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Growing up too quickly in childhood. Increasing worriesof Gambian parents for early puberty of their children

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What is puberty?

Puberty is an unsettling stage in anyone’s life, but if it appears at the age when a child is still playing with her dolls, it can be very worrying indeed., Puberty involves huge physical, emotional and hormonal changes as the body prepares for reproduction. There is also rapid growth and weight gain and the appearance of body hair and for many, an unwelcome crop of acne.

Girls develop breasts and begin to have menstrual periods, while boys begin to produce sperms and their voice becomes lower pitched.

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So far, there is no agreement among doctors about whether we are just seeing a continuation of this decline in the average age at which puberty occurs, or whether it is a part of a more worrying environmental trend towards children growing up too quickly.

However, most agree that if breasts and pubic hair development happen before the age of eight or nine in the case of girls, or signs of puberty manifest themselves in boys under ten, it is “abnormal”. However, the onset of signs of puberty before age seven or eight in girls and age nine in boys can be physically and emotionally difficult for children, and can sometimes be the sign of an underlying health problems.

There is also evidence that children with early sexual development become sexually active earlier. There are also thoughts whether early childhood could have a knock-on effect, which makes them susceptible to adult health problems, such as cancer and heart diseases.

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In Britain and in some other European countries, it is now more or less established that up to at least one in six children is affected. Indeed, there are some recent studies that show that school girls as young as six are already entering puberty. There are also a few studies from some African and Asian countries reporting similar early childhood development in puberty and early sexual maturity too.

Whatever the cause, a growing number of children are being deprived of childhood and are turning physically into mini-adults at an increasingly young age. But without the emotional maturity to deal with these changes, they are vulnerable to exploitation.

Here are 10 puberty facts that all kids need to know about

Puberty can be a scary time for kids, especially when they don’t know what to expect. So, it helps kids when parents can talk about puberty in a natural, everyday way. This helps to normalize puberty for them and prepares them for the changes that will be coming their way!

There are a lot of puberty facts for your child to learn, but here you will find 10 that are more about the principles than about facts.

1. You will experience both physical and emotional changes

It isn’t just your body that changes as you go through puberty. Your brain and your feelings change as well. So, your child needs to know that they will start to think and feel differently as well. This article from Hey Sigmund explains what teens need to know about the adolescent brain.

So, make sure your child knows what changes will be happening to their body (read about the stages of puberty for males and females), as well as the fact that their feelings will change as well.

2. Puberty is normal and happens to all kids

Our second of the puberty facts is all about making puberty a normal stage of life., When going through puberty, your child may feel as if they are the only one going through it. So, it helps if you can remind them that they aren’t alone. Remind them that their friends will be going through puberty as well. And that you too, went through puberty and survived.

3. Puberty means your body can make a baby

Puberty is all about making us capable of reproducing and starting the next generation. Which means that your child’s body will eventually be capable of creating a new life if they are fertile. So, they need to know this, that if they had sexual intercourse with someone of the opposite sex, that they could make a baby.  Reassure them though, that even though their body may be ready that they still need to do a lot more ‘growing up’ before this will happen.

4. The changes won’t happen overnight

Reassure your child that the changes that will be happening to them, don’t happen overnight. They happen over months. Which means that they will have plenty of time to get used to them! So, start talking to them about how to care for their body as it changes. When you start to notice an underarm smell, buy them deodorant and start chatting about why they sweat and how they should manage it.

5. Puberty happens to both boys and girls

Remind your child that puberty happens to all children (regardless of their gender and biological sex). Some of the changes will be similar (pubic hair, body odor, pimples) but some won’t be (ejaculation, periods). So, make sure your child knows that all of their friends will be going through changes, but that some of the changes will be different for them.

6. Puberty starts at a different time for everyone

Let your child know that we don’t all start puberty at the same time. Some kids start much earlier or later than others. Which means that some kids will be much taller than others, and some kids will be flat-chested whilst others are needing a bra. Everyone is different so their body will start changing when it is ready to. You can’t make puberty start any earlier or stop it from happening. Your body knows what to do and will start when it is ready for it.

7. Changes can happen quickly or slowly

Some people’s bodies can change more quickly or slowly than others. So, their friend may have lots of pubic hair within a few months whilst it may take months for them to just grow a few! Everyone is different but by the time puberty is over, everyone has had the same changes, and end up with similar adult bodies.

