What is normal puberty? A time of transition from childhood to adulthood, marked by rapid, complex physical, mental and emotional changes: gain in height, weight, muscle mass (especially boys), bone strength, sexual maturity, social and cognitive development, rebellion and independent thinking; with implications for academics, career decisions, social and financial status. The end result is ideally a physically, reproductively, and socially mature young adult. The tempo of puberty is affected by family patterns of growth, general health, nutrition, exercise, and the environment (urban/ rural; altitude, etc.).
The growth process lasts for 4-5 yrs. girls start (breast buds) at 9-11 yrs, grow rapidly for 2-2.5 yrs, then start their periods, grow slowly for 2yrs, then gain no further height. Boys start (increase in the size of testes) at 10-13 yrs, grow steadily for 4-5 yrs, then gain no further height. Parents should pay attention to the general health of their 10-15 yrs old children: make sure they get 1-2 hrs daily of exercise, 8 hrs of sleep, enough low-fat dairy (milk, curd, paneer) and daals, and no junk food at home—if you have biscuits, chocolates, cold drinks, mithai, fried namkeens, samosas—so will your children!
It’s not surprising that this crucial time is surrounded by myths. Let’s discuss some today.
If my daughter starts her periods early, it doesn’t matter, she will grow till 18 yrs.
No! As we saw, if a girl starts puberty at 8 yrs, periods will start by 10 yrs, and growth stops by 12-13 yrs. Or a boy starts at 9 yrs, he will be done growing by 13-14 yrs. The growing time is relatively constant at 4-5 yrs.
If my 6 yrs old daughter’s height starts shooting up, that’s wonderful!
No! Is this due to puberty? Then she will likely reach final height by 10-11 yrs, with a high chance of being short finally. Consulting the doctor when she gets her periods by 8-9 yrs is already too late—the growing ends of the bones have nearly fused, with hardly any scope for growth left, so no treatment will work much.
It’s not our fault we missed our child’s pubertal development: we are not doctors.
Wrong! Please go to your paediatrician twice a year from 5 yrs—“well visits”—get height, weight, BP, puberty checked. Detect problems early.
My child gained 10 kg during the Covid lockdown, but she will grow out of it.
No! obese girls can start puberty early, and may end up short. Not just early puberty, obese children have a high risk of developing high BP, diabetes, fatty liver, PCOS, knock knees, sleep apnea, and other diseases, even by adolescence.
When my daughter started her periods at 8 yrs, my mother-in-law said don’t interfere with nature; all hormone treatment is wrong.
No! Precocious puberty has important, even serious, implications for your child: in rare cases, it could be due to a brain tumour. It is more worrying in boys and younger girls. Please consult a pediatric endocrinologist (hormone specialist).
The writer is a Senior Consultant Endocrinologist, Madhukar Rainbow Children’s Hospital.