Precocious Puberty: Concerns for Your Daughters' Growth

Q: Precocious Puberty: Concerns for Your Daughters' Growth

Hello： Due to improved nutrition compared to the past, there is a trend of earlier onset of secondary sexual characteristics in children. <br>However, your daughter's onset of menarche at the age of 9 is relatively early. <br>You may want to consult a pediatric endocrinologist to

Precocious puberty issues?

Hello Dr.
Liang, I am currently residing in Indonesia and have two daughters, one aged nine and the other aged six.
My eldest daughter began breast development around seven and a half years old and started her first menstruation at nine years old.
She has been growing rapidly, especially since the third grade, with significant increases in height and weight.
In just the six months from eight and a half to nine years old, she grew 6.5 cm (now measuring 145.5 cm in height and weighing 47.5 kg).
I suspect she may be experiencing precocious puberty and am concerned about its potential impact on her future height.
I myself stopped growing after sixth grade (152 cm), and my menstruation started later than my younger sister, who is two years younger than me.
However, my sisters are all over 158 cm tall.
A traditional Chinese medicine practitioner told me that this could be due to excessive consumption of herbal supplements by my parents.
Now, I worry that my daughter may not grow tall like me in the future.
I would like to seek medical advice, but it is not convenient to do so in Indonesia, and I cannot bring my daughter back to Taiwan.
I would like to know which department to consult in Indonesia and how to describe her condition (in English).
Additionally, my younger daughter grew 7 cm and gained 5 kg between the ages of five and six.
Is this normal? Thank you for your help!

Yen Fang, 40~49 year old female. Ask Date: 2004/01/04

Dr. Liang Hongjian reply Pediatrics

Hello: Due to improved nutrition compared to the past, there is a trend of earlier onset of secondary sexual characteristics in children.
However, your daughter's onset of menarche at the age of 9 is relatively early.
You may want to consult a pediatric endocrinologist to assess if there are any abnormalities.
Additionally, height is influenced by parental height, along with factors such as nutrition and exercise.
It is advisable to increase the intake of protein and calcium-rich foods.
Furthermore, it is important to consider the possibility of underlying health issues (such as pediatric endocrine disorders).
Therefore, seeking expert advice to evaluate your daughter's actual condition would be the best course of action.
Dr.
Liang Hong-jian, Pediatrician, Miaoli Hospital.

Reply Date: 2004/01/04

More Info

Understanding precocious puberty is crucial for parents, especially when it comes to the growth and development of daughters. Your concerns about your eldest daughter, who began developing breast tissue at a young age and has recently started menstruating, are valid. Precocious puberty is defined as the onset of secondary sexual characteristics before the age of 9 in boys and 8 in girls. In your case, your daughter is showing signs of this condition, which can indeed have implications for her future growth and overall health.

The rapid growth you mentioned, where she gained 6.5 cm in just six months, is often associated with the hormonal changes that occur during puberty. However, it is important to note that while children may experience growth spurts during puberty, early onset can lead to a premature closure of growth plates in the bones, potentially resulting in a shorter adult height. Given your own family history, where you experienced a halt in growth after sixth grade, it is understandable that you are concerned about your daughter's future height.

In terms of seeking medical advice in Indonesia, it would be advisable to consult a pediatric endocrinologist. This specialist focuses on hormonal issues in children and can provide a thorough evaluation of your daughter's growth patterns and hormonal levels. When making an appointment, you can describe your daughter's symptoms using terms like "precocious puberty" and "rapid growth." It may also be helpful to mention her age, height, weight, and any other relevant medical history, including your own growth patterns and family history of height.

As for your younger daughter, who has also shown significant growth (7 cm in one year), this can be within the normal range for children aged 5 to 6. Growth patterns can vary widely among children, and factors such as genetics, nutrition, and overall health play a significant role. However, if you notice any signs of early puberty in her as well, it would be wise to discuss this with a healthcare provider.

In addition to seeking medical advice, monitoring your daughters' growth through regular check-ups is essential. Keeping a record of their height and weight over time can help identify any concerning trends. If possible, you might also consider consulting with a healthcare professional who specializes in pediatric growth and development, even if it is through telemedicine or online consultations, which can provide you with guidance without needing to travel.

Lastly, while some traditional beliefs, such as the idea that consuming too much herbal medicine can lead to early puberty, may circulate, it is essential to rely on scientific evidence and professional medical advice. Hormonal changes are complex and can be influenced by various factors, including genetics and environmental influences.

In summary, your concerns about your daughters' growth and development are valid, and seeking the expertise of a pediatric endocrinologist in Indonesia is a prudent step. By addressing these concerns early, you can help ensure that your daughters receive the appropriate care and support for their growth and overall well-being.

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