Just noticed 6YO DD has a few pubic hairs. Bit worried about it...

[Bitzer]

Noticed when we were changing at the beach earlier. She hadn't mentioned it and is a bit shy about changing in front of anyone other that DD1, me or DH. She's tall for her age - slim athletic build. Has always been quite an early developer ie early first teeth, early talker, way ahead of most of her peers academically. But this was a bit of a shock. No idea how common it is, when I googled it the results were all about early onset puberty, which she isn't showing any other signs of. Anyone have any experience of this? Don't really want to take her to the Dr because I think that would just make her worry about something that doesn't currently seem to be bothering her. All advice gratefully received :)

[0AliasGrace0]

Thanks for the link busstop, I've had a gander. I tend to gauge her growth spurts by other people's responses to her, and how many clothes I have to buy as she just seems to grow all the bloody time! A couple of months a go everyone started up with the 'hasn't she grown again!' comments, but I don't know, she just doesn't seem to stop. I stupidly refused to have her height and weight done by school bloody nanny state so measured her myself, she's grown about 7 cm since September, which I don't think is too much really. But then what do I know?!

Hope you get on ok today Bitzer.

[BusStopBetty]

Print off one of those height and weight charts and plot her growth. If she's growing, but following her curve it's not probably not a puberty related a growth spurt.

[0AliasGrace0]

Good idea - just did it. From memory she was always plotting between 75th-91st centile (sticks in the mind due to her prematurity and initial difficulties), now she's just above 91st centile, so that's not a big jump at all, I know it's not uncommon to move centiles but big changes can ring alarm bells, which that isn't. I think they say dropping or jumping two centiles is a cause for concern. Feeling quite positive about that. Wish I could find her stupid red book though.

Bitzer, did you manage to talk to the GP today?

[Bitzer]

Hi alias glad the plotting exercise has been helpful. From memory, DD was in the 90th percentile for height at birth haven't checked her in ages!

The doctor did call eventually. Suggested I bring her in for a 'general check-up' and she put a note on her file so that whoever sees her will know to handle it sensitively. She's with GPs this week while I'm working so will take her in next week. Thanks for asking :)

[yawningbear]

DD who is 7 has had breast buds for ages now, first went to the GP about it when she was around 3 and she was seen at the endocrine clinic at the kids hospital for ages, she would go every few months for a check up. As with a pp it was always done in a way that did not make her feel uncomfortable.

When she was around 6 they started growing even more rapidly so she had blood tests, an ultra scan and bone X-ray. Basically they said that if they see more than one sign then they would consider it to be early puberty, so if she had also had Body odour, or hair growth then they would have been more concerned and may have considered giving medication to slow things down, but only if they are under 8, over 8 and they just let nature take its course.

So if your DD only has hair growth hopefully it will be fine, and great that she is not bothered about it. DD has never been bothered particularly until one of her pals commented about it on a sleep over a while ago. She only told me recently that anything had been said, she was great though, just said to me in a very indignant voice, she shouldn't have been looking at me, she should have been concentrating on getting her own PJ's on!

[0AliasGrace0]

Great news Bitzer, hope the appointment goes well. I have managed to find her red book, she was only a diddy dot when she was born and lost loads of weight but climbed between 75th-91st once she was on prem formula. They told me they were concerned that she'd be obese as a child if I didn't watch her weight , but she was born on the 75th centile, so it never worried me. Her records show her 75th-91st for weight and height consistently, so I think this is a good sign.

Yawningbear - sounds like your daughter has handled it all really well! Thanks for sharing, it's really reassuring. Here's hoping we get a similar result.

And sorry Bitzer for crashing your thread! I'll shh now.

[Bitzer]

You're not crashing it at all alias - great to have you here :)

actually I wanted to ask you something. When you first noticed your DD's developments, did you say anything to her? And did you say anything before taking her to the doctor the first time? I can't decide whether to say anything to her other than the fact that she's going for a regular check-up i.e. if the dr decides to take it further and send her for some tests I think she might work out what it's all about and feel disappointed that I didn't tell her right at the start. But equally, if I don't think she feels comfortable talking about it yet so don't want to mention it unnecessarily

[0AliasGrace0]

It's a tough one, but I always think age appropriate honesty is the best way to go. I didn't mention the pubic hair when I first found it, just did a quick google and realised that minus other signs it was probably fine so decided to monitor it still feel guilty for not ringing doctor sooner. When I realised she smelled I was helping her into the bath, so I gave her some shower gel and told her she needed to rub it all over because she smelled - not my finest moment, but she was good humoured about it. When I gave her the deodrant she thought it was great because she'd 'smell like Mummy' and evidently I always smell 'lovely', very cute.

