Premature puberty. Source; Chonnam Medical Journal
Angela Onwuzoo
Paediatricians say there is a cause for concern when girls under the age of seven start developing breasts, noting that such development is abnormal and requires medical evaluation.
They said the appearance of physical and hormonal signs of pubertal development at an earlier age, known as precocious puberty, is considered abnormal before the age of eight years.
Mayo Clinic says precocious puberty, also known as premature puberty, is a condition in which a child’s body begins to change into that of an adult too soon. It states that precocious puberty usually occurs before the age of eight in girls and before the age of nine in boys.
The child health specialists revealed that early onset of puberty could be caused by tumours in the brain, tumours in the ovary, hormonal imbalance, enzyme deficiency, and obesity.
Apart from the concerns of parents, girls themselves are also worried due to the challenges ahead as experts say the early appearance of breasts, which will also lead to early menstruation, can cause emotional distress for them.
The paediatricians suggested that when parents notice abnormal puberty signs in their children, they should see a child specialist.
According to them, the child must be seen and evaluated by a paediatric endocrinologist, who decides whether there is nothing to worry about or there is a concern.
A Paediatric Endocrinologist at the Lagos University Teaching Hospital, Idi-Araba, Dr Elizabeth Oyenusi, in an exclusive interview with PUNCH Healthwise, gave insight into early puberty in girls, treatment, and how parents can go about it.
Dr Elizabeth Oyenusi
The specialist, who is the President of the African Society for Paediatric and Adolescent Endocrinology, told our correspondent that it is not normal for a girl to develop breasts before the age of eight, stating that such a child needs to be seen and investigated by a child specialist.
She said, “Any pubertal development, meaning breast development, pubic hair development, or axillary hair development before the age of eight years in a girl is abnormal. It is precocious puberty.
“So apart from the development of breasts, the development of pubic hair, the development of axillary hair, and also having adult body odour and body shape, are some of the things you can see. It is not normal.
“The things that can cause it are varied. There is one called idiopathic, you may not be able to find any cause. That one most times, it may run in families.”
Oyenusi, a senior lecturer in the Department of Paediatrics, Faculty of Clinical Sciences, University of Lagos, also listed some other causes of early puberty, which she said are more dangerous.
She added, “Things like having a tumour in the brain, in the ovary, or in the adrenal gland. All these things can cause a child to start developing earlier than normal.
“And so, if a child gets breast or any of that pubertal development before the age of eight, then you are required to see a doctor, specifically, a paediatric endocrinologist.
“Sometimes, when they are around seven years old and you check them out, it may just be that they are starting earlier and there is no other problem.
“But because there are many other problems, which if you don’t solve, can cause that, it means that you must investigate the child.”
She also pointed out that early puberty could expose children to psychological distress and also impact their growth by making them have a small height in adulthood.
Experts say early puberty will cause a child’s body and moods to change much sooner than that of friends and classmates, adding that this may make a child feel self-conscious and embarrassed or be teased by other children.
Apart from tumours, Oyenusi said there are some other genetic diseases too, such as enzyme deficiency and hormonal imbalance, that could make children have puberty too early.
According to her, some studies have shown that children are developing breasts earlier unlike in the past, like 10 or 20 years ago when they started developing breasts at about 10.
“But recently, studies that were done in Lagos like four years ago showed that they are developing much earlier because they are overweight. When a child is overweight, it can also drive puberty, it can make a child go into puberty early,” she added.
On how early puberty could be managed and treated, Oyenusi said, “If we see a child that has precocious puberty and we investigate, if there is a life-threatening cause, it has to be treated. But if it is just that they are starting too early and they can’t handle the progression, we stop puberty by giving them puberty-blocking drugs.
“When parents notice abnormal puberty signs in their children, they should go and see the doctor. The child must be seen and evaluated by a paediatric endocrinologist who decides whether there is nothing to worry about or there is.”
She advised parents to ensure that their children who go into puberty too early are evaluated and treated.
In a 2023 article published in BMC Paediatrics, titled, “Analysis of risk factors of precocious puberty in children”, the authors said in recent years, studies have pointed out that the incidence of precocious puberty in children is increasing year by year.
BMC Pediatrics is an open-access journal publishing peer-reviewed research articles in all aspects of health care in neonates, children, and adolescents.
“Precocious puberty in children will lead to increased hormone secretion, which will affect their psychology, height, nervous system tumours, etc., seriously endangering children’s physical and mental health, and may also advance the time of bone maturity in children, resulting in short adult height.
“And may increase the risk of high blood pressure, diabetes, obesity, and infertility in adulthood”, the authors said.
In her post on healthychildren.org, the American Academy of Paediatrics parenting website, a paediatrics specialist and fellow of the academy, Dr Brittany Allen, said puberty often begins earlier than parents think―especially in girls.
According to her, the earliest sign of puberty in most girls is the development of breasts.
She said parents could help their daughters navigate this time by learning about these changes and starting conversations about them early.
Another consultant paediatrician, Dr Rotimi Adesanya, said the average age a girl is supposed to attain puberty is 11, stressing that a lot of girls are now having early puberty as a result of obesity and a sedentary lifestyle.
Dr Rotimi Adesanya
He said these days, children would rather play computer games or play games on their parents’ or siblings’ smartphones than go outside to exercise.
The expert informed that such a lifestyle of eating without exercising has led to obesity and now makes them reach puberty early.
Adesanya said, “These days, some of them show those signs at age eight. Obesity has strong links with precocious puberty and what favours it is the diet and sedentary lifestyle.
“Children no longer do exercises; they don’t trek to their school the way we did back then, which helped us to burn fat from our body. So, that is one major cause of early puberty.”
He advised parents to stop feeding their children junk, particularly fat and sugar, and to engage them in regular exercise.
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