Children's Health Ames IA
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Medical School: Kirksville Coll Of Osteo Med, Kirksville Mo 63501
Graduation Year: 1995
By Lisa Marshall
One day in the fall of 2001, Denise de Reyna glanced at her 4-year-old daughter, Emily, and noticed something terribly odd. “It looked like she had little breasts,” recalls de Reyna, a mother of three who lives in Port Washington, New York. At first, de Reyna attributed it to baby fat. But when she ran her hand across her daughter’s chest and felt a hard mass beneath her nipple, she got worried.
The next day, as Emily stood in the doctor’s examination room putting her clothes back on, the pediatrician delivered some inconceivable news to de Reyna: It looked as though her preschooler was beginning puberty. “I was horrified,” she recalls. “I’d never heard of such a thing.”
Two years later, Emily had developed underarm hair and body odor. With the possibility of early menstruation looming and doctors warning that an early bone growth spurt could radically stunt her final height, Emily’s parents were forced to make a painful decision: Take a wait-and-see approach and face the physical and emotional consequences, or give Emily monthly injections of a hormone suppressant and stall time.
“In my eyes, I could not have my kindergartner going through puberty,” says de Reyna, who reluctantly opted for medication. “She had already lost some of her childhood, and I would be sadder if she had lost more.”
According to researchers, physicians, and parent advocacy groups, such stories continue to grow more common, as the average age of the first signs of puberty decreases and healthcare providers and parents grapple with what to do about it. In 1997, a landmark study published in the journal Pediatrics confirmed what anyone who had been to a shopping mall or water park recently could confirm: American girls are growing up faster (at least physically) than their mothers and grandmothers did. The study of more than 17,000 girls in the US found that 1 percent of Caucasian girls and 3 percent of African American girls begin developing breasts and/or pubic hair by age 3. By age 8, roughly half of African American girls and 15 percent of Caucasian girls show clear signs of sexual development. Overall, African American girls begin puberty between age 8 and 9, and Caucasian girls begin by age 10—as much as a full year earlier than in the 1960s. And girls today start menstruating between ages 12 and 13, slightly earlier than in decades past.
Because boys’ first sign of sexual development (enlargement of the testicles) is more hidden, data on them remains sparse. But one federally funded 2001 study of more than 2,000 boys suggests they too are maturing earlier, with 30 percent of Caucasians, 38 percent of African Americans, and 27 percent of Latinos showing some genital development by age 8, and an average age for pubic hair development between 11 and 12.
In order to quiet parental fears and prevent unnecessary treatment with potentially dangerous medications, many in the pediatrics community have responded by lowering the definition of “norma...
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