Please tell me about precocious puberty...

[fivi2]

Twin dds just turned 7 in December (and were preemies). They are petite but proportional (ie, they are slim, but I have never worried about them being too skinny).

Twin B was complaining about her nipple hurting yesterday. It was slightly swollen compared to her other one, and there is a small lump under it.

Dr. Google is basically only turning up breast buds and the beginnings of puberty. I am not ready for this - they are in first grade! I did develop on the early side (started my period in 5th grade) but I don't remember starting this early!

I had asked their ped at 7 yo check up about their body odor - her said not to worry... Well, I am now worried.

I love our ped, but I don't think he is going to take this seriously. I can go to a specialist without his referral.

Any advice? What sort of doctor do we go to? Is there anything a doctor can/should/would do? Arggh!!

Thanks!

[tambo]

I would see an endocrinologist. Although your pedi may be right and it may be nothing to worry about at all, an endocrinologist may want to check labwork and will know how to interpret it better than your pediatrician. He or she will also do a more thorough exam looking for other potential signs of puberty. There can be many potential causes of precocious puberty, some of which can and should be treated.

[Mermanaid]

DD8 was diagnosed with precocious puberty right as she was turning 7. She complained about her breasts hurting and I noticed pubic hair. Our pediatrician immediately sent us to the ped endocrinologist as soon as we discussed the symptoms.

The first thing the endo did was a physical exam and a bone age test. The bone age test is just a hand X-ray where they measure the distance between joints to determine how old the body thinks it is. If the body thinks it is two years or more over chronological age they treat immediately.

DD was about a year and 7 months on the bone age so we waited a few months and went back for a very long blood test (can't remember the name of it) where they dosed her up with hormones and drew blood every hour for three hours to test her estrogen and other levels. Then we went back for a 24 hr draw. She failed that test miserably.

The next step was to have an MRI to make sure there wasn't a pituitary cause (was this happening in her ovaries or pituitary gland). In our case it was ovarian, which is easier to treat.

So last fall we took her in and had Supprelin inserted into her arm. It is kind if like the old Norplant. Releases a low dose of Lupron to suppress the body. This has to be replaced every year. The alternative is a monthly injection so we thought this was much easier.

The whole idea of precocious puberty is very scary at the outset. But there are ways to control it. What I have found to be most important with DD is to help her understand and deal with it on an emotional level. We haven't given her the details, just that her body is growing and changing faster than it is supposed to. But she knows and asks questions that we answer honestly.

The Supprelin is really doing its job though. At six weeks post implant her breasts were really softening. We are at 6 months now and her acne is almost non existent and the mood swings have really slowed down.

Please let me know if you have any questions. I honestly think this was much harder on me than it was on DD

[fivi2]

Thank you! I must admit that I am completely freaking out right now!

I am glad your dd is doing so well - that must be a relief.
I will call the ped endocrinologist Monday and try to get in asap.

Do you have any idea if this is genetic? Should I try to get both tested even though only one is developing the breast lumps? They are identical twins and both have body odor issues.

[anamika]

Hi Jenn,
I just wanted to say thanks for the detailed posts. I have read most of your posts on this and have found them very helpful.
DD had some protuberance around her nipples but not lumps. I had her checked and the ped was able to reassure me that it was in the realm of normal.
We also had DD's bone age tested and she is 2 years younger than she should be. People are always asking if she is 6 when she is 8.
Fivi, I hope you get some answers soon. If your ped is not taking it seriously I would seek out a specialist for sure.

[urquie]

If it were me, I'd ask for a lab work-up and a bone age test.

DD (8yrs) has armpit hair, so took her to the ped, to get checked. She sent us for an x-ray, to determine bone age and for a blood draw/lab work-up. Turned out she is fine, just a bit early.

Something interesting thing I learned is that breast buds and menstruation are connected, one generally following the other by two-ish years. And body hair and I think facial blemishes, (maybe body odor) are connected.
It's a bit fuzzy now, but I was surprised that they are separately connected... So we don't need to worry about DD menstruating or needing a bra soon, just because she is growing body hair.

[Mermanaid]

It can be genetic, it can be environmental. Our endo does not believe it is caused by the hormones in food because we just don't get enough exposure (controversial, I know). She believes it's an evolutionary change and has noted that girls are going into puberty earlier but in many cases their periods aren't starting until the "typical" ages. I really wish I knew the answer.

If I were in your shoes, I would call your ped and explain the body changes in one twin. Ask for a referral to a ped endo. I say this because our ped opened the door to get into Children's Hospital much sooner than we could have on our own.

If you skip the ped or he/she isn't cooperative and go straight to endo yourself, I would explain the twin situation when making the appt. The Drs office can help you figure out whether they should both be seen.

If only one is exhibiting symptoms though I would focus on that one for initial appts and evaluation.

