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? Is 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’t arrive only when a child becomes a teenager; that’s 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 “supposed to”, 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.
- Between the age of 8 and 13 years (average of 11 years) in girls.
- Between 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. Generally speaking, full sexual maturity should be attained by age 18 for both boys and girls.
The 5 Tanner Stages for Boys and Girls
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2. What are the first signs and symptoms of puberty for both boys and girls?
- For 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.
- For 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?
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 Population and Family Development Board (LPPKN), Malaysian girls are reaching puberty at an earlier age. This report was published in The Star as far back as 2010.
“The average age for puberty in Malaysia has gone down,” said Dr Norliza Ahmad, director of LPPKN’s Human Reproduction Division. “Puberty now commonly occurs in girls between the ages of nine and 13½ years, and in boys between 9½ and 14 years. There are also more cases of precocious puberty among Malaysian children – where girls reach puberty before the age of eight and boys before the age of nine.”
True Cases:
- A nine-year old girl gave birth to a baby boy in Penang in 2010. The father of the child was 14 years old.
- An 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:
- Breast growth and first period in girls
- Enlarged testicles and penis, facial hair and deepening voice in boys
- Pubic or underarm hair
- Rapid physical growth (growth spurt)
- Acne
- Adult 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?
According to WebMD, there are two types and causes of Precocious Puberty:
- Central 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.
- Peripheral 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 and 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’s 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 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. Late blooming is influenced by both genetics and environmental factors. It is not a medical condition and doesn’t 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. The 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:
- Children with underlying chronic illness such as uncontrolled diabetes, cystic fibrosis, kidney disease, heart and lung disease.
- Some medication such as high-dose steroid can cause stunted growth and delayed puberty.
- Hypogonadism, due to a defect in the brain (hypothalamus/pituitary) Chemotherapy or radiotherapy.
- Malnutrition or obesity.
- Certain genetic conditions such as:
- Turner syndrome (one of a female’s two X chromosomes is abnormal or missing).
- Klinefelter 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?
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?
Boys tend to show the first physical changes of puberty between 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 two years later than that of girls. Boys 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 boys may continue to grow another inch or so in their later teen 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 pubertal timing during the teenage years. Also, if the pituitary gland doesn’t produce enough hormones to support normal growth, growth slows 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 will be old enough to understand the 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’t want them to be misguided, misinformed or taken advantage of.
For more parenting insights and guides, visit Motherhood.com.my.