Unfortunately I had already dropped her off at school before I rang the GP, and then they wanted me to bring her down straight away, so I was quite breezy when I picked her up. I asked her if she'd noticed she had some hairs on her front bottom, and she said yes, and I told her the doctors wanted to have a look because although it's totally fine to hairs down there, just like Mummy has, it usually happens when you're older, so we needed to work out why she'd got them now. Cue why are we breaking the underwear rule questions from her. She coped really well, but I hasten to add, she is very used to it having had a fair few hospital/health examinations (just not in this area). When the GP said she was referring, I explained to DD that we were going to visit another doctor at the hospital so they could have a look at her too. She asked when etc and said she didn't want to but was quite happy when she realised we'd go and count the ladybirds again (mural at the hospital). Oh to be 5 again!

We've had a few conversations since ie when I've got out the shower and she's announced I don't want hair all over my bottom like you makes me sound like a yeti, and I've just gently explained that it's what happens as you get older. She's also asked if she'll get 'boobies' and I've said yes, but hopefully not yet. We've always talked about how people are different because I've always had difficulties so for example sometimes I use crutches. And she has a great understanding of her difficulties, so she knows why she has to do her physio, and why somethings are more difficult for her than others. I haven't spoken to her about periods yet because she gets hysterical about blood, ridiculously so. So I'm leaving that in the hope that it's not something I have to approach until she's more rational older. I hope I don't regret it.

I guess you'll know your DD best and the approach she'll find the easiest - maybe a book might help? I have absolutely no idea how I'm going to explain any tests to her if she has to have them. Despite me always taking her to my regular blood tests since she was diddy, it hasn't helped, and I have no control over her when she loses the plot, which she will. I am hoping the hospital will be able to lead on this, and I will have to find something useful to do with my anxiety because she'll feed off that. And I will be anxious because last time was so awful. My friend is a nurse and reassured me that they will work out the best way to do things.

^ back to wittering again, sorry, offloading my anxieties in the hope that I become more at peace with them (and I'm honestly not usually an anxious person, can't be in my job!).

[Bitzer]

alias thanks so much, that's really helpful. Sounds as if you've handled it all really well. Will give it some though before we go in next week. Thanks again :)

[0AliasGrace0]

Hi Bitzer, how did you get on?

We had a wonderful holiday and now back to reality. Our pead appt is next week and I'm calm at present, I'd like it over now though.

[Bitzer]

Hi alias,

Sorry I haven't checked into this thread for ages. Glad you had a good summer, ours was lovely too. We are still waiting for our paed referral. Apparently it takes 6-8 weeks, wish they would hurry up because I've definitely noticed a big increase in the body odour and DD is v embarrassed when I try to talk to her about it.

How did your paed appointment go? Hope all is well with you and your DD

[0AliasGrace0]

Ah bless her. We're slowly getting into the deodorant routine - a little hit and miss but we're getting there, and it's noticeable on the 'miss' days unfortunately.

I found the waiting for the appointment very difficult, but it definitely helped that we were away for two weeks of it so I was distracted copious amounts of French plonk helps too

The appt was fine. Weight is fine, height just about fine but on the limits of not being, so it's being monitored regardless. The physical exam was not nice, but we tried to distract her as best as possible and it was done sensitively and as quickly as they could. They contacted the endocrinologist whilst I was there for guidance as to what tests should be done also, which was reassuring. They were generally very positive, reiterating that most of the time it is just an anomaly and nothing serious, but due to her presentation it had to be investigated.

We had the blood tests done there and then - they are pros, and although it took four of us, DD did brilliantly, I treated her with a toy after. We are awaiting a bone age scan (x ray?) and so far haven't had any contact re: results, which I'm taking as a positive. I'm quite sure if there was anything alarming we'd have heard by now So now it's wait and see, and I'm actually coping with it much better.

They are writing to school, but I've already been in for a conversation with her new teacher, who was great about it (albeit utterly shocked, she'd never heard of anything like it before).

Have you tried ringing the hospital directly? I did, and I told them I'd be willing to take a cancellation. They did present us with one but it was whilst we were away. Might be worth a shot? Although I appreciate that different hospitals will respond differently.

Really hope you hear soon x

[Bitzer]

Thanks v much, Alias - it sounds as if the appointment was pretty positive all in all.

