I think it’s safe to say that every mother I know who has an elementary school-age girl took a much closer look at her daughter after Sunday’s New York Times Magazine story on the apparent increase in early puberty among girls in the U.S.
The story raised many anxiety-producing questions, among them, why are girls starting to develop breasts and show other signs of puberty earlier — like at age 7 and younger — and what kind of harmful physical and emotional implications might all this have?
But the piece also had a few kernels of comfort, at least, for parents considering medical intervention for girls on the early side of “normal” puberty. Elizabeth Weill reports:
…Greenspan says this is a bad idea, because Leuprolide’s possible side effects — including an increased risk of osteoporosis — outweigh the benefits for girls that age. “If you have a normal girl, a girl who’s 8 or 9, there’s a big ethical issue of giving them medicine. Giving them medicine says, ‘Something is wrong with your body,’ as opposed to, ‘This is your body, and let’s all find a way to accept it.’ “
I asked Dr. Diane E. J. Stafford, a pediatric endocrinologist and training program director at Children’s Hospital Boston about her thoughts on the story and what parents should know. Here is our short Q and A.
Rachel Zimmerman: If you have a daughter on the edge of “normal” say 7 or 8 and developing early, what should you, as a parent, do and should you consider medical intervention at that point?
Dr. Diane E. J. Stafford: It is important to remember that while the medical community is defining the “normal” range for breast development as after the age of 7 for Caucasian girls and after 6 for African American girls, this is a statistical norm and may not necessarily apply to all girls. We need to look at each case and determine if the timing is “appropriate” for that child. There are several factors that might prompt a referral for evaluation and possible treatment between 6 and 8 years of age. If a girl has a family history of delayed puberty (for instance, late menarche in her mother), short stature, behavioral factors that might make pubertal change an issue, significant headaches or visual changes (or other neurologic symptoms) or seems to have a rapid pace of progression, further evaluation may be warranted. This is both to determine if there is a pathologic cause, but also to determine if medical intervention should be considered. Continue reading