DEAR DOCTOR,

My soon-to-be 9-year-old is a bit chubby but I noticed that her breasts are starting to grow and it is not baby fat. I feel like she is too young to start growing breasts and perhaps it is something in the hormones causing this? What causes early signs of puberty in girls? Is it about nutrition?  I am worried.

 NINA

DEAR NINA, 

Puberty is the stage when a child’s body begins to grow gradually into an adult. In a girl this is marked by development of breasts and appearance of pubic hair. Hormonal changes and surge in level of estrogen is responsible for these changes.

Usual age for puberty is 12 to 15 or 16 years. But it may occur sometime before or aftet. Genetic factors also determine the age of puberty. If some blood relative like the Mother or an aunt had early or precocious puberty, a girl child of the family can have same.  Excess Consumption of processed foods  can also lead to changes in hormone balance and precocious puberty. High fat diet, lack of physical activity and resultant obesity can also cause early puberty in a girl child

Due to  internet, children these days have exposure to adult contents like never before.At this age, due to gradual hormonal changes there is a natural attraction towards opposite gender. Watching porn  or discussing sex with peer group friends  or th8nking about sex, may affect surge of estrogen, resulting in premature puberty. Encourage the child to be physically active, keep her busy with creative leisure time activities and ensure that she takes a balanced nutritious diet. This will help in keeping the hormones in balance.

Precoccious puberty can also be due to infections or injury of the brain. Disorders of the pituitary or thyroud gland  or adrenal gland,cause early puberty as one of the manifestations. But here, there  would be other clinical features like feeling more hot or cold, altered bowel habits, dry skin, e.t.c. Any one of these disorders, if present can be detected easily by available tests and is curable.

It is also important to educate the child about puberty and even sex at this stage of life. Since signs of puberty are already  there, she should accept it and know what it signifies. There is no need to be anxious. If there is doubt of any medical  disorder,  relevant tests can be done on advise of a medical doctor.

Dr Rachna Pande is a specialist in internal medicine 

E-mail rachna212002@yahoo.co.uk