[mom2binsd]

My DD complained of the same pain when she was 7 years 6 months, when our ped examined her her determined it was breast buds and that she was within the normal range for development, at that time there were no other signs of puberty. It was only on one side for a bit, then both sides. She has slowly developed breast tissue over the last two years, and at age 9 years about 3 months began to develop pubic and underarm hair, which I can tell you comes in quickly once it starts....:eek:

So although we were shocked that it was not a "cyst" as was my initial reaction, my DD was just at the early end of normal.

She also did NOT fit the profile of some of the girls who start puberty early, she has no body fat, is currently 58" tall and only weighs 63lbs, so those it almost makes it more obvious, as her breasts seem to stick out more....

I'd definitely start with your ped or ask for referal to and endrocrinologist.

As for the genetic component. I was a typical to late bloomer, got my period about age 13, but MIL was an early bloomer. My mother passed away a long time ago and I don't know about her development.

[fivi2]

Thanks again everyone! I appreciate all of the advice. I will call the ped first and see what he thinks, but I probably won't stop with him. (I do like him a lot, but he tends to be old school.)

Thank you for the help!

[Mermanaid]

Oh and I wanted to add that both the ped and ped endo noted that if the breast buds had started developing at age 8 or later then they probably would not have done anything to stop the puberty. 8 and up is considered normal. I wish I had a picture of my facial expression when they told me that!

The ped did state that she thought 8 was on the young side but that it's not unexpected.

[citymama]

I'm not an expert as the others are here, but doesn't a lump under one breast seem like something other than precocious puberty? Sending hugs, OP, as I can well imagine how tough it is to be in this place. Keep us posted.

[mom2binsd]

[QUOTE=Mermanaid;3734967]Oh and I wanted to add that both the ped and ped endo noted that if the breast buds had started developing at age 8 or later then they probably would not have done anything to stop the puberty. 8 and up is considered normal. I wish I had a picture of my facial expression when they told me that!

The ped did state that she thought 8 was on the young side but that it's not unexpected.[/QUOT

A lot of my reading put the normal range starting at age 7, I guess because my Dd was 7.6 they chose not to send for further testing. It seems that this is such a newish area that there is a lot of variation in recommendations too. I'm glad your little one is doing great and part of me wishes that my dd wasn't having to deal with puberty right now and that we could have delayed things a bit if it had been truly precocious puberty and not just early normal puberty.



Sent from my SPH-L710 using Tapatalk 2

[Green_Tea]

I'm not an expert as the others are here, but doesn't a lump under one breast seem like something other than precocious puberty? Sending hugs, OP, as I can well imagine how tough it is to be in this place. Keep us posted.

I agree. I wouldn't assume that a lump under one breast is necessarily the beginning of puberty and would probably just watch it for a week or so and then call the ped. FWIW, my DD also had body odor in 1st grade, and is now 10 and in 4th - and she still hasn't started puberty.

[AnnieW625]

Oh and I wanted to add that both the ped and ped endo noted that if the breast buds had started developing at age 8 or later then they probably would not have done anything to stop the puberty. 8 and up is considered normal. I wish I had a picture of my facial expression when they told me that!

The ped did state that she thought 8 was on the young side but that it's not unexpected.

I remember girls starting to get breasts in the 3rd grade in the mid 80s so yeah I think 3rd grade or 8 could be normal and now with more red shirting I bet 3rd grade will be much more common.


I'm not an expert as the others are here, but doesn't a lump under one breast seem like something other than precocious puberty? Sending hugs, OP, as I can well imagine how tough it is to be in this place. Keep us posted.

It could be a papaloma, my sister has one directly underneath her breast (not directly near her nipple, but down off to the side at the bottom of the cup). Hers started when she was 4 or 5.
http://en.m.wikipedia.org/wiki/Papillomaviridae

Good luck and I hope things go well.

[westwoodmom04]

I agree. I wouldn't assume that a lump under one breast is necessarily the beginning of puberty and would probably just watch it for a week or so and then call the ped. FWIW, my DD also had body odor in 1st grade, and is now 10 and in 4th - and she still hasn't started puberty.

This is reassuring. My dd started needing deodorant in second grade (she is 8), and it has me a little concern. No other signs of puberty yet except moodiness but that seems to be more a permanent personality trait.

[fivi2]

I'm not an expert as the others are here, but doesn't a lump under one breast seem like something other than precocious puberty? Sending hugs, OP, as I can well imagine how tough it is to be in this place. Keep us posted.

It could be. But when I google nipple pain, slight swelling and small lump, Dr Google overwhelmingly pulls up precocious puberty... and it appears that it being on one side id not uncommon. I may have been hypersensitive due to the bo issue. But -it is bothering her and iI'd like to get it checked out. I may be jumping to conclusions.