Precocious Puberty
"All of our friends told us to cherish every moment," Claudia says. "When I started planning her first birthday party, I remember crying and wondering where the time had gone."
Even so, Laila's parents never expected their baby to hit puberty at age 6.
They first noticed something different when Laila was 3, and she began to produce the sort of body odor normally associated with adults. Three years later, she grew pubic hair. By age 7, Laila was developing breasts.
Without medical treatment, doctors warned, Laila could begin menstruating by age 8 - an age when many kids are still trying to master a two-wheeler. Laila's parents, from the Los Angeles area, asked USA TODAY not to publish their last name to protect their daughter's privacy.
Doctors say Laila's story is increasingly familiar at a time when girls are maturing faster than ever and, for reasons doctors don't completely understand, hitting puberty younger than any generation in history.
About 15% of American girls now begin puberty by age 7, according to a study of 1,239 girls published last year in Pediatrics. One in 10 white girls begin developing breasts by that age - twice the rate seen in a 1997 study. Among black girls, such as Laila, 23% hit puberty by age 7.
"Over the last 30 years, we've shortened the childhood of girls by about a year and a half," says Sandra Steingraber, author of a 2007 report on early puberty for the Breast Cancer Fund, an advocacy group. "That's not good."
Girls are being catapulted into adolescence long before their brains are ready for the change - a phenomenon that poses serious risks to their health, says Marcia Herman-Giddens, an adjunct professor at the University of North Carolina-Chapel Hill.
"This is an issue facing the new generation," says Laila's doctor, Pisit "Duke" Pitukcheewanont, a pediatric endocrinologist at Children's Hospital of Los Angeles, who treats girls with early puberty. "Many parents don't know what is going on."
Researchers don't completely understand why the age of puberty is falling, Herman-Giddens says. Most agree that several forces are at work, from obesity to hormone-like environmental chemicals. There's no evidence that boys are maturing any earlier, says Paul Kaplowitz, author of Early Puberty in Girls.
But data clearly show that girls once matured much later, probably because poor diets and infectious diseases left them relatively thin, Steingraber says. Girls' lack of body fat may have sent a message to their bodies that they weren't yet ready to carry a pregnancy, she says.
In the 1840s, for example, girls in Scandinavia didn't begin menstruating until age 16 or 17, says Kaplowitz, a pediatric endocrinologist at Children's National Medical Center in Washington. As nutrition and living conditions improved, the age at first menstruation occurred two to three months earlier each decade. By 1900, American girls were getting their periods at age 14.
Though the age at which girls get their first period has continued to fall slowly since then, the age at which girls begin developing breasts has declined much more dramatically.
Early puberty increases girls' odds of depression, drinking, drug use, eating disorders, behavioral problems and attempted suicide, according to the 2007 report. When these girls grow up, they face a higher risk of breast and uterine cancers, likely because they're exposed to estrogen for a longer period of time.
Early puberty isn't the only way that childhood is changing
In only a generation, children have become less connected to nature and, in many ways, less free, says pediatrician Chris Feudtner of Children's Hospital of Philadelphia. Today's children rarely, if ever, are permitted to roam wild or play outdoors alone, out of sight of watchful, worried parents. Schools are eliminating recess, even as they install vending machines in school cafeterias.
No one should be surprised, Feudtner says, that this generation of children is heavier, less active and more prone to chronic disease and hormonal changes.
"It's very concerning that girls are continuing to develop earlier and earlier," Herman-Giddens says. "We need to look at our environment and our culture, and what we're doing to our kids."
Maturing too quickly
When Laila's parents took her to a doctor, he had disturbing news.
One of the causes for their daughter's precocious development, they learned, could be a brain tumor.
"That's when you have your sleepless nights," says Laila's father, Joe, an engineer.
Although scans showed that Laila did not have a tumor, tests did find that she was maturing at an alarming rate, with the skeletal development of a child several years older. Yet her early maturation was likely to cut short the total amount of time she spent growing, so Laila - who was tall, athletic and slim - probably would wind up much shorter than many of her friends, her father says.
Doctors told the family that monthly hormone shots could stop her breast development and prevent Laila from getting her period. Typically, girls get their periods at around the same ages that their mothers did. Claudia says she didn't begin menstruating until 12.
