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Preparing Children For Puberty

Puberty can be a rocky time in any child’s life, so it’s important to prepare children for the transitions of puberty before the changes start.

These discussions can be difficult to have.  

Parents want to know how to begin the conversation, and how much information is enough—but not too much.  

Relax, there’s help on the way.

To learn more about preparing your child for puberty, listen to SMG Radio’s interview with pediatric and adolescent medicine specialist Dr. Dahlia Hall.
Preparing Children For Puberty
Featured Speaker:
Dahlia Hall, MD
Dr. Hall is an expert in pediatrics and adolescent medicine.  She has taught medical students and residents at New York University School of Medicine and Lenox Hill Hospital.

Learn more about Dr. Hall
Transcription:
Preparing Children For Puberty

Melanie Cole (Host):  Puberty can be a rocky time in any child’s life and a parent’s life as well. It’s so important to prepare children for this transition before those changes start but not a lot of parents know how to begin those conversations and to tell their children what’s going to happen to them. My guest is Dr. Dahlia Hall. She is a pediatric and adolescent medicine specialist at Summit Medical Group. Welcome to the show, Dr. Hall. So, puberty – when technically does it begin?

Dr. Dahlia Hall (Guest):  Usually puberty begins about age 10, on average. It usually begins between age 10-13 years of age. That’s usually when it will begin. For girls, the first thing they do is grow and you might have a little body odor. The other thing that often happens is then they start with the breast buds. Then, after that, they’ll get some pubic hair. Usually, about two years after that, then they may start their period. There is a lot going on at that time and it’s important that you start teaching them how to take care of their bodies before that begins. Hygiene is an important thing to start from the very beginning--from when they start being independent at four to six years old and start trying to take their bath and clean themselves properly. You want to continue that throughout so that when they start puberty and start having body odor that they understand that they do need to take a bath or shower at least once a day and they do maybe need to start deodorant. What’s great now is there are so many things on the market that have natural ingredients and are safe for younger kids to use.

Melanie:  I was going to ask you that question about deodorant. Do we want to give deodorant that does not have aluminum? They want to take it to school so in gym class they can use it after, too.

Dr. Hall:  Right. So, you definitely want it in their gym back and if they play sports, you definitely want to have deodorant there available for them as well because oftentimes, too, the kids don’t actually smell themselves. The rest of us smell them but they don’t smell them. It’s so important that once they start having the body odor, really encouraging them to use something that is safe for someone that age.

Melanie:  How do we start the discussion with them about things? Even with our boys. If they are going to start having wet dreams; if they are starting to notice things changing, how do you begin that discussion with them?

Dr. Hall: The first thing is, you want to put it in the context of their maturity and their age group. One of the things I often say to people is, do it within the context of an everyday activity. For example, if they are playing video games, if they are watching something on T.V., or if you guys are watching a family movie together, that’s a great time to bring up the topic. Sometimes, they will ask certain things about their friends. You want to put it the context of an everyday activity so that way it is not just that you’re having the talk because you want to have the environment where they feel comfortable asking you these questions. You might point out something like, “I notice now that you’re having some body odor, so you know this is the start of puberty.” Most children, once they hear that word they get a little uncomfortable and things like that but what you want to do is, let them understand that sometimes you don’t have the right words to ask the questions, but it’s okay to ask the questions. Whatever word you feel is right to use, that’s okay. It’s just trying to understand what’s going on. With boys especially, puberty is a little different because they grow for longer than girls do, so they may not suddenly get tall right away. Sometime between the age of 10 and 13, they’ll start growing but the first sign is really that their testicles enlarge and then their penis grows. Then, they start with the underarm hair and they’ll also start with pubic hair. Also, one of the facts that people often forget is that boys also get breast buds. It’s very tiny, but it’s there and sometimes it hurts a little bit. Usually, it goes away within 18 months. It shouldn’t get very large. It should just be a little bud that they can touch and feel. But, we know that when kids are a little bit larger, then it can be more prominent and they can start being self-conscious about it. It’s a conversation that you want to have sooner rather than later. Again, it’s part of their general health and keeping a healthy body, exercising and that sort of thing. That helps them in terms of self-esteem because during the time of puberty, that is the time that you will find that some of the data shows that’s when girls are most vulnerable for having low self-esteem. That happens with boys, too. Especially boys who may be a little shorter than their peers. It is important to at least start the conversation so that they understand that this is just the start of a process that is going to extend over a period of time. We all take that process a little differently--each one of us. For girls, we know that in terms of when their period starts, it often depends on when their mother’s period started. It’s important to get that conversation going. With boys, who are most commonly concerned about their height, oftentimes if dad didn’t have a growth spurt until he was at the end of high school, then his might follow that curve as well. But, knowing that it’s normal. And also knowing what isn’t normal is important for parents to understand. If a child is less than 8 and is starting to have some signs of puberty, that’s a reason to see your doctor. Or, if a child is older, like 14 or 16, and having no signs of puberty that’s a reason to also see your doctor. There are lots of factors in between that are variations of normal. If there is a question about it, then they want to make sure to speak to their pediatrician to know that things are going at a rate that it should be.

