INTRODUCTION:

A baby is born with many instinctive abilities which enable In the past, women did not reach puberty until the age of 16 or so, the last half a century; the average age of puberty has fallen, with a large differences depending on a person’s background.

Every child is unique and puberty will begin at a different age. Puberty can be a very exciting and thrilling, yet scary and confusing time for child. During puberty, child will go through an astounding number of changes. While there is a fairly large range just when a child may start puberty, there is cause for concern if child starts to develop too early; which is known as precocious puberty, girls who begin maturing before the age of seven or boys who enter puberty before the age of nine should need consulting.

Precocious puberty (Blossoming Early)

Precocious puberty means having the signs of puberty (development of breasts, testes, menstrual bleeding; body odor, pubic and underarm hair and increased growth rate) earlier than usual. Precocious puberty is puberty that starts before age 7 in a girl or 9 in a boy.

Precocious puberty is much more common in girls than in boys. Many girls experience precocious puberty in the absence of any disease condition. In boys, however, precocious puberty is more likely to be associated with some 0underlying medical problem. While in many cases the exact cause of precocious puberty cannot be determined, a small number of cases are related to abnormalities of the ovaries or testes, thyroid gland abnormalities or other hormone problems, genetic conditions, tumors, infections or injury to the brain.

Is blossoming early good, or bad?

Earlier puberty is neither good nor bad. It is just something that happens. But one problem is that parents of the early developers sometimes don't believe that puberty started so earlier to their children. Parents may be confused and even frightened by their children's behavior as they go through the physical and emotional changes of pubertyVarious complications may arise from puberty starting at too young an age.

There are two kinds of early puberty.

Central precocious puberty Is the more common form of precocious puberty. This occurs when the brain starts earlier the normal process of puberty triggering the release of various hormones. In most cases, there is no known reason. Very rarely, central precocious puberty has a medical cause, like an infection or growth in the brain.

Peripheral precocious puberty is less common. It usually develops when a problem with the ovaries or testicles like a cyst or a tumor triggers the release of the hormones estrogen or testosterone.

Possible reasons for early puberty are:

· Bottle feeding is the majore problem of the children. It has more calories than mothers’ milk and does not have the natural preventatives that mothers’ milk contains.Studies have shown that breast fed babies have less body fat than formula fed babies.

· Better nutrition which leads to greater body mass and more body fat, which can start puberty early. Leptin is a protein produced from fat cells that encourages early breast development. So, the more fat cells, the more leptin are produced by the body. In addition, overweight girls have more insulin circulating in their blood. High levels of insulin stimulate the production of sex hormones such as oestrogen.

· Lack of exercise in very active children, such as gymnasts, puberty starts later, so inactivity may start puberty earlier.

· Stress girls whose parents divorce, for instance, may start puberty earlier. A father’s presence has been consistently shown to affect a girl’s first period; the longer the absence of a father the earlier a girl’s first menstruation.

· Chemicals in food are present day majore problem, they causes early puberty in children.

· Environmental Chemical the early breast development of the children are linked to exposure to phthalates, a ubiquitous chemical plasticiser. They are found in shampoo, building materials, food packaging and food wrap, teething toys, baby bottles and other children's products, medical devices, garden hoses, shoe soles, cleaning supplies, automobile undercoating, wires and cables, carpet backing, carpet tiles, vinyl tiles, swimming pool liners, artificial leather, canvas tarpaulins, notebook covers, tool handles, dishwasher baskets, flea collars, insect repellents, skin emollients, hairsprays, nail polish and perfumes.

· Medical conditions such as congenital adrenal hyperplasia, neurofibromatosis, and hypothyroidism, Head injury including radiation and surgery.

Signs of Precocious Puberty

In girls, the signs of precocious puberty include :

· Early breast development

· Changing body smell. "mature" body odor

· Development of pubic or underarm hair earlier

· Getting pimples.

· Rapid growth in height.

· Menstruation occurs

In boys, the signs of precocious puberty before 9 years of age include:

· Early enlargement of the testicles or penis

· voice deepening

· Development of pubic, underarm, or facial hair development

· Rapid growth in height

· Changing body smell “mature" body odor

Diagnosis

· A physical exam, to evaluate any changes in the body.

· A family history, to find out if early puberty might run in the family.

· Blood tests, which detect elevated levels of sex hormones and sometimes thyroid levels.

· X-rays, usually of the hand and wrist, to check a child's bone age. This is a way of seeing how quickly he or she is growing.

· MRIs of the brain. These are sometimes used to rule out medical problems that could cause central precocious puberty, like tumors. MRIs are not routine for most of the kids.

· Ultrasounds of the ovaries can be helpful in some cases.

Preventing Early Puberty

Precocious puberty is a dangerous experiment of this-century living, making children teens before their time. However, with vigilance, education and the commitment to healthy life changes, our children's endocrine well-being and their future health can be ensured.

The greater success of reversing the signs of puberty is by earlier identification of this problem.While genetic factors play a role in the early onset of puberty, parents can help to delay the environmental causes of early puberty. Preventive measures include:

I. Encourage child to maintain a healthy weight.

Some eating habits that will help child to lose weight include:

Breast feeding: Instruct about the benefits of breast feeding to all mothers through local hospital and clinics.