Comment: Monthly hormone shots to stop premature development? It would seem that the last thing that young girls would need is more hormones!
Girls entering puberty by the age of six - but are drugs the answer?
Meanwhile, as highlighted in a forthcoming BBC radio programme, a debate is raging in the medical profession about what should be done about this trend: should powerful drugs, normally used to treat cancer, be routinely prescribed to young children to block the hormonal changes taking place in their bodies; or should the medically defined normal age range for onset of puberty simply be adjusted downwards so that the increasing number of children reaching sexual maturity while still at primary school are no longer viewed as abnormal?
Not surprisingly, the drugs industry supports the first approach.
In the past four years, drug manufacturers have alighted on this expanding market for premature puberty treatment. The hormoneblocking drugs Gonapeptyl and Decapeptyl have been licensed for use in children, although the manufacturers refuse to say how widely they are being prescribed.
A spokesman for Ferring, which makes Gonapeptyl, says the drug was licensed to treat girls who reached puberty before their ninth birthday and boys who reached puberty before the age of ten, but claimed it had not been on the market long enough to report what the take-up had been.
A different approach is being suggested by experts such as the American Academy of Pediatrics which wants to lower the age of 'normal' puberty to as young as seven.
Given Laila's fear of needles, the prospect of monthly injections seemed too traumatic, her parents say.
"I'd heard horror stories, about three nurses having to hold down an 8-year-old" to administer the shots, Joe says.
Laila's parents reconsidered after their doctor learned of a newer type of hormone therapy, which is implanted beneath the skin once a year, during minor surgery. Laila, now 9, has since had two of the implants, with no side effects. The family is considering one more implant before allowing nature to take its course. As in most cases of early puberty, doctors have never pinpointed what caused Laila's precocious development.
Comment: Dr. Mercola lists important information in the following article that may pinpoint the cause of precocious development in young girls: The Alarming Reason Why More Girls are Starting Puberty Early
What's Causing Precocious Puberty?For a more in depth look at the evils of dairy read the following: Why Milk Is So Evil
Scientists have brought forth a number of potential explanations, and in all likelihood it's a combination of factors, such as:It's now a well-established fact that commonly used plastic chemicals, such as bisphenol A and phthalates, disrupt the human endocrine-system and affect your hormones, which control development and function in your body.
- Hormones in food
- Pesticides in produce
- Obesity (which exposes girls to more estrogen because estrogen is stored in fat tissue)
- Phthalates in plastics and cosmetics
There's also mounting evidence that these chemicals can cause developmental harm in fetuses and children, either through active exposure during pregnancy and/or while nursing, or due to the preexisting toxic load of the mother.
Unfortunately, it's near impossible to actually study and test these factors because we're surrounded by so many estrogen-like chemicals, there are virtually no 'clean' control populations with which to compare!
It is truly a sad testament to the level of chronic toxicity we humans now live in.
Overweight children have elevated levels of insulin, an increased ability to convert hormones into estrogen, and an increased ability to store environmental toxins, all of which may contribute to early puberty. But obesity is not a cause of early puberty in and of itself.
It is, however, directly linked to diet, and the primary reason why diet may be a driving factor behind the early puberty phenomenon is the excessive use of hormones and other estrogen-mimicking chemicals in livestock and dairy production.
The US FDA currently allows six different kinds of steroid hormones to be used in food production.Federal regulations allow these to be used to 'beef up' cattle and sheep, but not poultry or pigs.
- Estradiol - natural female sex hormone
- Progesterone - natural female sex hormone
- Testosterone - natural male sex hormone
- Zeranol - synthetic growth promoter
- Trenbolone acetate - synthetic growth promoter
- Melengestrol acetate - synthetic growth promoter
In addition to these types of growth hormones, most conventional meats are also heavily contaminated with pesticides, courtesy of the cattle's grain- and corn-based diet.
Dairy is another major source
The genetically engineered recombinant bovine growth hormone (rBGH or rBST) is permitted to be used on dairy cows to increase milk production, despite the fact that rBGH-containing milk contains high levels of a natural growth factor (IGF-1), which has also been incriminated as a major cause of breast, colon, and prostate cancers.
