Spring is the season for everything to recover and the "golden season" for height growth. Parents hope their children can grow up healthily and happily, and pay special attention to their children's growth and development in daily life, but sometimes it is not a good thing to grow and develop too fast.
Recently, some media reported that a girl in Shanghai was diagnosed as central precocious puberty at the age of 6 due to food and other problems, which caused heated discussion among netizens. In fact, in recent years, the incidence of precocious puberty in children has been on the rise, which has become a public health problem concerned by many families.
How to evaluate and prevent children from "precocious puberty"? Recently, surging news interviewed Yu Hong, the founding chairman of the Adolescent Health and Medicine Professional Committee of the Chinese Medical Doctor Association. Since graduating from the medical department of Harbin Medical University in 1988, Yu Hong has devoted himself to the research and practice of pediatrics. She has worked in pediatric medicine, pediatric surgery, pediatric urology and other fields, and has accumulated rich clinical experience. In the past 23 years, she has focused on the research of adolescent health and medicine, established the discipline and specialized system of adolescent health and medicine in China, and committed to systematically cultivating specialized medical personnel to promote the development of adolescent health and medicine in China.
Yu Hong said that in recent years, more and more children have come to see precocious puberty in hospitals, which shows that parents are paying more attention to children's growth and development, and on the other hand, the incidence of precocious puberty is gradually increasing. Experts remind that when a child is found to have secondary sexual characteristics or grow rapidly before he or she reaches the age of development, he or she should seek medical advice in a timely manner so that the doctor can evaluate and treat the child correctly.
Yu Hong, founding chairman of the Committee of Adolescent Health and Medicine of the Chinese Medical Doctor Association [Dialogue with Yu Hong]
Surging news: what is precocious puberty? What are the general morbidity trends and characteristics of precocious puberty?
Yu Hong: Generally speaking, the normal development is that girls begin to show secondary sexual characteristics one by one at the age of 10-12.5 and boys at the age of 12-14.5. In 2010, the Guidelines for Diagnosis and Treatment of Sexual Precocity (Trial) issued by the Ministry of Health defined sexual precocity as the second sexual characteristic of boys before the age of 9 and girls before the age of 8.
There are many kinds of sexual development problems, including sexual development in advance, precocious puberty, male breast development, menstrual disorders, acne, sexual development lag, sexual development delay, etc. Sexual precocity accounts for a high proportion. Since children with precocious puberty may go to other departments for consultation, such as childcare department, endocrinology department, gynecology department, andrology department, and even psychiatry department, it is difficult to collect accurate data of precocious puberty cases. In terms of the cases I have worked for 23 years, I found that the proportion of outpatients with precocious puberty was about 20%.
At present, we have observed that cases of precocious puberty are increasing year by year. One is that the number of patients receiving treatment is increasing year by year due to the fact that they are eating well and much, as well as environmental pollution, food pollution, and the improvement of parents' awareness and medical treatment rate.
Another characteristic is the younger age. The criterion of precocious puberty mentioned in the Guidelines for Diagnosis and Treatment of Children's Precocious Sexual Maturity with Integrated Traditional Chinese and Western Medicine (2023 Edition) is changed to the second sexual sign of girls before the age of 7.5, which indicates that there is a trend of younger age at present.
The surging news: how to judge whether children are precocious? What are the characteristics of precocious puberty in terms of age and gender?
Yu Hong: It's really a professional thing to judge whether it is precocious. If parents find that the child has early development of secondary sexual characteristics, such as breast development before the age of 7.5 or the child suddenly grows fast, they need to be careful. They should seek professional help from doctors, go to the hospital in time, and determine whether it is precocious puberty through a series of examinations, including bone age, ultrasound, sex hormone levels, etc.
At present, in clinical observation, there are more girls, because there are more estrogen like and estrogen in the environment, and estrogen has a faster effect on girls, so there are fewer boys. However, boys' precocious puberty is more hidden, and once found, it may be in the middle and late stages.
Surging news: what are the dangers of precocious puberty?
