Tips for Parents: Puberty Starting in Children Younger than Age 9

rn-remedies-bianca-salvetti-thumbBy RN Remedies blogger, Bianca Salvetti, MSN, CNS, CPNP

Talking to your child about puberty can be difficult at any age, but discussing normal body changes with your 12-year-old might not seem as scary as talking to a 6-year-old. Recently, I had a friend ask me about this very topic—How do you talk to younger kids who are developing earlier than other children? His 7-year-old niece started her period and the family wasn’t sure how to talk to her about it. Working in the Division of Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles, I discuss puberty with teens, young adults and/or their families quite often. What is normal? What is abnormal? These questions are often the most concerning for families. We will look at the causes and symptoms of early puberty or “precocious puberty,” and share some ways to talk to your child about puberty and managing the feelings that can come with it.

What is early (precocious) puberty

Precocious puberty is when boys who are younger than age 9 and girls who are younger than age 71/2 or 8 show any sign of secondary sex characteristics. These secondary sex characteristics are the same for normal puberty as they are for those with precocious puberty, they just occur younger than expected. “Precocious puberty affects 1 in 5,000 children and is more common in girls,” states Mitchell Geffner, MD, division chief, Division of Endocrinology at Children’s Hospital Los Angeles.

There are two type of precocious puberty:

  1. Gonadotropin-dependent precocious puberty (also known as central precocious puberty)—The most common type. Central precocious puberty is triggered by an early release of gonadotropins, which are the hormones responsible for puberty. This could be caused by a tumor, but for most children no medical cause can be found.
  2. Gonadotropin-independent precocious puberty (also known as peripheral precocious puberty). This type of puberty is caused by over production of sex hormones due to problems with testicles, ovaries or adrenal glands. It could also be caused by external exposure to estrogen or testosterone (e.g. using estrogen cream or taking testosterone shots).

Puberty symptomsPuberty Starting in Children Younger than Age 9: Tips for Parents

The following are the most common symptoms.

Girls

  • Breast development
  • Menstruation
  • Pubic and/or underarm hair growth
  • Ovulation

Boys

  • Penis and testicle growth
  • Pubic, underarm and/or facial hair growth
  • Spontaneous erections and/or production of sperm
  • Voice changes

If you notice secondary sexual characteristics in a child who is under 8 to 9 years old, be sure to speak with your medical provider to discuss diagnosis and treatment, if needed.

Talking to your child about puberty

One of the hardest parts of puberty for your child will be feeling different than their peers. However, for parents, the hormonal changes that lead to moodiness are difficult to manage. Here are some tips to start the conversation and how to promote a healthy transition into adolescence.

“If your child is ages 8-10 years old, you can explain to your child that their body is starting to grow up like mommy’s or daddy’s,” suggests Dr. Geffner.

  • Provide an open, non-judgmental line of communication with your child.
  • If you’re not sure where to begin, use books or online resources to help start the conversation (The American Academy of Pediatrics is a great online resource).
  • Allow your child to ask questions, and provide them with honest answers.
  • Use language that is appropriate for your child’s developmental age but still use correct terminology. (e.g. Penis versus “pee pee,” vulva versus “down there”). Using proper anatomical terms will help your child learn that this is a normal part of human development and it is okay to talk about it.
  • Try not to “tell” your child how they are feeling or thinking; instead, ask.
  • Always listen. You do not have to know everything or have all the answers. Children want to know that you heard what they said and can empathize with their feelings. If there are questions that you can’t answer, simply say, “I’m not sure but we can look into it together.”
  • Keep the conversation going. This shouldn’t be a one-time conversation. If the line of communication is kept open, your child is more likely to keep talking to you about other changes they’re experiencing as they become teenagers and young adults.
  • Check in with your child a few days later to see what they remember from your conversation. You can use this time to reinforce information or ask more questions.

Promote good self-esteem and self-acceptance. These nine tips can help:

  1. Limit focus on physical appearances and instead focus on your child’s accomplishments and achievements.
  2. If your child makes a negative comment about a physical feature, offer a compliment about a positive physical feature.
  3. Do not tease or frequently point out your child’s new physical developments. Encourage other family members to do the same.
  4. Help your child choose activities based on their abilities and development. A child can appear older but may not be mentally ready for organized sports or activities.
  5. Be a model for self-acceptance. Be mindful of the negative comments you make about your own appearance. Children often look to their parents as role models.
  6. Reflect on your own experiences and offer to share them with your child.
  7. Look at old photos of yourself and talk about how puberty was for you.
  8. With permission, you can ask other family members for their stories as well.
  9. It’s okay to share what was good and bad about this stage of your life.

Precocious puberty can trigger the same feelings and physical changes as normal puberty. However, for a younger child it may be more distressing as they learn to cope with these changes. Parents can find it difficult to speak with their young child about puberty due to the child’s development and understanding of their bodies. It may seem like it is easier to use more “kid-friendly” words but this may actually confuse your child as they get older and learn the appropriate terms. The best advice for any parent is to provide your child a space to voice their frustrations, fears and feelings. Remember what puberty was like for you and empathize with your child as they begin their transformation into adolescence. If you’re having trouble talking to your child about puberty, ask your health care provider for suggestions.