Unfortunately, labeling is not required by law. Some brands will state that their milk is "rBGH-free" however, and organic dairies also do not use rBGH. Either of these are certainly preferable to milk that contains this dangerous hormone, but I still don't recommend drinking any kind of pasteurized milk, organic or otherwise.
"She is still our baby," Claudia says. "But to look at her now, and think that she is growing faster than the average, we can't help but to feel like we are being rushed through her primary years."
Why is this happening?
Like Laila's parents, many people wonder: Why is this happening?
While much about early puberty remains a mystery, researchers say that suspects include:
- Obesity The clearest influence on the age of puberty seems to be obesity, Steingraber says. In general, obese girls are much more likely to develop early than thin ones. And the number of heavy girls is growing, with 30% of children overweight or obese, the Centers for Disease Control and Prevention says.
Obesity raises the levels of key hormones, such as insulin, which helps regulate blood sugar, and leptin, a hormone made in fat cells that helps regulate appetite, Steingraber says. While leptin may not trigger puberty by itself, research suggests that puberty can't start without it.
Scientists aren't yet sure whether insulin - or the body's problems processing it - is a factor in early puberty, Steingraber says. - Prematurity Rising rates of prematurity - which have increased 18% since 1990 - may contribute to early puberty, as well.
Babies born early or very small for their gestational age tend to experience "catch-up growth" that can lead them to become overweight, Steingraber says. Children who undergo rapid weight gain tend to become less sensitive to the hormone insulin, putting them at greater risk for diabetes, Steingraber says. - Genetics Studies consistently show that black girls in the USA go into puberty earlier than whites, suggesting a possible genetic difference. Yet Steingraber notes that, 100 years ago, black girls actually matured later than whites. And she notes that black girls in Africa enter puberty much later than those in the USA, even when their nutrition and family incomes are comparable.
Kaplowitz notes that black girls in the USA tend to have higher levels of insulin and leptin. He notes that researchers are trying to figure out how problems in the body's response to insulin, which are more common among American blacks, might also affect the start of puberty. - Environmental chemicals A variety of chemicals - found in everything from pesticides to flame retardants and perfume - can interfere with the hormone system, Herman-Giddens says. For example, chemicals used to soften plastic, called phthalates, can act like hormones. In a small study of 76 girls in Puerto Rico, researchers found that 68% of girls who went through early puberty had been highly exposed to phthalates, compared with only 3% of girls developing normally.
Steingraber is also concerned about an estrogen-like chemical, called BPA, or bisphenol A, that is found in hard plastics, the linings of metal cans and many other consumer products. Although BPA can cause early puberty in animals, its role in humans isn't as clear. But studies by the CDC show that more than 90% of Americans have BPA in their bodies.
The National Institutes of Health is funding research to answer questions about environmental causes of early puberty and hormonal changes, says Frank Biro, director of adolescent medicine at Cincinnati Children's Hospital Medical Center. Biro and colleagues are testing more than 1,200 girls for their exposure to chemicals such as BPA, phthalates, pesticides and chemical flame retardants. The National Children's Study, also funded by the federal government, will study 100,000 children, from before birth through age 21, looking at a variety of environmental exposures. - Screen time There's no evidence that watching sexy TV images can trigger puberty, but spending too much time in front of the screen can harm kids in other ways, such as causing them to gain weight, Steingraber says.
Preliminary research also suggests that screen time may hasten puberty by lowering levels of a critical hormone called melatonin, whose production is regulated by the daily cycles of light and dark, and which appears to keep puberty at bay, Steingraber says. - Family stress Family relationships also may play a role in the start of puberty. Preliminary research suggests that girls may be more likely to develop early if they experience more family stress, or if they don't live with their biological fathers, says Julianna Deardorff, a clinical psychologist at the University of California-Berkeley's school of public health.
Comment: Researchers: Obesity May Start as Early as a Baby's Bottle
Three separate studies presented at the European Congress on Obesity in Geneva found that mice which were exposed during early development to chemicals used in products such as plastic food containers or even boat paint tended to become fat later in life.
The findings could change how obesity is viewed and dealt with, according to an expert on the subject.