I hadn't even thought of telling the class teacher. Haven't told anyone apart from you and others on this thread and DH (who I think it struggling to acknowledge the issue if I'm honest).

I don't know which hospital they've asked for a referral to so can't call them. Though actually I might just call the surgery today and suggest that. Thanks again for taking the time to post - it helps to be able to "talk" about it...

[0AliasGrace0]

Hi Bitzer,

Had 2 letters from the hospital: one with a summary of our appointment, the other was the letter for the school - which is why I spoke to her teacher first (also the social worker in me kicked in and I figured if by any small chance she did start her periods, their first thoughts would be towards something more sinister).

I've rung them this morning as we still haven't had any information on the bone age scan, but I had to leave them a message as I couldn't get through. Grr. I'm taking their silence over the test results as a positive, but I do wish they'd just tell me.

How did your DD cope at the doctors appt that you had?

It definitely helps to have a place to 'talk'. I'm so lucky with my work colleagues and the setting I'm in, we spend our days discussing bodily functions so it's not out of place and no one is easily embarrassed. How are you coping?

[0AliasGrace0]

Good news!

Consultant rang and her results so far are all normal! They feel it was probably a surge in hormones during a growth spurt but they've settled now. We have an appointment on Weds for her xray, and still awaiting a few more results, but so far so good.

Fingers crossed for the rest. My call to them the other day definitely spurred things on, so glad that I gave them a poke.

In other news DD got Star of the Week at school - very proud. This time last year she was in such a pickle she didn't talk at school for 6 weeks. The transition has been handled completely differently this year and it shows

[Bitzer]

That is great news - so glad to hear that Alias and big congrats to your DD on her star of the week, well done here.

I still haven't got an appointment, and even DH has had to admit that he's noticing the body odour issue so between us we're going to help her implement the regular deodorant application!

Very much hoping that, as with your DD, it is just a one-off surge. We shall see. On call waiting to the hospital at the moment, no-one ever picks up the phone...

[Bitzer]

Soooo glad you encouraged me to chase up the appointment. Finally got through to the hospital and they had never received the referral. Just made them give me a print-out at the GP and then scanned and sent direct to the paeds adminstrator. Kind of irritated that they fobbed me off last time when I followed it up and basically just said you'll have to wait. Lesson learnt there. Also, the wording of the letter is a bit odd, it ends with asking for advice on "whether any ongoing investigations for her symptoms are required". Just feel the whole thing is being played down a bit, I mean, she's only 6 and showing signs of puberty. Feels pretty obvious to me that it's worth investigating!

Thanks again Alias

[youcantgoback]

My DD went through early puberty and her advanced bone age was missed as something significant, even though she was on the 0.4th percentile 😟
It's really important that it is monitored as it can excelerate quickly and so they lose 2 years or more of growing time. My lesson learnt was to always see the results and properly assess the affect of potential height. DDs endocrine unit didn't do this. They can slow down bone age if it's going to result in abnormally short stature. It needs to be assessed by a paediatric radiologist and there aren't always enough of them!

[Bitzer]

youcantgoback sorry not to have posted sooner. I had a hospital appointment with DD last week and was a bit disheartened by the whole thing and couldn't quite bring myself to post.

I'm really sorry about your DD, how frustrating that you don't feel the endocrine unit investigated properly.

We went to the hospital last week, to the endocrine unit, and I honestly felt like all my concerns were swept under the carpet and I was just treated like a neurotic mum.

Firstly the GP's measurement had put her at 91st percentile but when they remeasured at the hospital she was actually 98%. And they kept saying 'oh well you and your DH are tall', which we're not particularly, I'm 5ft6 and DH is under 6ft. They said there was 'hardly any' pubic hair and were 'surprised I'd noticed it' - I only did by chance at the beach, but the point it, it is there, and she's only 6. The doctor said she couldn't smell the BO (it wasn't particularly obvious at the appt because she hadn't been running around). Anyway, they said they'd measure her again in 6 months but otherwise they didn't think there was any cause for concern and implied that I'd just been doing too much reading up on the internet.

The thing that worries me is that her trajectory has been so different from her older sister's (2 years older, none of the same symptoms). They are now the same height, which I know isn't uncommon but when they asked DD during the appointment she said, "oh no DD1 is 2 inches taller" - so the registrar then said "right so her sister is tall too".

(a) DD2 doesn't really know what an inch is
(b) DD1 isn't two inches taller
(c) I feel that the registrar would be better off taking my word for it in this scenario.

