Two year old with pubic hair and body odour

[GS1990]

Hi, Im posting because I'm finding it really difficult to find information from parents who have experienced something similar. Hopefully someone has any information which can help. I'm just looking for some similar experiences and to know what happened at what age, symptoms, signs, outcomes etc - it may give me a teeny bit of reassurance while we wait for our appointment.
My daughter is two and we've noticed a few long dark pubic hairs when changing her nappy, she also has a significant body odour from under her armpits, similar to that of my teenage daughter in strength of smell, so quite unusual for a toddler.
We've seen her GP, who has referred to Paediatrics as urgent. However, I've been worrying myself sick because for about 3 weeks she has been complaining of tummy and back pain. Everything I read online points to premature adrenarche but the back pain is also a symptom of an adrenal tumor. She also has an acne/eczema type rash on cheeks and an itchy rash on torso which GP has said is just viral.
We were hopeful that her 'tummy pain' was just her glands being up from a virus but she's also persistent about her lower back aching and hurting (her vocabulary is excellent so she can tell us clearly).
The wait for an appointment is apparently 8 weeks so not until March, we're happy to pay privately and travel to be seen ASAP but again, anyone I speak to on NHS is unable to help refer or point us in right direction and I'm being told to wait. My fear is that if the cause was something sinister, the waiting period could be the difference between a positive or negative outcome for her. Any helpful, construcive advice would be appreciated. Thanks 🙂

I'm really sorry to hear this. It sounds very difficult.

Does the doctor think she may have cancer, or premature puberty? They must think the latter or they would have put her on a 2WW pathway.

Could you ring or see the GP again and ask if they are sure it's not cancer? And why? Emphasise that your dd is having persistent stomach and back pain.

Speak to the GP again and update the symptoms - the backache / abdo pain are new.

TBH could be tricky to get private appointment - not sure that many paeds do them

I've just googled. Does she have any of the other symptoms of an adrenal tumour, ie high blood pressure, palpitations, headache, nausea? Did the doc check her BP?

The stomach pain could be a sign that she's about to have a period...

Did they dip test her urine for an infection? That could cause back and stomach pain.

The above are more helpful replies, but just to chip in - ovulation can be painful and I would imagine at her age it could be really very painful, poor little thing.

But trust your gut, if it doesn't feel right keep nudging the doctor. And if she is acute pain I'd take her to A&E.

Hi sounds scary. Are you still BF?

my daughter had pubic hair and hair around her nipples and swollen nipples…. I was very concerned. HV said it was from BF. She is 3 and a half now and hair has gone.

If your daughter is experiencing Precocious Puberty, could the tummy & back pain be related to the possibly of period pain?
As she is experiencing new symptoms I'd go back to the GP, especially as they've been ongoing for 3 weeks.
I hope you get some answers very soon, I can completely empathise with how worried you must be feeling.

Any chance your husband is using Rogaine or hair growing products?

Speak to your gp on Monday and say have they excluded an adrenal tumour. This should get the desired response of a two week referral.
If the abdominal pain gets worse take her to your nearest children’s hospital A&E rather than your local A&E. They are much more likely to be able to sort out your daughter.
It is probably precious puberty but there are treatments for this and tests need to be done.
Good luck

Where are you in the country?

I have nothing practical to add in terms of a diagnosis but pester the paediatrician. My friends little one needed to be seen urgently due to some abnormalities with her skull and she phoned the children’s hospital where he had been referred to directly, I really admired how pushy she was for her child, I’d of probably been more passive. She got his appointment moved up as she managed to nab a cancellation.

I really don't want to worry you but feel I must say something, I am a former children's Cancer nurse. There are lots of things this could be, but you are correct that one of those things could be a brain tumour. For various reasons (not related to the competence of GPs) general practitioners do not always provide the quickest route of diagnosis. If this were my daughter, I would take to A&E (ideally one of a large university hospital) under the guise of the stomach and back pain. Make it clear she is going through precocious puberty and insist she is scanned there. I would also ask for a second opinion before leaving if your concerns are brushed off. I wouldn't be happy to wait 8 weeks for this myself. I hope this is helpful and I haven't unnecessarily scared you, but please do act sooner. It is unfortunately quite usual for children and their families to spend a long time pushing for diagnosis for time-sensitive conditions that ought to be investigated and treated immediately. All the best to you and daughter, please let us know how you get on.

My advice is just keep turning up: Go back to the GP, take her to your local urgent care centre for the stomach and back pains and tell them everything. Tell them every time how worried you are and ask them why they can rule out cancer. And go back again when symptoms persist. Call the clinic you’ve been referred to, tell them how worried you are and ask to be seen sooner. Just keep showing up with her and presenting yourselves and your concerns.