Melanie: Dr. Hall, if a girl does start her period, do they have to start with pads?  Or, can girls these days start right away with tampons because back in the “only pad” days, they couldn’t then swim. They were very self-conscious about clothes that they wore. Tell us what goes on now.  

Dr. Hall:  We still recommend, initially, that they start with pads. Usually in that pre-period pack that I have my parents get, I usually tell them to put pads in it and show them how to use it. What kind of underwear should you be using with this? That’s important as well. In terms of tampons, absolutely. If they are on the swim team or they do sports, they are going to use tampons. But, remember, with tampons then you need to have a little talk about anatomy so that they understand how to put it in. You also need to talk about toxic shock syndrome which is a serious infection that can occur if you leave the tampon in too long. What I usually tell parents is show them how to put the tampon in. I personally recommend a plastic applicator. I know for the environment they like cardboard but a plastic applicator when you’re first using it because it’s easier to slide in. Also, teaching them to take one out before you put the other in. So, maybe, you shouldn’t be on the phone when you’re doing this because now they are always on their phone. This is something that you don’t want to have any distractions when you’re doing. You want to take one out before you put another one in. Also, that you should usually wear a panty liner even if you have a tampon in just in case there is overflow or an accident because you don’t want it get on your clothes. That is how I usually explain it to kids. Definitely, with the tampon it’s making sure they know where it goes, how far up it goes. Most boxes will have a paper in it that shows them pictures and shows them how to do it. But, sometimes, they need a little help and that’s okay, too. Being open to that conversation is the most important thing and letting them know, “Let me see how you do it.” When it’s in properly, you shouldn’t feel uncomfortable with it. If it’s not in far enough, then you feel uncomfortable with it. Even just knowing that fact is very helpful.

Melanie:  What about shaving? When are we allowed to let our daughters start to shave under their arms or their legs?

Dr. Hall:  In terms of shaving that’s very individual based. That’s also culturally what’s appropriate within your family. When you talk about shaving, then you have to talk about some people are at increased risk for razor bumps and things like that. If you’re going to start shaving, then you’re committing yourself to shaving regularly once you start that. You want to explain to them things like the razor – is this a razor that you can reuse and, if so, how many times can you reuse it. You should never share a razor with someone else or any other personal item. You should be the only person using your razor. In terms of shaving cream and things like that, that’s another thing that you want to make sure that you show them the technique on how to shave. What direction you should be shaving in? For kids especially, I find many times, the issue becomes shaving the bikini line or whether you should wax. Wax, for some people, is very painful--sometimes worth it. For others it’s too painful and not worth it. It’s just trying to figure out what works best but without having things like razor bumps and scarring that you didn’t have before. It’s trying to figure out what works for you. In terms of swimsuits and things like that, there are so many options it just depends on what you feel comfortable with.

Melanie:  In just the last minute, Dr. Hall, give your best advice for parents in starting that discussion about puberty and as our children are starting to go through. This such exciting change in life.  

Dr. Hall:  My first recommendation to my parents is usually somewhere between eight and ten I recommend The Body Book. It is, I think, one of the best books on the market for young children. They have the boy’s Body Book and they have the girl’s Body Book. What’s great about that book is that it goes through it from their perspective. It’s written with little cartoons showing different actions like a boy shaving or smelly monsters coming from under their armpits. It’s actually kind of funny as well. I always tell parents they should read it first. Just so they know what exactly is in it and make sure, first of all, that they approve of it. Then have their children read it. Most children, after they read it, at some point they are either completely like, “Oh, my gosh. I don’t want anything to ever do with this.” But they understand that it’s happening or they’re excited at the thought. “Oh, this is okay. I’m okay.” I think that is a good way to introduce the topic. Again, always make it age appropriate. You’re the one in your family setting the tone and letting your children know what expectations are. I think the most important thing any family can do is to make sure that their children understand that this is a safe place to talk about anything. This is your safe place. Remember, as a parent, you’re there and you’re going to try to do what is in their best interest--not so much their friend. They need to understand that you are probably the best person to talk to. That has to be something that permeates different aspects of the child’s life at home so they know that you are not going to get upset. You are going to try to figure out what’s okay and what isn’t and why isn’t it.

Melanie: Such great information. You are an amazing pediatrician, Dr. Hall. Thank you so much for being with us. You’re listening to SMG Radio.  For more information you can go to SummitMedicalGroup.com. That’s SummitMedicalGroup.com. This is Melanie Cole. Thanks so much for listening.