Early Development in Children May Not Always Indicate Precocious Puberty

(HealthDay News) — Children who develop certain signs of puberty at an early age are commonly referred to specialists for an evaluation, but this is often unnecessary, according to a new American Academy of Pediatrics report published in Pediatrics.

It is not uncommon for young children to show certain traits associated with puberty, including some pubic hair, underarm hair, and the beginnings of breast development, Paul Kaplowitz, MD, PhD, lead author of the report, told HealthDay. He said early signs of sexual maturation are one of the most common reasons that children are referred to pediatric endocrinologists. 

However, the vast majority of those children do not have precocious puberty, said Dr Kaplowitz, an endocrinologist at the Children’s National Medical Center in Washington, D.C.

The report points to a few signs that a child’s development might be out of the range of normal: testicular enlargement in a boy younger than 9 and progressive breast development in a girl younger than 8. Rapid growth in pubic hair or acne at a young age are also possible warning signs.

“Although there is a chance of finding pathology in girls with signs of puberty before 8 years of age and in boys before 9 years of age, the vast majority of these children with signs of apparent puberty have variations of normal growth and physical development and do not require laboratory testing, bone age radiographs, or intervention,” the researchers wrote.

Look for an upcoming feature from Endocrinology Advisor on this report as well as evaluation for central precocious puberty.


  1. Kaplowitz P, Bloch C; for the Section on Endocrinology Executive Committee. Evaluation and Referral of Children With Signs of Early Puberty. Pediatrics. 2015;doi:10.1542/peds.2015-3732.