· Healthy Meals: child should eat three well-balanced meals of average size each day. Serve fewer fatty foods. It is best to prepare foods that are baked, boiled or steamed, rather than fried. Provide large servings of vegetables.

· Organic foods: Provide as much of organic diet as possible. This will eliminate the toxin, hormone-disrupting chemicals that are sprayed on fruits and vegetables. Also, should eat organic meat, poultry, dairy foods and butter that are free of steroid hormones and antibiotics. Organic foods have been found to contain higher amounts of vitamins and minerals.24 Be aware that the following commercially grown fruits and vegetables have been found by the Environmental Working Group to contain the highest levels of pesticide contamination: spinach, strawberries, apricots, green beans, peaches, celery, cucumbers, cherries and grapes

· Glutamine-rich foods such as broccoli, cauliflower and other cruciferous vegetables, asparagus, spinach, watermelon, pears, squash and potatoes help the liver to remove environmental waste and give protection against pollution: Allylsulphide-containing foods like garlic, shallots, onions and chives stimulate glutathione production..

· School: Eliminate high calorie foods in the school setting.

· Drinking: Encourage child to drink four to six glasses of water each day, especially before meals. Water has no calories and it will help to feel full. Other drinks can include diet sodas and lowfat milk. Avoid regular soft drinks or fruit juices, as they are high in calories (150-170 calories per serving).

· Single Servings: Avoid serving seconds of the main course or dessert. Can eat more salad or other vegetables if still hungry.

· Desserts: serve fresh fruit as a dessert and avoid frequent eating of ice cream or cake or other high calorie foods.

· Grocery shopping: buy low-calorie and lowfat meals, snacks and desserts and buy low fat or skim milk. Avoid buying high calorie desserts or snacks, such as chips, soft drinks or ice cream.

· Eat at the table: Avoid permission to eat meals or snacks outside of the kitchen or dining room. And no eating while watching TV.

· Avoid Fast Food: children should limit to eat fast food, as it is usually high in fat and calories.

· Get exercise. Exercise promotes sweating. Sweating eliminates all kinds of chemicals from our body.

II. Prevent Exposure to chemicals:-

· Avoid exposure to exogenous hormones like estrogen, testosterone, androstenedione that may be found in creams/gels, hair treatments, medications, and nutritional supplements.

· All external sources of hormones and hormone-mimicking chemicals should be avoided. These include non-organic meat, pasteurised dairy products, sugar and refined carbohydrates, junk food, agricultural and industrial chemicals, and all commercial household cleaning products and personal care products (suntan lotion, shampoos, bubble baths, moisturisers, etc.). Our bodies, our homes, our gardens and our schools should be made chemical-free zones.

· Don't let children chew on soft plastic toys. Phthalates are added in soften plastic toys. These plastic toys also retain any pesticides sprayed in the house for up to two weeks. Buy unfinished wood or natural fibre toys.

· Teach children to wash their hands frequently and not to lick their fingers or bite their nails. Since chemicals inevitably get deposited on surfaces, frequent cleaning with organic cleaning products is a safe, preventive measure

· Use plants for filtering chemicals from the air in home. Even chemicals emitted from new carpets or curtains can be filtered by common household plants

· Encourage children to involve growing a garden within the school in connection with the community or help with a farmers market if available.

Girls have more negative effects on early puberty

They face mental and physical health problems including:

· Girls’ tend to be looked down upon and treated poorly by peers

· Kids with precocious puberty usually don't achieve their full adult height potential.

· Emotions and behavior may change in kids with precocious puberty. Girls become moody and irritable. Boys become more aggressive.

· They develop low self esteem.

· Risk for breast cancer

· High incidence of developing smoking, drinking, and cosuming drugs.

· Increase in depression and anxiety.

· They become confused or embarrassed about physical changes.

· Higher pregnancy rate and

· Sexual experimentation. Develop a sex drive inappropriate for their age.

Treatment

The goal is to prevent, kids from dwelling on sexual development or developing a poor self-image or low self-esteem.

Once it's diagnosed, the goal of treating precocious puberty is to halt or even reverse sexual development and stop the rapid growth and bone maturation that can eventually result in adult short stature. Treatment is recommended if the early puberty may cause problems later in life for the Kids, such as weak bones or ending up as a very short adult. Depending upon the cause, there are two possible approaches in treatment:1.Treating the underlying causes, 2.Lowering the high levels of sex hormones.

Role of Parents in handling their children.

The Parents how they are coping up with this issue can also determine how successfully their child will coping up.

· Provide a simple, hopeful, clear explanation about the changes.

· Teach them the reality that his or her body has showing the puberty changes earlier than actual timing.

· Explain abuout treatment choices and get cooperation.

· Watch for signs of teasing or other difficulties associated with precocious puberty. It may be affecting child’s emotional development.

· Create a supportive environment.

· Check warning signs to get treament include:

v Less Concentration on studies

v Not minkiling eith friends at school

v Loss of interest in daily activitie

v Mood changes

· Avoid comments on appearance of children; instead, praise for achievements in school or sports.

· Support the child to participate in all activities of school.

· Advise them not to drop friends of their own age group.

Received on 27.01.2012 Modified on 27.02.2012

Asian J. Nur. Edu. & Research 2(1): Jan.-March 2012; Page 25-27