Your little prince and princess are growing up. One day soon, they will reach puberty and that day may arrive sooner than you think. Is your daughter already menstruating at age 8? \u00a0Is your son having underarm and pubic hair and body odour at age 9? When should you start talking to them about the birds and the bees? Puberty doesn\u2019t arrive only when a child becomes a teenager; that\u2019s an inaccurate assumption as medical history proves that it can arrive before age eight for girls and before age nine for boys. Conversely, puberty may not arrive at all when the child is already in his or her mid-teens. If your child is, or is not, physically developing the way he or she is \u201csupposed to\u201d, would you be worried that this is not normal? Find out more below. 1. What is puberty and what are the five stages of puberty? Puberty is the normal physical and emotional developmental milestone in children as they transition from middle childhood (9 to 11 years) to adolescence. Puberty takes place over a number of years. \tBetween the age of 8 and 13 years (average of 11 years) in girls. \tBetween 9-14 years (average of 11.5 years) in boys. In fact, Professor James Mourilyan Tanner, Emeritus Professor of Child Health and Growth, at the Institute of Child Health, University of London, was the first person to identify the stages of human growth and the visible stages of puberty. He categorized puberty into five stages and today, these are known as the Tanner Stages or sexual maturity ratings that every child typically goes through. The Tanner Stages are used as an approximate timetable as to when and how a boy or girl will go through puberty.\u00a0 Generally speaking, full sexual maturity should be attained by age 18 for both boys and girls. The 5 Tanner Stages for Boys and Girls 2. What are the first signs and symptoms of puberty for both boys and girls? \tFor girls: Breast buds appear and can be tender for several months, or for one breast to develop before the other. Pubic hair starts to grow. They may notice more hair growing on their legs and arms. \tFor boys: The testicles grow bigger and the scrotum begins to thin and redden. Pubic hair begins to grow at the base of the penis. 3. What is the earliest age a child can reach puberty? Girls nowadays can reach puberty by the age of eight (Image Credit: les-anderson-unsplash) Maybe it is due to the food we eat, our general health and lifestyle and the environment we live in, but puberty for girls and boys seems to be starting earlier and earlier as compared to previous generations. When before, the average age for girls to start their first period was 12, nowadays they may begin menstruating at age eight. In Malaysia: According to the National Popula\u00adtion and Family Develop\u00adment Board (LPPKN), Malay\u00adsian girls are reaching puberty at an earlier age. This report was published in The Star as far back as 2010. \u201cThe average age for puberty in Malaysia has gone down,\u201d said Dr Norliza Ahmad, director of LPPKN\u2019s Human Reproduction Division. \u201cPuberty now commonly occurs in girls between the ages of nine and 13\u00bd years, and in boys between 9\u00bd \u00a0and 14 years. There are also more cases of precocious puberty among Malay\u00adsian children \u2013 where girls reach puberty before the age of eight and boys before the age of nine.\u201d True Cases: \tA nine-year old girl gave birth to a baby boy in Penang in 2010. The father of the child was 14 years old. \tAn 11 year old girl in Bahau, Negri Sembilan, gave birth to a baby boy in 2015. 4. What is precocious puberty? Puberty starts on average in girls between ages eight and 13 and in boys between age nine and 14, says MayoClinic. But if it starts before the girl is eight and the boy is nine, it is called Precocious Puberty. Here are the signs and symptoms of precocious puberty: \tBreast growth and first period in girls \tEnlarged testicles and penis, facial hair and deepening voice in boys \tPubic or underarm hair \tRapid physical growth (growth spurt) \tAcne \tAdult body odour It is best to bring the child to a paediatrician for an evaluation if this happens. 5. Who is more likely to develop precocious puberty? Girl or boy? Girl, usually with breast development first. The MayoClinic further says being obese or overweight further predisposes the child to developing precocious puberty. 6. What are the causes of precocious puberty? Childhood obesity and the consumption of processed, high fat foods can cause children to enter puberty early (Image Credit: jcomp-Freepik) According to WebMD, there are two types and causes of Precocious Puberty: \tCentral precocious puberty: When all the normal steps of puberty starts too soon and no underlying health reason can be found. The pituitary gland in the brain starts making hormones called gonadotropins which trigger the testicles or ovaries to make other hormones like testosterone or estrogen which in turn bring on puberty. \tPeripheral precocious puberty: Or precocious pseudopuberty is a different and less common condition. The hormones estrogen and testosterone trigger the symptoms without the involvement of the brain\u00a0and pituitary gland. The problem may be due to the ovaries, testicles, adrenal glands, pituitary gland or thyroid gland themselves. Other reasons include ingesting or coming in contact with estrogen or testosterone such as an adult\u2019s cream, ointment, prescription medication or dietary supplement that contain these hormones. A report from the AFP says early puberty in girls is linked to chemicals in personal care products. Childhood obesity and the consumption of processed, high fat foods can cause children to enter puberty early. 