My DC had a medical condition that turned out to be a rare childhood disease (treatable) and if I had been fobbed off the many, many times they tried I’d never have got a diagnosis and treatment to help him. I must have spent hours in urgent care and schlepping back to the GP.

If you are worried about the waking period, could you afford to go private?

Stomach pain in small children can be sign of headache. If you have insurance ring them for consultant name. If no maybe go on to an insurance website like Bupa and search for right doctor. I would choose someone who also works for nhs as you can get referred back higher up the cue if they are concerned.

OP has already said they're willing to go private

Poor little poppet, and poor you, the waiting would drive even the most patient person crazy. I was going to also suggest A&E under the guise of stomach and back pain. Will be thinking of you.

Another vote for A&E under the guise of going for the pain. And once there dig your heels in.

I don’t think A&E would be helpful to be honest. I would find a private paediatrician.

You can see private paediatricians at Evalina in London (Google Evalina private), and they'd be in touch with the NHS too if needed as it's an NHS hospital. You can also organise a private paediatrician through HCA healthcare (check website). Both in London though - if too far see if there's a private paediatrician nearby otherwise travel to London if you're worried (though agree with speaking to GP again first to rush things)

Hi all, just logging back on. Thanks so much for all of your replies. I'll respond individually over the weekend as I get chance, but we're in Wales and I've contacted our local private hospital and Spire, neither of which will do any tests. Spire said they do have a consultant but not with the endocrinology and even if we see them, they wouldn't test due to her age.
Ive called the hospital Thurs and Fri and begged for a cancellation or for the consultant name to contact and pay privately but they told me she hasn't been assigned a doctor yet! What that even means, I don't know. They also had no information on how to go private. We're close to Bristol but their hospital said that we can only go there if we live near or are referred. I've been back to GP twice and raised my concern about tumour. They did dip her urine Friday, but not in front of us as we had to drop it off after gathering a sample as she's still in nappies. They said they would check for protein and blood and if anything was found they'd call. I didn't get a call so Im hoping it was clear.
Ive told them three times about back and tummy pain. Noone seems to have any sense of urgency. I think I am going to put my concerns in writing to paediatric team and GP and hope my nagging pays off.
Not sure what someone meant about hair products? But no, no unusual hair remover or anything here and no I'm not breastfeeding. She was cow milk protein intolerant for first 18 months but thankfully grew out of it and just has normal cow's milk now (used to be nutramigen).
She's chatty and busy in herself, doesn't look unwell, just these bizarre symptoms of the hair, smell and complaints of back pain.
I will definitely keep nagging and yes I'll travel anywhere in or out of the country for her (which I've told them). We're not loaded or anything but i would be able to find funds, just want to know its nothing to worry about. She's my third child, second daughter and I've experienced all manner of childhood ailments but this is just another level in terms of worry.
Thank u all so much for replies and ill keep updating when there's news xx

So the typical course of puberty would involve breast growth ahead of the other features. Pubic hairs / odour without the other features can suggest isolated adrenarche which tends to be benign. There are blood tests that can reliably determine one way or another.

Back pain in children this young is very unusual and I think if you ask your GP to call Paediatrics emphasising that aspect of the history things might move faster. Sometimes there is an email based service where consultants reply within 24h. I think it's ok to verbalise "I am worried about cancer, that is my main concern", most GPs in that situation will want to get the ball moved for their own reassurance too.

Most places don't operate a "two week wait" analogous to adults - the speeds are 1. literally bring your child now, 2. "don't drop everything this second but we'd like a review tomorrow or the next day", or 3. outpatient referrals measured in weeks even when flagged as urgent.

For your situation I'd hope a GP encountering you re-presenting with these concerns would be sufficiently persuasive to paediatrics to get you seen for option 2 above. Paediatricians are usually quite responsive to expressions of concern around parental instincts in situations where there is a lot of uncertainty. There is sometimes a "hurry up and wait" quality because they are juggled into acute assessment units but they tend to enable a good plan that makes everything safe by the end of the day you're scheduled for.

On the whole, for anything actually serious and urgent private paediatricians aren't very useful, if they are worried they would just funnel you back into NHS which handles all urgent care, unlikely to be faster than the above.

Great Ormond street take private patients and have a fantastic endocrinology team. It sounds like precocious puberty and they can offer blockers to halt development. Is she particularly tall for her age?

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OP your GP may already have asked you this, but is there any chance that she's in regular contact with an adult who is using topical testosterone? www.gov.uk/drug-safety-update/topical-testosterone-testogel-risk-of-harm-to-children-following-accidental-exposure