Confused about your child’s early puberty?

By Nicole Namubiru

Doctors explains why children are growing way too fast, and how parents can cope

Dr. Thereza Piloya-Were; a pediatric endocrinologist at Mulago National Referral Hospital in Kampala has witnessed firsthand how children these days tend to grow up faster than in past generations. She has done research on it.

She says early on-set of puberty is now an average of 9 years for girls and 10.5 years for boys. That is when girls will start to show breast growth and the testes of boys will start to enlarge. It can be challenging for parents who, basing on their own experience, expect these changes to come later.

Jane Ndibazza is a typical parent. She can never forget how worried she was when her daughter started developing breasts at the age of nine while she was in primary four.

Ndibazza says she could not understand why her daughter was growing this fast.

“I started developing breasts when I was 15 years old,” she says.   She was confused on whether it was the right time to start having sex education sessions with her daughter. She knew next in line for her young girl was menstruation. Still she was shocked when her daughter’s first period came at age 11.

“Now this was mind blowing, I felt like my daughter was way too young to go through this,” she says. Most parents of teen girls these days have, at least, Primary Level education. This means they are in school longer and the average age of first sex is 17 years. It is higher for girls in wealthier, urban locations, with longer stay in school. The average of first sex for men is 19 years. It is lower for men in poorer, rural setting who drop out of school. In all cases, it means the parents will be in their late 20s and early 30s when their dot-com era daughters hit puberty.  The frustration of this cohort of parents can be based on the fact that girls of their generation, like Ndibazza, experienced these body changes at a later age bracket, mostly between ages 15-17 for menstruation.

Changing lifestyle

Experts say the secular trend towards early puberty has been realised over the years and attribute the changes on environmental effects, genes, nutrition, and chemicals that children are exposed to daily that people in the past generations were not.

Piloya explains: “These chemicals, especially hair shampoos, contain estrogen which is a female sexual hormone. This hormone stimulates body growth of the female characteristics of the body. This in turn leads to the early on-set of puberty.”

Pesticides and herbicides have also been found to accelerate this trend.

“They contain chemicals that have a structure similar to the female hormone since they are meant for plants to look beautiful,” Piloya says, “Since many of today’s children are exposed to such chemicals; they are prone to arriving at puberty early.”

Pesticides, herbicides, and other chemicals are released into the atmosphere and are inhaled on a daily by children. But Piloya says it is not just the chemicals in hair shampoos and pesticides that may have accelerated this trend. She attributes it to changes in lifestyle and names increased consumption of foods, especially those rich in calories and fat. She says children are fatter these days and thus have a higher body mass index (BMI) than children in the times past.

Dr. Sabrina Bakeera-Kitaka, a senior Paediatric and adolescent health specialist at Mulago National Referral Hospital says obesity might correlate with earlier puberty in some girls although, oddly, fat boys appear to have later puberty than other boys.

“Excess calories in the body are stored as fat and this leads to stimulation of high levels of leptin by fat cells. Leptin triggers production of hormones which is an indicator to the brain that the person has matured and so it is time for puberty,” Kitaka says.

In some circumstances, however, the early on-set of puberty; including signs like breast development and pubic hair growth may come way before the average age of 9 or 10 for girls and boys respectively. In this case, the experts say, this is an abnormality called, ‘precocious puberty.’   “This situation is different from the secular trend of puberty because it is abnormal,” Piloya explains.  She says this can be reversed by using medicine to stop further production of these hormones. She cautions that the medication is more effective when administered at the earliest on-set of puberty signs of a young child.

Challenges

Demeter Margaret Namuyobo; a medical coordinator of Reproductive Health Uganda, says early puberty increases children’s exposure to sexual exploitation.  She says young children will attract people of the opposite sex even at an early age and this exposes them to sex even before they have the psychological maturity to handle it.

She recommends that sex education in primary schools needs to be intensified yet it was previously done in only secondary schools.

“This is very vital because it helps to sort the confusion in the minds of the children on whether to retain childhood behaviors or move to the next step of development and adapt adult tendencies. And sex education is seen to prevent tendencies of early and destructive hyper sexuality,” she says.

In some cases, early onset of puberty can lead to psychological torture associated with being different from other children in the same cohort that may not have arrived at puberty. Namuyobo says this may lead the children to attempt to conceal the changes. They may become shy among their peers. She says such children need guidance and counseling to tell them that these changes are healthy and normal.