Jerry Heindel from the United States National Institute of Environmental Health Sciences said:"If these findings are proven to be true in humans, then the focus must change from losing weight as adults to prevention of weight gain during development, through reducing the exposure to such substances."
Comment: Environmental Chemicals can have devastating effects on human health, in the following article US Doctors and Young Mom Want Overhaul of Toxic Chemicals Law. Dr. Linda Giudice discusses treating thousands of patients over the years with a range of troubling reproductive disorders, and she fingered chemicals as the probable cause.
"There is increasing evidence that environmental contaminants may be playing a role in these disorders," said Giudice, who chairs the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco.According to the Dr. Mercola article linked above:
"Today there is ubiquitous exposure to environmental contaminants through air, water, food, drink, cosmetics, personal care products, pesticides, herbicides and everyday household items," said Tracey Woodruff, director of UCSF's program on reproductive health and the environment.
Even the flame retardants used in furniture contain potentially harmful chemicals, said Woodruff.
"We have begun to question whether exposure to these are affecting our reproductive health," she said.
A massive study released in August that showed US girls are starting puberty earlier than they were just 10 years ago singled out endocrine disruptor chemicals as one of the likely culprits of early onset puberty, said Woodruff.
An overwhelming majority of the girls in the study who developed breasts and started their menstrual cycles as young as age seven had high levels of flame retardant and other chemicals in their bodies.
Some of the chemicals were banned decades ago but "remain in the food chain," said Woodruff. Others are commonly found in household cleaners and other items that people come into contact with every day.
There are about 75,000 chemicals regularly manufactured and imported by U.S. industries - the vast majority of which have never been tested for safety. Rather than compile an endless list of what you should avoid, it's far easier to focus on what to do to minimize your exposure.To learn more about the connection between early puberty in girls and toxic chemicals read the following articles:
Theo Colburn's book Our Stolen Future is a great source for further investigation as it identifies the numerous ways in which environmental pollutants are disrupting human reproductive patterns. I believe it is one of the best resources on this topic and highly recommend it.
Endocrine Disruptors Really Do Suck
Puberty in Girls Hastened by Harmful Chemicals
Exposure to fluoride induces early puberty
Vaccine Exposures to Thimerosal (Mercury) & Premature Puberty
During the past decade, possible advancement in timing of puberty has been reported in the US. Recently, attention has been paid to the possible role of endocrine-disrupting chemicals on the timing of puberty. The US Agency for Toxic Substances and Disease Registry (ATSDR) of the US Centers for Disease Control and Prevention (CDC) reported that mercury is a known endocrine disruptor and it adversely affects the steroid synthesis pathway in animals and humans.
Supporting girls as they go through puberty can help them weather the stress, at any age, says Eleanor Mackey, a child psychologist at Children's National Medical Center in Washington.
Laila's mother says her family's faith has sustained them.
"We're a prayerful family," Claudia says. "Laila is very secure in who she is and all that God has given her. Our job is to be there for her and support her through it all, and to make sure she is healthy and getting all she needs."
While the experience has been frightening at times, Claudia says her daughter has emerged as a more caring person.
"At first, as we were going to all these doctors, we tried to keep stuff from her," Claudia says. "Eventually, we had to share what was going on. We'd be at Children's Hospital, and she'd see all of these kids in wheelchairs, and ask, 'Mommy, am I sick? Am I going to get sick like that?' I told her no, but said, 'Consider yourself blessed that this is the only thing that you have to go through.' "
Comment: Additional articles on the topic of the precocious puberty:
Study: More U.S. Girls Starting Puberty Earlier Than Ever
Average Age of Girls Starting Puberty Falls Below 10
Breasts at 7 Years Old: How Chemical Hazards May Wreak Havoc on Children's Bodies
Puberty Hitting Girls as Young as 4 Years Old:
That scientists "can't figure out" what the causes are, when it is so obvious, really. Obesity is #1 (fat produces estrogen); even when I was a child the larger girls developed years earlier. And BGH, naturally. These two things alone probably account for 50% of the early onset, the rest being various other exposures to toxicity and plastics. But to acknowledge the problem (rather than pleading ignorance) I suppose would mean they would have to take action, and well, we know they don't want to do that. More $$'s to be made off injecting the kids with more poison.