Some kids seem to grow up faster than others. That’s even truer if your child has central precocious puberty (CPP). That’s sexual maturity that starts before age 8 in girls or age 9 in boys.
Puberty can affect how your child looks, feels, and acts. And when it happens too early, kids may get confused or embarrassed. You and your doctor can help talk them through the process.
Here are some topics to bring up.
Often, it's not a medical problem that causes CPP. It’s just an early start to a natural part of life. Jami Josefson, MD, an endocrinologist at Ann & Robert H. Lurie Children’s Hospital in Chicago, says that’s something you should tell your child.
“They may be the first one to have some body changes, and that’s OK,” Josefson says. “Let kids know there’s nothing wrong with them, this is just the way it goes. Soon, everybody else will have these changes, too.”
Josefson suggests parents read about puberty with their child. There are lots of books to choose from, but she likes the Care & Keeping of You series by the American Girl doll company.
Alla Vash-Margita, MD, chief of pediatric and adolescent gynecology at Yale Medicine, agrees that your child should know what’s happening to their body. You can tailor your talks based on your child’s level of maturity and age.
In her practice, kids who are 7 or older usually understand the word puberty, but a 4-year-old may not. So for younger children, she’ll say they’re going through a “transition” from their childhood to teenage years.
Vash-Margita, who treats girls and some transgender boys, says she also explains everything from breast development and growth spurts to pubic hair and periods. Sometimes she’ll use teaching aids.
“I have lots of pictures in my office, so I show them what a body of a child looks like and the body of a girl who has had puberty.”
It’s pretty common for kids with CPP to take drugs known as puberty blockers, Vash-Margita says. One of the main reasons is because early puberty shortens the window kids have to grow taller. Treatment can stop the brain from telling the pituitary gland to make the sex hormones testosterone and estrogen. If taken before puberty ends – something doctors figure out based on bone growth – medication can pause or reverse the maturing process until your child is older.
Medical tests and treatments can be a little scary for kids. So Vash-Margita tells them why their puberty is early and why they’ll stop it. She uses illustrations to show how the brain, ovaries, and uterus all work together.
Then she points out, “In your case, the brain started sending signals to your ovaries, and your ovaries started producing another hormone, and this hormone is making all these changes in your body, and we can give you medication to block that process."
It can be hard for really young children to grasp all that. So Vash-Margita sometimes just tells kids that medicine will slow some body changes down and “allow you to look just like your classmates and friends.”
Girls who develop earlier than their friends may become self-conscious. “Developing breast buds when you’re 4 or 5 is stressful,” says Vash-Margita.
On top of body changes, kids with CPP might have mood swings.
Talk to your doctor if your child isn’t ready for puberty.
“One of the goals of therapy is to keep girls from having a monthly menstrual cycle,” Josefson says. “Which, when girls are really young, can be a challenge to understand emotionally and also from a hygiene perspective.”
Josefson says puberty blockers can "put everything on pause to prevent kids from developing and appearing older than their age."
And let your child know they can come to you if they’re feeling low. Make sure to ask them how their schoolwork and friendships are going, too. Reach out to a mental health professional any time you or your child needs some extra help. Josefson says a social worker or therapist can help your family talk through some of the fears and anxieties around CPP.
Keep in mind that CPP might be a little tougher on transgender children – those who don’t identify with the sex they were assigned at birth. Josefson says most kids with CPP are comfortable with their gender identity. But early puberty can be extra confusing or unwanted for those who aren’t.
Talking to Others About CPP
It’s important to have honest talks with your child and their doctor. But this kind of information is private, Josefson says, and you don’t have to share details with anyone else.
If your extended family or child’s teachers bring the subject up, “you just say the child is tall for their age or this is how development runs in our family,” she says. “It’s kind of none of their business.”
Jami Josefson, MD, pediatric endocrinologist, Ann & Robert H. Lurie Children’s Hospital of Chicago; associate professor of pediatrics, Northwestern University Feinberg School of Medicine.
Alla Vash-Margita, MD, chief, Division of Pediatric and Adolescent Gynecology, Yale New Haven Children’s Hospital; assistant professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine.
KidsHealth.org: “Precocious Puberty.”
Ann & Robert H. Lurie Children’s Hospital of Chicago: “Precocious (Early) Puberty.”