Daffodil Pediatrics

When Puberty Starts Early

Just as some children will reach physical maturity a little later than their peers, others will develop ahead of the norm. However, pubescence rarely arrives so prematurely that it can be classified as precocious puberty, which can be manifested by the appearance of breast buds in a girl under the age of six or seven or an increase in the size of a boy’s testicle before he turns nine. The incidence of precocious puberty is roughly the same as that of belated puberty, affecting approximately 1 in 160 otherwise healthy youngsters.

No underlying disease is detected in about 90 percent of girls and 50 percent of boys who experience precocious puberty. Their sexual development, while occurring abnormally early, still falls within the range of normal. As with delayed sexual development, there is often a family pattern. Nonetheless, a youngster who enters puberty unusually early should be evaluated by a pediatrician, who might subsequently refer him or her to a pediatric endocrinologist.

Pseudoprecocious Puberty

In pseudoprecocious puberty, abnormally high levels of sex hormones prematurely activate the growth process, but only partially: The size and development of the testicles and the ovaries remain at preadolescent levels; boys cannot yet produce sperm, nor can girls make eggs. Believe it or not, the use of hair creams, makeup and other cosmetic products containing estrogen can spur this growth disorder, which is also referred to as incomplete puberty.

Organic Causes of Precocious Puberty

How Precocious Puberty is Treated

There are circumstances when a pediatric endocrinologist might suggest hormone-suppression therapy to treat nonorganic precocious puberty, which manifests itself by causing premature growth. Suppressive therapy does not permanently stunt growth; what it does is prolong the prepubertal period of childhood. Sexual development begins at a more appropriate age, thus sparing a youngster from the sense of isolation that precocious puberty can bring.

Encouraging Self-Acceptance

Most boys and girls enter puberty with an idealized image of what they hope to look like and an exaggerated sense of their physical flaws. Girls are particularly prone to unhappiness over their appearance. Taken to extremes, a poor self-image can place a youngster at risk for eating disorders and abuse of anabolic steroids, not to mention the emotional and social problems engendered by low self-esteem and self-confidence.

There are many ways that we can help our children to cope with the changes of puberty and learn to be more accepting of themselves. First and foremost, downplay the importance of physical characteristics. Stress to your son or daughter that ultimately what makes a person attractive is a combination of personality, accomplishments and how they treat others. And explain that many of the perfect chiseled faces and bodies they see courtesy of the entertainment and fashion industries benefit considerably from computer-generated images, airbrushing, battalions of hair stylists and makeup artists, lighting that would flatter Quasimodo and plastic surgery. When you come across a picture of a famous beauty sans makeup, show it to your youngster and explain that under the glitz, these are normal people too.

Help Your Child Choose Activities Based On His Abilities and Size. A boy who stands five feet three and weighs 110 pounds may find greater success and satisfaction playing soccer or running track than trying out for the freshman football team. On the other hand, you know your son: If he’s determined to give it a shot and is realistic about his chances, don’t discourage him.

To Allay Late Bloomers’ Fears That They Will Never Mature, Show Them Pictures of Mom or Dad At The Same Age. “Then,” says Dr. Felice, “they can see what their parent looks like now and know that if they just bide their time, everything is going to fall into place.”

Don’t Tease Kids About Their Developing Bodies. Respect the fact that teens are often highly self-conscious about their “new parts.” It is important not to make kidding remarks about a girl’s budding breasts or a boy’s wisp of a mustache.

Without Overemphasizing The Importance of Physical Appearance, Tell Your Teenager Over and Over How Attractive She Is. When your daughter moans, “My hair is so hideous,” call attention to her elegant hands, her pretty smile, her soulful eyes. She may pretend to be unimpressed (“Of course you think I’m pretty, Dad; it’s your job to say things like that”), but secretly she’ll be pleased by the compliment. Also, encourage youngsters to make the most of their good points by practicing scrupulous personal hygiene and grooming, and maintaining proper posture. If you’ve got a knack for dressing stylishly and are reasonably familiar with teen fashion trends, help them to pick out clothes that accentuate their best features.

Examine The Attitudes You Convey About Your Own Body. Do you go from one diet to another and complain chronically about your weight and shape? (Mothers are probably more guilty on this score than fathers are.) “Mom is the most important female figure in a girl’s life,” points out Dr. Gaggino. “She may think, If Mom is unhappy with the way she looks, how could I possibly look good? Women have to be careful about what they say about their own bodies, because girls internalize those messages.”

Source: Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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