Is My 6 Year Old Starting Puberty?

Puberty was about the furthest thing from my mind as my daughter was finishing her kindergarten year. But around her 6th birthday, that changed.

She had always been on the petite side but at her well-check had gained about 12 lbs in one year. That was significant. Her pediatrician made a comment about laying off the sugary drinks. Except she doesn’t like juice and pretty much only drinks water and milk. She’s an active kid and eats pretty healthy, the weight gain was concerning for me. Add to that, I had started to notice she was having body odor. Weight gain and body odor – the symptoms that put early puberty on my radar. The pediatrician was able to explain it away, we started using a natural deodorant, and we went on with life.

Over the course of the next year I continued to have concerns about the increasing body odor. When she was about 7 I noticed the first growth of pubic hair.

Around this time we moved cities and I had a new pediatrician to get in front of. She was able to explain away all of the symptoms and didn’t believe they were connected. She told me this was the age that girls might showing signs of puberty but it didn’t mean puberty was actually starting. To put my concern at rest, she suggested we do a non-invasive bone age scan. We had a quick visit to the radiologist and were told that her bone development was completely normal and on track with her chronological age. While that should have put me at ease, my gut felt like I something else was going on.

At about age 7.5 I noticed additional pubic hair, breast development and hair under her arms.

We went for another bone age scan, 6 months following the first scan, and her scan showed accelerated growth. My daughter was 7.5 chronologically, but her bones were maturing quickly and showing a bone age of 10.5. This lead our pediatrician to order some bloodwork and eventually refer us to a pediatric endocrinologist. Just before her 8th birthday she was diagnosed with Central Precocious Puberty.

Central Precocious Puberty (CPP) is a condition where puberty starts too soon in children, usually in girls under 8 and boys under 9.

We ruled out any specific underlying cause of the CPP and discussed treatment options. Along with the recommendation of the endocrinologist, we decided to move forward with treatment. We were trying to prevent 1) a menstrual cycle at a young age and all the emotional weight that would carry, but possibly more importantly, 2) fusion of her growth plates at too young of an age. She is always going to be on the petite/short side, but we want her to be able to reach her maximum growth potential.

I won’t get too technical into the medication involved, but in the most basic sense, we are using a drug to block sex hormones and prevent further development. That drug is administered in a monthly injection or a small implant that can last up to 18 months. She understands that her brain tells her body when to grow. In her case, her brain is telling her body to grow too fast and we need to help slow down the process. We started with injections and eventually had the implant surgically placed. We will treat her until she is 11 years old, and at that time, we will let nature take over.

After three months of treatment, her bone age scans have leveled out and her hormone levels are right where they should be for her chronological age.

This has been a good reminder for me to always trust my “parent instinct” because had I not made such a fuss about it, I think we would have missed the window to treat her.

For more information about Central Precocious Puberty, here are two websites I found helpful in my research:

https://www.lupronped.com/understanding-central-precocious-puberty.html (full disclosure this is from one of the drug companies, however I found it to be incredibly informative and helpful. Also included help for explaining to my child what was happening.)

https://www.magicfoundation.org/growth-disorders/precocious-puberty/ (very thorough and helpful information regarding CPP and how to talk to your pediatrician)

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