Physical Developments: Early Puberty

American girls are maturing quickly. Learn how to help young children enter puberty with grace.

“Kids grow up too fast these days.” Rising rates of early puberty have turned this most common of parental laments into reality for many American children.

“The ‘classic’ description is that girls start puberty at 10 on average, with a ‘normal’ range of 8 to 12,” says Ernest Post, MD, a pediatric endocrinologist and puberty subspecialist at Cooper Health System in Camden, NJ. According to the most recent figures from the journal Pediatrics, more than 10 percent of Caucasian girls experience breast development, the most common entry to puberty, by the age of 7, a 5 percent jump since the early 1990s. African American and Hispanic girls mature even faster, with nearly 25 percent and 15 percent, respectively, now entering puberty by 7.

These numbers have been widely corroborated and are accepted as fact. Experts are less certain about what’s causing the increase, though theories abound. The following factors are among the most widely debated:

  • Childhood obesity
  • Hormones in meat and milk
  • Endocrine disruptors — chemicals that can affect the body’s ability to produce hormones — found in everyday items like plastic bottles, cosmetics and cleaners (read more about these chemicals here)
  • Environmental factors like stress in the home

Of these, the corresponding rise in childhood obesity rates is the basis of most medical agreement. Dr. Post cites a 1970s study that found menarche (the onset of menstruation) to begin on average when a girl reaches 110 pounds. This finding predates the obesity epidemic, but as girls continue to hit this weight milestone sooner, doctors see obesity as a major indicator of early puberty. The Pediatrics report also linked soft-drink consumption specifically to early menarche.

How to Have the Puberty Talk
“Girls want basic information, to feel prepared and to be reassured,” says Debra Moffitt, kids’ editor of Nemours’ and author of the Pink Locker Society series of novels dedicated to helping tween girls deal with the “PBBs” (“Periods, Bras and Boys”). “Parents should get out ahead of the situation,” initiating a discussion by the time their daughters turn 8, ideally before the facts are presented in health class (generally in 4th grade).

  • Parents need to take the lead, start discussions and answer questions as they come up throughout childhood. Provide info in a matter-of-fact way without embarrassing or teasing your daughter.
  • “It’s vital that parents talk about menstruation before their daughters actually get their periods. If girls are unaware of what’s happening [in their bodies], they can be frightened by the sight and location of blood.”
  • “Some moms tell me they don’t want to talk with their daughters because they believe their girls are late bloomers and what's the use of worrying them? But puberty is a tough concept for young kids because they like everything to be very clear-cut. They know they will be able to drive at 16, but it feels strange to them that one girl is well developed and has her period at 11 while another can be the same age yet still very much look like a younger girl. So whether they are early, late or in between, all young girls need to be informed and reassured.”

“Yes, statistically [obesity] is a contributing factor. No, it’s not the whole story or the primary change,” says David R. Langdon, MD, FAAP, clinical director of the Division of Endocrinology at the Children’s Hospital of Philadelphia. Furthermore, “There is evidence that social and family factors can affect time of puberty. [But] it is impossible to determine these for individual children.”

Hormones in milk and meat have been a discussed factor since 2010, when a handful of babies in China developed signs of puberty after ingesting infant formula allegedly containing bovine growth hormone. Not all medical experts are convinced of the connection, however. Charles Scott, MD, pediatrician at Advocare Medford and past president of the NJ chapter of the American Academy of Pediatrics, agrees that body mass index impacts physical maturation, yet flatly states: “Hormones in food do not contribute to early puberty.”

Mature responses to early puberty

Whatever the causes, early puberty is an understandable concern for parents who want their daughters to develop a positive body image and refrain from sexual activity until they are mature enough to handle it. Additionally, according to a study by the National Institutes of Health, girls who enter puberty before 12 are at higher risk to develop breast and uterine cancer as adults — and should therefore be cognizant of being screened for these diseases as they get older.

Sometimes, early puberty can be stopped with medication. However, “The majority of patients have nothing wrong with their hormone levels,” says Dr. Post. For most, the emotional impact of this milestone overshadows the physical.

Nurture self-esteem when puberty hits

“It can be emotionally stressful for girls to be different from their peers,” says Charlene Brock, MD, pediatrician at St. Chris Care at the Falls Center, Philadelphia. “Since early puberty means an early growth spurt, if a girl is a lot taller than her classmates, including boys, this can be difficult.”

Boys and Early Puberty
Like girls, American boys are entering puberty at increasingly early ages. (The first signs for boys? Enlarged testes and the onset of sperm production.) A November 2012 study in Pediatrics found that more African American boys are reaching puberty earliest, at age 9, while Caucasian and Hispanic boys hit the mark a year later, at 10. Again, the causes are difficult to pin down, but environmental factors and obesity remain important culprits. Despite this new information, boys still seem to reach sexual maturity at the classic point in their teens, so the full puberty transition does not happen overnight.

Dr. Brock stresses that parents should unabashedly welcome a child’s questions about puberty. “A family that keeps the lines of communication open and provides affirmation and support can go a long way in helping the child navigate this awkward period,” she says. “Young girls need to be informed about their bodies and what happens during puberty.

“The road through adolescence is often rocky,” she continues, “and most kids are resilient and adjust without any permanent emotional scars.”

Hannah Morrison is a MetroKids intern and communications student at Temple University.


Categories: Medical