16-month-old baby has big breasts, has a period because of her mother’s habits

According to TS.BS Huynh Thi Vu Quynh – Children’s Hospital 2, Ho Chi Minh City, said that she had received a case of a girl who was breastfeeding but had menstrual-like vaginal bleeding and large breasts. When examining the baby, the doctor discovered that the child had precocious puberty.

Screening for the cause, the results were quite surprising, because the baby had early puberty due to hormone feeding. The reason is because the mother uses estrogen-containing drugs on the nipples. When the baby is breastfed continuously for many months, it will affect the baby.

Dr. Quynh said that in daily life, parents should be careful not to let children use BPA plastic bottles.

At Children’s Hospital 2, doctors received many cases of children with precocious puberty. According to doctor Quynh, girls with early puberty are not as dangerous as boys because boys have potential health risks such as brain tumors.

Patient Pham Le An Nh. Born in 2015, has been treated for precocious puberty since the age of 16 months. This patient has no medical history but has had large breasts since birth. From the age of 16 months, the patient came to the clinic, the breast developed in the 2nd stage of puberty.

The doctor ultrasounds the breasts, uterus and ovaries, takes X-rays and measures bone age. The result of the uterus is older than the age, the bone age is also 24 months. On blood test, the LH index was high, so the patient was admitted to the hospital for a normal blood ionization.

The patient was also screened for brain tumors but found no abnormalities. The patient does not need treatment because puberty has not progressed, so he should be monitored and scheduled to see a doctor after 12 months.

One year after going to the doctor, the height increased by 13 cm, the bone age was 1 year older, the uterus was older than the age. The patient was diagnosed with progressive central precocious puberty.

Illustration.

Many times the doctor consulted and followed up the MRI but there was no brain tumor. The patient was treated with drugs to inhibit precocious puberty for 1 month and followed up at home for 1 year. A year later, the re-examination of precocious puberty indicators leveled off. The bone age at 4 years old is approximately the same as that of a 40 month old baby.

The patient continued to follow up after 2 years of treatment for precocious puberty, and the patient’s height increased by 10 cm/year. Abdominal ultrasound was normal but bone age was increased. Up to now, the patient has had several brain MRI scans, and the patient continues to be treated with drugs to inhibit precocious puberty.

BS.CK2 Nguyen Khoa Binh Minh, Deputy Department of Nephrology – Endocrinology, Children’s Hospital 2, said that early puberty is a common trend among children around the world. It was found that within 60 years, the age at onset of breast development in girls decreased rapidly.

In early 2000, children started to have breasts from 10.5 to 11.5 years old, but now it has decreased from 9.5 to 10.5 years old. In 2020, it was found that puberty decreased by an average of 3 months over 10 years.

Up to this point, the pediatric community agrees that precocious puberty is under 8 years old for girls, under 9 years old for boys.

In parallel, with the appearance of breasts and testicular development, the age of starting menstruation in girls is only 12-13 years old compared to 17-18 years old before.

Dr. Minh said that experts predict that the next 5 years can increase the rate of precocious puberty to 7.1% and the cost of treatment for precocious puberty is 75 million EURO.

Indicating treatment for early puberty, Dr. Minh said that it is necessary to consider factors such as age of onset, speed of puberty, rate of height growth, predicting height in adulthood.

For girls, starting treatment before the age of 6 can increase their height by 6 to 10 cm. If the child begins puberty between 6 and 8 years old, the final height increase is about 4 to 7 cm lower. Onset of puberty after age 8 years, there is no evidence of increase in height with treatment. Therefore, family members need to monitor their children for medical examination and prescribe early intervention so that children can achieve their genetic height.

For boys, it is currently determined that children with central puberty before the age of 9 are treated undifferentiated like girls. The treatment of early puberty helps children grow in height optimally.

Currently, the treatment for children with precocious puberty is still controversial.

Does anyone think that treatment after 7 years old will increase height? In recent years, it has been found that puberty after 7 years of age does not improve height with treatment. But by 2021, it was found that after 7 years of age, the onset of puberty, the bone age of children over 12 years old can still grow taller.

At Children’s Hospital, treating precocious puberty is individualized by doctors to make decisions that are right for the child.

Khanh Chi