The difficult thing was, because DD was in the room with me, I didn't want to query the doctor or make a fuss because I thought it might make her anxious. But I'm actually a bit down about the whole thing now. I guess we will just have to wait 6 months and see what they say at the next appointment.

[PurpleBoot]

I'm sorry you had such a disappointing experience. I have a severely disabled DD and so have had quite a few such appointments with health professionals etc talking down to you. Some others do have a great bedside manner though, so it is just down to luck (and personality I guess). They are not always right either - you know your child better than them. Hopefully there is nothing to worry about with your DD but it might be worth calling the secretary just to correct any facts that were not quite right eg DD1's height. It's so easy to say nothing at the time and then feel quite patronised afterwards. Been there, got the T-shirt. 😀

[youcantgoback]

Bitzer, I know it's hard when you have to talk in front of DD. I always felt the same, like they thought I was over anxious and I couldn't put over my thoughts as the clinician would undermine me, condescendingly.

My family used to ask me why I kept going to clinic when the clinician kept telling me it was just Familial Short Stature and I use to say "because I won't be able to live with myself if I haven't done everything possible to ensure that's all it is". Sadly I now have to live with myself knowing I didn't do everything. And i wouldn't want any other mother to be saddled with that torment. I could never have known the clinician would have lied that bone age was actual age, when in fact it was a years advanced when they discharged DD having "eliminated all possible causes".Just because it was so called in normal range! It ended up 2 years advanced and as my DD was on 0.4th centile, she didn't make adult height, which has had life changing consequences. The advice to come back if she dropped off her growth line was ridiculous as when that happened she'd stopped growing at 12 due to untreated advanced bone age. And at that point the hospital didn't want to know, saying it was too late now😢.

Don't ever worry about making a fuss. You're just taking care of your DD. You just need to be able to air your concerns without your DD being there.
I would advice that you write to the clinician and say you are concerned you weren't able to speak openly with your DD there. Clinicians are very cautious about written 'on the record' concerns from parents. I think you should say that DD regularly smells of BO and that you are with her every day and can confirm that she does smell after being active. Say you are concerned that they haven't assessed her bone age (which would be advanced if she's starting early puberty) or hormone levels to check for precocious puberty. She has pubic hair, BO and tall stature so you cant understand why she isn’t being evaluated for precocious puberty. Could you also check where DD2 is on growth charts? If DD1 is the same height as DD2 was at say 7.5, that would be worth mentioning.

I would doubt there's anything to worry about, but you don't feel heard, not surprisingly.

The Child Growth Foundation would be very helpful for you to speak to. They are really knowledgeable. Just google it and give them a call. They'll be able to explain everything. I only know a bit, but have learned the hard way that you can't go back and children grow for a short time really and have their whole life to live with the result. Your DD is so young, you have plenty of time to do something and of course, she might not need any treatment☺. You're her advocate though.

[PurpleBoot]

Great post youcantgoback

[goingmadinthecountry]

Teacher point of view - don't need to know too much, but if your dd is a bit embarrassed about changing, please do mention it - no details required - so they can change for PE in the loo (and therefore put on deodorant alone afterwards).

Hope all investigations go well.

[Bitzer]

Thanks so much for posting everyone. Thanks in particular to youcantgoback a very helpful perspective. The registrar was absolutely adamant that it wasn't precocious puberty because apparently you would definitely see breast buds if it was - she said there are two strands of hormonal development and the one that brings about precocious puberty involves early breast development. In fact her parting words were (delivered in quite a condescending manner):
"my message to you is that this isn't precocious puberty. You may have read something online about precocious puberty but this isn't it. And even if it was we wouldn't take any action because while it is early, it is only a little early. But this isn't precocious puberty."

To me, 6 years old does feel pretty early. DD2 also is very active, has always rejected dresses, hairclips, and what might be considered 'girly' stuff, always more into football and skateboarding, almost all her friends are boys etc so I think she in particular would really find it difficult if she developed a more mature body earlier than the rest of the girls in her class.

I will consider the letter option but the whole thing is complicated by the fact that we are moving abroad for 18 months in January so I'm not sure how much point there is in following this up. And if there's absolutely nothing wrong, I don't want to turn it into a big thing for DD. I just feel anxious about the whole thing and, frankly, rather patronised by the doctor.

goingmad that's a really helpful perspective on the changing at school, thank you.

[Bitzer]

Also youcantgoback I meant to say, you obviously did do everything in your power at the time to make your concerns about your DD heard. I'm so sorry that they weren't listened to at the time but you shouldn't blame yourself - I hope you had the opportunity to put in writing your feelings about not having been listened to at the time.