Yu Hong: The harm of precocious puberty mainly includes three aspects: sexual development, growth and development, and neuropsychological and behavioral health.
First, from the perspective of sexual development, sexual precocity will affect sexual function and window period, affect fertility and window period, and may lead to premature aging and reduce life span.
The second is growth and development. Premature sexual development will also affect the growth and development of children, including the growth rate and growth space of height. To take a simple example, a child will have a rapid growth period from birth to about two years old. In addition to the corresponding thyroid hormone and growth hormone secreted by the body, there is also the backward movement of maternal sex hormones on the baby. About six months after birth, this backward effect gradually disappears. The baby's own biological feedback system will allow the hypothalamus and pituitary to continue to "work". The various phenomena generated by this biological feedback (bunching, breast development, labia minora coloring, etc.), let the child have a medical so-called "little adolescence". But I think children at this stage should actually be called "puberty slow progress period", which is a process of sex hormone metabolism, during which children grow up very fast.
In addition, during the rapid development period of adolescence, the sex hormones begin to rise again gradually, the second sexual characteristics begin to appear one by one, and the children's stature will also grow rapidly. Once sexual precocity occurs, the first thing to do is to affect the child's sexual development process. The shortened sexual development will affect the child's sexual function and window period, fertility and window period, aging and life span; The second is to affect the growth speed and growth space of children's height. The annual growth rate of the human body is relatively fixed. The emergence of precocious puberty will compress the rapid growth time of children in adolescence, leading to narrowing of growth space, resulting in shorter or shorter height.
Third, precocious puberty will affect the development of children's nerves, spirit, psychology and behavior. What should not happen in this age group may affect the neuropsychiatric, psychological and behavioral development of children in this age group. When children are precocious, they have sexual psychological needs and desires, which can easily cause many problems when they are extremely immature.
Surging news: What are the clinical treatments for precocious puberty at present?
Yu Hong: The early stage of precocious puberty can be treated with TCM intervention, and the middle and late stages can be treated with gonadotropin analogues of western medicine. If height loss occurs, it should be treated with growth hormone.
If the primary disease is involved, such as hypothyroidism, it needs to be treated with Eugal; Germinoma can also be interfered by radiotherapy; Children with adrenal hyperplasia are recommended to use glucocorticoid for life.
In general, the causes of precocious puberty are very complex. It should be emphasized that once children are found to be precocious, they must seek treatment from professional doctors and go to the hospital regularly for inspection.
Surging news: how to prevent sexual precocity? Will problems such as drinks and food additives affect children's growth and development?
Yu Hong: Some food additives may affect children's endocrine system, so we should take things in food seriously. My advice to parents is that you should never treat your children as white mice, especially those at the developmental stage.
In addition, eating a large amount of high protein food for a long time will also affect various functions of the body, which may promote sexual development, but is limited for growth. High cholesterol food itself is the synthetic material of sex hormones. If more synthetic sex hormone materials come, more things will be processed. It is not recommended to eat more. In addition, overeating high calorie foods is easy to store in the body and become fat, which also has a touch on sexual development. These are indirect factors.
In addition to some foods that may lead to precocious puberty, environment, drugs and other factors may also cause problems in children's growth and development, which also need attention.
As for the relationship between drinks and precocious puberty, first of all, if the calorie in drinks is too high, children will become obese, and obesity will easily accelerate the sexual development of girls, leading to precocious puberty. In addition, if the drink contains ingredients that affect the metabolism of sex hormones, a large amount of consumption will also lead to precocious puberty. In addition, bisphenol A, a chemical substance mainly derived from plastic containers, may precipitate after heating. Bisphenol A has estrogen like effects. When it enters the human body, estrogen receptors are directly docked without such high recognition ability, and sexual development is started. If the beverage contains these things, it will become one of the reasons for precocious puberty. Some drinks even add estrogen directly, saying that they have cosmetic effects and promote growth. Parents must be alert.
The best drink suitable for children is plain water, or a drink made by parents themselves, (or) ensure that the raw materials are natural, green and free of additives. Compound drinks with unknown ingredients and functional drinks with unknown functions are not recommended.
