What to do if your child has precocious puberty

Nowadays, many babies who are still breastfeeding have shown symptoms of precocious puberty, which makes parents particularly distressed because there is no dietary problem at all. But in fact, infants and young children can also suffer from precocious puberty. This is because some milk powders now contain hormone ingredients. If parents do not pay attention to choosing milk powder, their babies will accidentally eat these milk powders that contain hormones. If this continues for a long time, it will sooner or later lead to precocious puberty, so it must be discovered in time and then treated to control it.

1. Luteinizing hormone-releasing hormone analogue (GnRHa): GnRHa is the first choice drug for the treatment of central precocious puberty and is not used to treat pseudo-precocious puberty. The goals of treatment are to improve adult height, delay the progression and speed of maturation of secondary sexual characteristics, prevent premature menarche, and prevent the emergence of psychosocial problems. GnRHa changes the structure of natural GnRH, making it have a stronger affinity with the GnRH receptor, while also having a long half-life and being less susceptible to degradation. Currently, the treatment mostly uses sustained-release preparations of LHRH, the main preparations of which are triptorelin and leuprorelin (enaptoplastin). Non-sustained-release preparations and nasal inhalation preparations used in the 1980s are almost no longer recommended.

LHRH stimulation tests, uterine and ovarian ultrasound, growth rate and bone age monitoring should be performed regularly before and after GnRHa treatment to help adjust the dose and detect whether the HPG axis is suppressed. If FSH and LH levels are elevated, it indicates that the dosage is insufficient. The recommended dose of GnRHa is 60-120 Ug/kg, subcutaneous injection, once a month. In patients who respond to treatment, FSH and LH return to pre-pubertal levels, the ovaries shrink, and the growth rate slows down. For patients with excessive growth deceleration (<4cm/year), the dose can be appropriately reduced. Some children may experience brief and small amounts of vaginal bleeding 1 to 2 weeks after the first dose. Normal puberty and development of secondary sexual characteristics resume after cessation of treatment.

GnRHa treatment can prevent the increase of bone age, so that the bone age/age after treatment is lower than that before treatment, thereby increasing the final height. The difference between the predicted height at the start of treatment and the final height can be considered as the height achieved after treatment, and has been reported by various institutions to be between 3.5 and 6.5 cm. These differences are affected by the size of the bone age at the start of treatment, the patient's growth potential, and the length of the treatment course. The earlier the treatment is started and the longer the course of treatment, the better the effect. The therapeutic effect is poor for those whose bone age has reached 12 years old when treatment begins. Treatment should be terminated at around 12 years of bone age. For those with slowly progressive idiopathic precocious puberty, further decisions on whether treatment is needed should be made based on close follow-up.

2. Danazol: It is a synthetic steroidal heterocyclic compound and a derivative of 17α-ethynyltestosterone. It inhibits estrogen synthesis and ovarian follicle development, can bind to progesterone receptors, accelerate the clearance of progesterone, has strong anti-gonadotropin and weak androgenic effects, and directly inhibits the secretion of GnRH and GH. The dosage is 100-200 mg orally once a night. Adverse reactions include skin allergies, weight gain, elevated transaminase, hematuria, and headache. Liver function and urine routine tests should be reviewed regularly. Some authors have used low-dose danazol to treat idiopathic central precocious puberty and found that danazol can accelerate the growth rate of height. An 8-year follow-up showed that 72.4% of the subjects' final adult height reached or exceeded the genetic target height without obvious androgenic side effects.

Therefore, parents should carefully check the ingredients in milk powder when purchasing it, and it is best to buy some safer milk powder so that they can safely feed it to their children. Also, be careful not to let your children sleep with the lights on. If you often sleep with the lights on, it will also lead to precocious puberty in children. It is best to take them out to play outside frequently and breathe fresh air.