When your four year old daughter "gets her first periods"

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A tinge of emotion from a mother can be as odd as ‘my baby has finally done poop after days…. or a BANG on my door from a terrified friend ‘my seven-year-old son has pubic hair!'…Ulala!

Conversations between mothers can either release, or blow-up a situation.

Last week I couldn’t control the urges for full body thorough ‘checks’ on my kids, don’t blame me.

Some mothers in my circle were sharing interesting but shocking things.

“My daughter (eight) has developed breasts…I can’t believe it, she is still a baby, is this normal?” one asked.

Don’t ask if I checked my six-year-old after Dr. Terry Piloya a Pediatric Endocrinologist at Mulago Hospital, Endocrine Clinic shared how she received a distraught mother to a four-year-old who had gone into menstruation.

Yes, four years old; also ask yourself if your child is ready for the ‘Puberty Talk'

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The four year old went through puberty early.  Unfortunately, the parents could ill afford the medicine to stop the periods.

Any child who gets puberty signs like menstruation or breast development before 8yrs in girls or testicle/penis enlargement in boys before 9 years, should seek medical attention according to Dr. Terry Piloya.

Eight years old is not too early for girls to develop breasts.

If they’ve not developed any signs of puberty by 13, then it’s delayed puberty, however 8-13 years is normal.

Menstruation or breast development under the age of eight is called precocious puberty. It’s considered pathologic (caused by a disease).

"It's abnormal, we investigate the cause of early puberty. In girls the cause of early puberty may not be identified (idiopathic) in 80% and in 20% there’s an identifiable cause that can be treated. In boy’s early puberty usually 60% of them there's identifiable cause," said Dr. Piloya.

Aside from idiopathic, other causes of early puberty are brain tumour, scarring in brain from infections like meningitis, cerebral malaria, abnormality in the brain or tumours in testis/ ovary among others.

She therefore advises parents with children showing early puberty signs especially before age 6 to seek medical expertise.

Dr. Piloya said that there is slight increase in the number of children who have gone into early puberty in both boys and girls during the Covid-19 lockdown period.

"…it's because of the extra weight they’ve gained. Many kids who were originally in boarding school have been at home for a year or two…are eating healthier and not as malnourished," she said.

So, the batteries for rapid growth have been charged during #StayHome measures.

"If one starves or does not get enough calories to maintain a certain critical weight and maintain the normal metabolic processes, there’s no way the body will switch into the puberty mode," she said.

Ever wondered, why you see very skinny /small girls or boys delaying to go into puberty; the body’s meter is still reading:  "s/he is still a child."

This is the case for often with victims of diabetes, sickle cell, HIV/AIDS etc. if the disorder is not well controlled.

Nowadays, the secular trends in endocrinology (system that controls hormones); children are getting into puberty a little earlier than the olden days.

Dr. Piloya says, there are many things in the environment such as pesticides, chemicals in animal feeds that are hormonal disruptors and make children grow faster.

"For girls, the heavier they’re, the more likely they’ll develop breasts earlier. The child might not eat meat so often but there are hormonal disruptors in the beef he/she is partaking…even hair chemical can change the cycle," she said.

While certain disruptors of the normal cycle could be within a parents control, others are not.

Be calm and relax; breast development might be a false alarm as Dr. Piloya explains.

"f your girl gets breasts, they may keep coming and disappearing. If they’re steady at 8½ or 9 years, since the cycle isn’t yet mature, then we give it two or three years for one to menstruate," she said.

Both genders can get pubic hair before age six; it is not unusual.  Many times, it may not be a sign of puberty because other physiological mechanisms in the body at play allow pubic hair to grow.

 

Advice to parents to prepare children for ‘Puberty Talk'

• Don’t panic; when you do, the child panics. Children need to know it is normal,
• Telling the children things appropriate for age is important
• Kick start the ‘puberty talk' as early as eight for girls, nine for boys.
• If the breasts appear, don’t press them-it will not reverse the process. Tell the child not to press them, let them be.
• Tell the child; your body is preparing you for the time when you become a Mother/Father.
• Don’t expose your chest when the breasts are there because it is a private part, etc.
• Slowly you’ll introduce menstruation since by eight, they don’t really understand much.
• Teach them how to shave and keep clean, etc.