8. Everyone is different

Your child needs to know that although the changes we go through are all the same, that they can still be different. So that may mean they have no pimples or lots of pimples. And there is nothing that they can do to change that. It is a bit like a lucky dip – you get what you get!

9. You can’t stop or alter the changes that will be happening to you

Some kids worry about the changes that will happen to them and want to know if they can stop them, or even change them. They can’t. Their body is already pre-programmed to change in a certain way. Which means that they will end up with the body they are meant to have.

10. You will start to think about sex differently

As well as making your child’s body fertile, puberty will slowly start to change the way they think and feel about sex.  This happens for a very good reason. For a baby to be made, you usually need to have sexual intercourse. So, puberty will rewire your child’s brain so that they will want to have sex.

Signs of early puberty in girls, the common signs include any of the following before the ages of seven or eight: breast development, pubic or underarm hair development, rapid height growth or spurt, onset of menstruations (periods).

Signs of early puberty

In girls, the common signs include any of the following before the ages of seven or eight: breast development, pubic or underarm hair development, rapid height growth or spurt, onset of menstruations (periods).

In boys these include: acne, enlargement of testicles or penis, pubic, underarm or facial hair development, rapid height growth, voice deepening, acne, “mature” body odor.

Similarly, some girls and boys may experience early growth of pubic and underarm hair that isn’t associated with early puberty and may require evaluation to rule out “true” early puberty or other health problems.

Going through puberty early can also be difficult for a child emotionally and socially. For example, girls with early puberty may be confused or embarrassed about physical changes, such as getting their periods or having enlarged breasts well before any of their friends. But the hardest part may be teasing children with the condition, especially girls.

Even emotions and behavior may change in children with early puberty; girls can become moody and irritable. Boys can become more aggressive and also develop a sex drive inappropriately for their age.

Causes of early puberty

The onset of puberty is normally by the hypothalamus (the area of the brain that helps control the function of some glands), in particular the pituitary gland which releases hormones that stimulate the ovaries in girls or testicles in boys to make sex hormones.

Sometimes, the early puberty stems from a structural problem in the brain (brain injury due to head trauma), an infection such as meningitis, or a problem in the girl’s ovaries or thyroid gland that triggers the onset of puberty ahead of schedule, but this is usually isn’t always the case.

In about 5% of boys, early puberty is inherited., Starting puberty early can be passed on from the father to the son. But less than 1% of girls affected by early puberty have inherited the condition.

Diagnosing puberty

I strongly recommend every parent who observes any signs of early puberty or any sexual maturity in their children before the age of 7to 8 to seek advice from a medical professional. The signs include, in girls early breast development, rapid height growth, menstruation (periods), excessive developing acne, in boy’s enlargement testicles or penis, changing voice or pubic or underarm hair.

The physical changes boys and girls go through during puberty are usually evidence to a doctor during an examination. To confirm a diagnosis of early puberty of your child a doctor may order blood and urine tests to detect elevated sex hormones or possible x-ray of your child’s bones.

Further testing may also be necessary. Scanning can help to roll out specific causes of early puberty, such as a growth in the girl’s ovaries, or boy’s testicles. Fortunately, all of the above-mentioned diagnostic facilities are now available including magnetic resonance imaging (MRI) scan for affected children to be appropriately diagnosed by specialists.

Is there any preventative medicine to prevent the development of early puberty or treat affected children?

Not surprising, the drug industry has developed quite a few drugs for prevention and also for possible treatment of premature puberty. The mean effects of these drugs are to block the early production of growth hormones, but the medical professionals are not happy to routinely prescribe powerful drugs, normally used to treat cancer, for young children.

I have met quite a number of children in The Gambia, in particular girls, with similar conditions who were brought to me by their parents.

As I strongly recommend, one should seek medical advice by medical professionals for performing an appropriate diagnosis for underlying health problems and for possible treatments.

For further information, check UNICEF and WHO websites, email [email protected], or send text messages only to Dr Azadeh’s WhatsApp on (00220) 7774469 from 3 to 6 pm

The author Dr Hassan Azadeh, MD, is a senior lecturer at the University of The Gambia, and clinical director at the Medicare Health Services.

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