What to do if your child's breasts develop early

We all know that every girl will go through a process of breast development, but the time for different girls may be different. Generally, the development is most obvious around the age of ten, and it is also the fastest time of development. However, some girls will develop breasts prematurely, and parents will be more worried at this time. So what should we do if children's breasts develop prematurely? Let me introduce it to you below!

Breasts, the earliest sign of puberty, usually begin to develop between the ages of 9 and 14. However, with the improvement of living standards, the onset of female breast development tends to be earlier. In recent years, when visiting breast specialist clinics, I often encounter young female mothers who bring their 7-8 year old girls to the clinic due to breast development. The mothers are very confused and worry about whether their children are suffering from precocious puberty and whether it will affect their future height development. As a breast specialist, I would like to discuss the following issues that concern parents and explain the differences between simple premature breast development and precocious puberty in detail. I hope this will be helpful to mothers and help resolve their confusion.

1. Definition:

(I) Isolated premature breast development (IPT) refers to isolated breast development in girls before the age of 8 without development of other secondary sexual characteristics. If it occurs in girls under 2 years old, it is mostly related to prepuberty, which may be due to the physiological activity of the hypothalamus-gonad axis. The common age of onset is less than 15 months, with typical onset below 2 years old, and atypical or variant onset at 4-7 years old. The most common clinically encountered children are girls aged 7-8 years old.

(B) Definition of precocious puberty in girls: It refers to the appearance of secondary sexual characteristics in girls before the age of 8 and in boys before the age of 9. Signs of the appearance of secondary sexual characteristics in girls: breast development, onset of menstruation, early bone age, rapid growth in height and weight, appearance of pubic and armpit hair, etc. Idiopathic central precocious puberty (ICPP) refers to a process in which no organic lesions are found, and the hypothalamus-pituitary-gonadal axis is activated and matured in a programmed manner similar to normal puberty.

2. Causes:

(I) Simple premature breast development (IPT): This may be because the child's hypothalamic stable negative feedback regulation has not yet been established. When the ovarian secretion of estrogen increases, the secretion of pituitary FSH does not decrease significantly, resulting in a temporary increase in blood E2 and FSH. In addition, the intake of exogenous sex hormones may also cause simple premature breast development for a period of time, which will lead to abnormal development of the internal reproductive organs over time.

(ii) Precocious puberty in girls: This may be due to abnormal neuroendocrine regulation function of the hypothalamus. The excitatory factors of the central nervous system become dominant prematurely, causing the medial preoptic nucleus and arcuate nucleus of the hypothalamus to produce excessive GnRH prematurely, leading to premature activation of the hypothalamic-pituitary-gonadal axis and hyperfunction.

3. Clinical manifestations

1. Simple premature breast development (IPT): Girls have enlarged breasts, which appear as disc-shaped nodules behind the areola. It is usually unilateral and progressive, but may become static or regress later. Secondary sexual characteristics do not appear.

(ii) Symptoms of precocious puberty in girls: breast development, appearance of pubic and axillary hair, onset of menstruation, early bone age, rapid growth in height and weight, development of secondary sexual characteristics, as well as development of ovaries or testicles. True precocious puberty means the girl has reproductive capacity.