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Fast Fact
The mean age for a girl's first period is 12.75 years.
Precocious puberty is defined as the onset of true puberty before 8 years of age in girls or 9 years of age in boys. (Boepple, et al. Endocrinology, Surgery, and Technology, Vol 1, 1996)
Isolated breast development that doesn't progress to the rest of puberty is called premature thelarche, and is a different, benign condition.
Precocious puberty is 10 times more common in girls than in boys. Sexual development may begin at any age. Pregnancy has been reported as early as 5 1/2 years old.
The Lawson Wilkins Pediatric Endocrine Society recommends evaluating for an underlying medical condition in Caucasian-American girls who have development of breast and/or pubic hair before age seven and in African-American girls before age six (Kaplowitz and Oberfield, Pediatrics 1999 Oct;104(4 Pt 1):936-41). These medical conditions include tumors, cysts, thyroid problems, McCune-Albright syndrome, or external sources of estrogen. Doing studies to look into these possible causes is especially important in girls younger than 6, and in all boys.
The earlier before age 12 a girl starts her period, the higher her lifetime risk for breast cancer (probably from the prolonged estrogen exposure). The highest average risk for breast cancer is in non-Hispanic white women, where it is 1 in 8, or 12.5%. In all girls who start their periods before the age of 12, taken together, the risk is 16.25%.
As a girl reaches maturity, she needs to be made aware of controllable risk factors for breast cancer, such as use of estrogen-containing birth control pills (10 years of use would raise her risk to about 22%), first pregnancy after age 30 (if she did this also, it would raise the risk to about 35%), high-fat diet, alcohol use, fertility drugs, pesticides, and radiation exposure. Each of these factors multiplies her accumulated risk.
My little boy is having a really hard time with teething pain. Is it safe to use benzocaine gel on my baby’s gums?
Benzocaine teething gels are a mixed blessing. They do reduce pain, but they can also leave a baby’s mouth feeling as if he has just been to the dentist. Some babies are happy with the pain relief, but others object to the swollen, numb sensation as much as they do to the pain. Either way, the effect of these gels is very short-lived. And they do carry a small risk of allergic reactions and decreased gag reflexes.
There are also very rare reports of benzocaine causing a potentially deadly blood disorder called methemoglobinemia. In this condition, oxygen delivery to the body is impaired, causing a child to turn blue. Most of these cases involved inhaled benzocaine, but teething gels have been associated with a few cases. Because of the risk for this serious condition, it’s important for parents to be careful when using products with benzocaine. Benzocaine-containing products should be stored in a location that prevents access to these medications by children. When used, the amount of benzocaine administered should be closely monitored.
To find clues as to the best toys, turn off the TV, put away the passive-play toys, and watch your child. Many kids will begin to play spontaneously, using whatever is at hand; take note of what they choose to play with. Click here for more tips on toys for two-year-olds.
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