers (4).
Unfortunately, even though this disorder is fairly common, there’s still very little information about it. It’s often misdiagnosed as obsessive-compulsive disorder (OCD) and inappropriately treated (5).
For you as a mom, it can be difficult to witness, but again you can try to redirect their attention. Or if your child is old enough to understand, calmly ask them to stop. Avoid making a big fuss about it, as this will likely cause unnecessary stress for both of you.
Alternatively, if you feel that your little one is doing it more when you’re asking them not to, try to ignore it. This can be hard, but scream on the inside and stay cool as a cucumber on the outside. In this case, they’re likely doing it just to push your buttons.
If you worry that your little one might have baby trich, it’s best to contact a professional.
Treatment for Baby Trich
Physicians primarily treat this disorder with cognitive behavioral therapy (CBT). This type of treatment helps your little one become aware of what they’re doing (6).
The aim of CBT is to teach your child how to recognize the emotions and triggers of the hair pulling. Depending on the age, this could involve anything from wearing bracelets to carrying something around as a reminder.
The second phase of treatment begins once your little one understands the problem. This involves reversal therapy.
Here, your doctor might recommend placing bandages on your toddler’s fingers to make hair pulling more difficult. Another suggestion is to tie their hair back in a ponytail, or cover it with a hat.
Generally, for older kids who like to play with their hair, doctors recommend giving them something with a similar texture to play with. This could be a textured pencil topper, feather, or ribbon.
4. Pica (Eating Hair)
You probably heard of this when you were pregnant (women craving strange things to eat, such as dirt or chalk). But it’s actually pretty common for young children.
As above, a baby can try eating their hair once or twice out of curiosity, and never do it again. However, Pica is a disorder when a child persistently eats more than one non-food item for at least a month (7).
This condition is not something to take lightly. The unnatural substances your baby puts in their mouth can contain toxins. In turn, this could lead to parasitic infections, poisoning, intestinal blockage, and even death.
Depending on your little one’s age, they could eat paint, plaster, fabric, or hair. Older kids may opt for sand, leaves, pebbles, and even animal droppings or insects.
This disorder can continue into adulthood, where experts often describe it as a severe form of self-harm.
Signs of Pica
Doctors take pica very seriously, particularly when it occurs in small children. The prevalence of death is, unfortunately, high, so they will examine your little one thoroughly.
The clue to look out for in smaller children usually includes seeing your little one eating one or more non-food items (such as hair). This has to continue for more than one month, despite your efforts to stop them from doing so.
Why Does Pica Occur?
Like baby trich, experts are not sure of the exact causes of pica. Still, there are a couple of circumstances that might contribute to its development. These include:
- Nutritional deficiencies: Sometimes a lack of iron or zinc can cause a craving for a non-food item.
- Malnutrition: However, this is not a common trigger in the U.S. This generally applies in developing countries, where children often resort to eating soil or clay.
- Lack of supervision or parental neglect.
- Other conditions: Autism or other developmental disabilities, for example.
- Mental health disorders: Like obsessive-compulsive disorder (OCD) and schizophrenia.
Treatment for Pica
Treatment generally aims at finding a way to prevent the hair-pulling. This could include placing mittens on their hands or giving them stuffed animals or blankets to comfort and distract them instead.
Next is to ensure that your little one gets all the nutrition they need. Your doctor might carry out tests to check if the levels of minerals are normal. If not, he or she will likely advise you to include more nutritious food into your toddler’s diet.
From what I see in practice, the most common reason an infant or child exhibits PICA is iron deficiency anemia. It may or may not be associated with a high serum lead level. My routine initial workup is a CBC, and a lead test under the age of 5.
Editor's Note:Dr. Leah Alexander, MD, FAAP
If your doctor suspects an underlying condition, continued checkups may be suggested. Fortunately, for most young children, pica is something they will outgrow.
Help! My Toddler Is Pulling at Others’ Hair
OK, as a mom who’s had to apologize countless times for a misbehaving toddler, I can relate to this one! It’s frustrating and embarrassing, having to face the judgmental eyes of the other moms and the screams of their tots.
But let’s start with babies.
1. For Babies
This will sound much like the hair pulling above, but it’s done as a way to experiment and explore.
When pulling at other people’s hair, it helps babies to work out cause and effect. This usually occurs between the ages of six and 12 months.
Your baby might pull your hair when they’re feeding or playing with you, merely to watch your reaction. Will you ignore it, just laugh, or get angry?
Remember, babies are learning everything from us. Even how to react to hair pulling!
How Should You React?
Because your baby is working out cause and effect, the best way to react is to simply put them down and ignore their actions.
It may be a case of, “You’re damned if you do and damned if you don’t.” Laughing at them can make it into a game. Whereas getting angry or exhibiting an extreme reaction could fascinate them and, again, make it worse.
Try this: when your baby is pulling your hair, give a clear verbal response that they can understand, like, “No”. It is important to make eye contact and remove distractions while saying “No”. Then gently remove their hand from your hair.
By doing this, you’re taking your attention away from your baby, which will clearly show them that it was unacceptable. Still, it might take a few times before they get it. Just remember to be consistent.
2. For Toddlers
Toddlers are more mature than babies and are probably aware that hair pulling is hurting the other person. But remember, this might be a way for them to express genuine anger or hurt (8).
For toddlers, especially younger ones, expressive words are sometimes hard to use. Perhaps your little one doesn’t speak yet. Therefore, it’s easier to bite, pinch, or pull someone’s hair, when that person did them wrong.
Another cause could also be copying someone. Toddlers are still learning the rules of the world, and when they see other kids pull each other’s hair, they may do it too.
What Can You Do?
The first thing to do is work out the reason behind the behavior. Why is your toddler doing this — is it something they see others do? Do they feel frustrated in some way?
Next, ask yourself how your reactions are received — are you getting angry or being supportive?
Here’s what you do:
- Stay calm: Even if you have to fake it. Your toddler will see this, and it’ll teach them how to deal with being frustrated.
- Turn away: If you feel your toddler is doing this for attention, take that away.
- Give a consequence: If they continue, despite your reaction, tell them how it hurts and gives them a consequence, like a time-out. I recommend 1 minute per year of age for time outs (i.e. one minute for a one-year-old). It is important to have a consistent time out location, and I discourage using a crib for time outs because this creates confusion at bedtime. I also suggest setting a timer. At this age, a child has no concept of time, so a timer helps him/her to realize they will “not be in time out forever.”
You can always teach them descriptive words by saying that they look like they’re feeling angry or sad. But remember, consistency is key!
Babies and young toddlers pulling either their own hair or that of others are, many times, just exploring their boundaries. However, it’s important to observe their behavior if they continue, since it could sometimes indicate underlying issues.
Fortunately, most outgrow this hairy habit. It will, undoubtedly, be something worth remembering and bringing up at their graduation party!