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Wednesday, April 30, 2014

Girls and Puberty - is your daughter normal?

I recently took part in a phone call with Dr. Cara Natterson, author of The Care and Keeping of You, an American Girl book. You might recall that last year I wrote about some puberty books for boys and girls. This is one of the books I covered.

Dr. Natterson was a practicing pediatrician, but is now a full time writer. She's also the medical advisor of HelloFlo, who sponsored the call (founder Naama Bloom was on the call too). More on them later!

Since I have a tween daughter, the puberty issue is of interest and I was curious to hear what Dr. Natterson had to say about it.

Interestingly, boys and girls are entering puberty one to two years earlier than 30 years ago. By puberty, she's referring to the start of body odor, moodiness, hormonal surges, hair and breast development. Now the average age of puberty starting is 8-9 for girls, and 9-10 for boys. You might have heard that for Hispanic and African American kids, the age is younger, and she confirmed this. This is significant because kids of younger ages now need the puberty information even earlier, meaning that it still has to be age-appropriate.

Obesity is associated with an earlier start to puberty, but it isn’t the cause. Obese children have more hormones circulating, which may cause puberty to start earlier for them.

What's the normal range for a girl getting her period?
Surprisingly, it's 8-16, she said, meaning that it's completely normal for a girl to get her first period during any of those ages. The driver of when she gets it is largely genetic. The best predictor is when the mom got her period. 

Again, another component is ethnicity. In the U.S., African American and Hispanic girls are getting theirs earlier than the others, on average.

The average age of a girl's first period hasn’t really changed over the last 30-40 years, in spite of the start of puberty getting earlier by 2 years. The average age a girl gets her period is 12.5 years, which has only shifted down by 2-3 months in last 30 years. Something is triggering our girls to get their period, but we don't know what. They are not accelerating through puberty quickly, but rather getting their periods about same time. No one knows why. 

When is my daughter ready for tampons?
Dr. Natterson said this is the most common question she gets. If your daughter isn't ready to talk about or look at her anatomy, she's not ready to put a tampon inside her body. If she's squeamish about saying the word vagina, she isn't ready. And that's okay.

-Tell her that no one knows she's having her period, no matter what she's using when she gets it. 
-Some kids are afraid they lost their tampon inside of them. This is because they don’t know their anatomy. Likely they either took it out and forgot, or the string is still inside. 
-Girls will tell you when they’re ready to use a tampon, and it's okay if that doesn't happen for a long time.
-For anatomy, show them the insert in box or a puberty book. When they're able to look at this, and can promise to change the tampon every 4-6 hours, they're ready.

I couldn't help thinking of the scene in Curb your Enthusiasm where Larry David tries to help a Girl Scout figure out tampon use when she gets it for the first time while selling cookies at his house.

Dr. Natterson gave a few tips for how parents should talk to their kids about puberty issues:

1. Don't use eye contact. If your child asks you a question while staring at you, one of you will feel uncomfortable and you'll edit your answer/tone. Instead, talk about it in the car, on a bike ride or when walking side by side, or at night when you turn off the light and say good night to them.

2. This isn't a one time conversation, so don’t worry if you think you messed it up. This should be a conversation over time.

3. Share your own personal stories, but recognize when you’re making it too much about yourself and redirect it to your child.

A book she recommends if the subject of sex comes up:
It's Perfectly Normal: Changing Bodies, Growing Up, Sex, and Sexual Health

In the next post, I'll talk about celebrating a girl's first period, Hello Flo, and the situation in Africa when girls get their periods. 

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