7. On the other hand, what is delayed puberty? Delayed puberty in girls may be caused by being too active in sports, or being too thin or having eating disorders such as anorexia nervosa. (Image Credit: valuavitaly-Freepik) Delayed puberty is defined as a lack of breast development in girls by the time they reach age 13 and n menstruation by the time they reach age 16, and lack of testicular enlargement in boys by the time they reach age 14. However, some teens are just late bloomers.\u00a0 Late blooming is influenced by both genetics and environmental factors. It is not a medical condition and doesn\u2019t need treatment. Late bloomers usually start puberty at their own time and eventually catch up with their friends. Did You Know? Girls require a certain amount of body fat before they can enter puberty. Girls who are extremely active in sports or who are too thin or who have eating disorders such as anorexia nervosa, may experience a delay in the onset of puberty. 8. What are the causes of 'late blooming'? The commonest cause of delayed puberty is Constitutional Delay in Growth and Puberty (CDGP). Genetics or hereditary factors have been found to be one of the causes. \u00a0The risk of a child having CGDP is higher if one or both parents were late-bloomers or if the child has a relative (uncle, auntie, brothers, sisters, or cousins) with the same condition. Other Causes: \tChildren with underlying chronic illness such as uncontrolled diabetes, cystic fibrosis, kidney disease, heart and lung disease. \tSome medication such as high-dose steroid can cause stunted growth and delayed puberty. \tHypogonadism, due to a defect in the brain (hypothalamus\/pituitary) Chemotherapy or radiotherapy. \tMalnutrition or obesity. \tCertain genetic conditions such as: \tTurner syndrome (one of a female\u2019s two X chromosomes is abnormal or missing). \tKlinefelter syndrome (boys born with an extra X chromosome, XXY instead of XY). 9. Who is more likely to have delayed puberty? Boy or Girl? Boy. Teens with CGDP are considered as late bloomers. Height will usually be affected as the late start in puberty and absence of growth hormones necessary for bone growth causes the child to be shorter than his peers. CGDP is a common cause for short stature especially in boys. CGDP is about twice as common in boys than girls. Among boys, about 60 % of delayed puberty is caused by CGDP. 10. At what age does a girl stop growing physically? A girl usually reaches adult height by the time she is 14 or 15 years old (Image Credit: jcomp-Freepik) Girls grow at a quick pace throughout infancy and childhood. When they reach puberty, growth increases dramatically again. During this growth spurt, girls grow about 3 inches (8 cm) per year. Girls usually stop growing and reach adult height by 14 or 15 years old, or two years after menstruation begins. 11. At what age does a boy stop growing physically? A boy usually reaches adult height by the time he is 16, although, depending on when he started puberty, he may continue to grow a bit more until he is 18. (Image Credit: cookie_studio-Freepik) Boys tend to show the first physical changes of puberty\u00a0between the ages of 10 and 16. They tend to grow most quickly between ages 12 and 15 but the rate of growth can vary a lot as boys go through puberty at different ages. The growth spurt of boys is, on average, about\u00a0two years\u00a0later than that of girls.\u00a0Boys tend to grow around 4 inches per year (10.16cm) per year during this period. By age 16, most boys have stopped growing, but their muscles will continue to develop. Some\u00a0boys may\u00a0continue to\u00a0grow\u00a0another\u00a0inch\u00a0or so in their\u00a0later\u00a0teen years (if they started puberty late) but are unlikely to grow significantly after age 18 to 20 as their growth plates would have fused. Once a bone is fused, it cannot continue to grow longer. Did You Know? Height is determined by genetics and also by puberty. Puberty is marked by a period of rapid skeletal growth called the pubertal growth spurt. In delayed puberty, affected children are typically shorter and less physically developed than their peers with normal\u00a0pubertal\u00a0timing during the teenage years. Also, if the pituitary gland doesn't produce enough hormones to support normal\u00a0growth,\u00a0growth\u00a0slows down or stops. On the flipside, children with precocious puberty may also have their height affected. They may grow quickly at first and be tall compared with their peers but because their bones mature more quickly than normal, they often stop growing earlier than usual. This can cause them to be shorter than average as adults. 12. Now that you know that puberty can occur early, when should you talk about puberty and the Birds and the Bees to your children? By age eight, kids\u00a0will be old enough to understand\u00a0the physical and emotional changes associated with puberty. Prepare them so that they are not alarmed when it happens. Girls should be told about menstruation before it happens as they may be frightened by the sight and location of the blood. This is also a good time to talk to them about the birds and the bees as puberty is a time of sexual maturity. They may be fraught with new feelings, bodily changes and sensations they may not understand and as a parent, you want to prepare them for that eventuality. Kids are also nowadays exposed to so much information about sex on the internet. Being at such an impressionable, vulnerable age, you don\u2019t want them to be misguided, misinformed or taken advantage of. For more parenting insights and guides, visit Motherhood.com.my.