This is growing up: Helping your child through the changes of puberty

Perhaps no other time in life is filled with such rapid physical, mental and emotional change than during puberty. Both boys and girls experience significant changes, but the physical changes a girl experiences are quite unique. And for some teens, they can be distressing. By being informed, parents can assist their teen through this process and provide the reassurance and support that is needed during this time of development. 

For girls, puberty typically begins somewhere between age 8 and 13 as the follicle stimulating hormone (FSH) responsible for jump-starting puberty begins to produce more estrogen and progesterone. As these hormones become more prominent in a girl's body, changes to physical appearance begin. 

Below is an explanation of the changes your teen may be experiencing as they go through puberty. Though development often occur in this order, it can occur in any order. There are also some important conversations you may want to have with your child to help them through these changes. 

Hair will grow in new places on the body

Often times, the first sign of puberty is the new growth of body hair in areas they didn't previously have it, like under arms, on legs and in the genital area. 

Talking points

• Hair growth is completely normal and part of growing older. 
  
  
• Your child may express interest in shaving some areas. There is no medical reason to do so, but there is not any harm in doing this if they follow safe and proper hygiene. If your child wants to shave, provide the supplies they needs to do so (shaving cream, new/clean razor, soap, towel, etc.) and show them how to do so safely. For example, leg hair can be shaved upward and under arm hair can be shaved in all directions. However, to avoid ingrown hairs, pubic hair should be shaved in downward strokes, similar to how a man shaves a beard.

Breasts will develop and grow

Breasts can begin budding as young as age 8, but typically by age 13. (Remember, development is different for everyone, so it can happen at any point within this range.) Nickel-sized bumps will begin to sprout beneath the nipple, then increase in size. It is possible for breasts to develop at different rates, so one side may develop more quickly than the other to start. Your child may feel some soreness as breasts develop, which can be easily treated with an over-the-counter pain medicine.

Talking points

• Everyone's body develops differently. When and how one develops breasts will be unique. How big breasts ultimately become will also be unique.
  
  
• At some point as the breasts grow larger, your child may want to consider wearing a bra. Visit a store together and help them find a bra that fits snuggly enough to hold their breasts in place, but not too tight that it's uncomfortable. Especially if they’re active and involved in sports, a bra can be helpful to your child in preventing soreness and discomfort as they play.

Body shape will change

Young girls and young boys under the age of 8 can often look similar in terms of body composition. However, as the female body reaches puberty, it will begin to change and look different than a boy's body. The addition of breasts is one of the first signs that this is occurring.

Your child will likely experience the fastest rate of growth between the start of breast growth and the time the first period begins. This growth spurt generally happens at a younger age than it does for boys, so it's likely boys of a similar age will not experience body changes until later a few years later (typically between 10-13 years old).

In addition to growing breasts, your child's hips may widen and their waist may get smaller — giving the curvier look of an adult woman vs. the look of a child.

Talking points

• Because her body is changing, your child's wardrobe may need to change a bit, too. Clothes that once fit may not fit anymore (due to the growth of hips and breasts). Though this can be discouraging, reassure your child that this is all a normal part of growing and getting older. Buying new clothes can be a way to celebrate these changes.

Menstruation will begin

On average, a female will get their first period around the age of 13. However, menstruation could begin anywhere from 18 months to 2 years after the first signs of puberty.

As the level of estrogen in the body grows, your child may experience some vaginal discharge anywhere from 6 to 12 months before their first period. They may also have some abdominal cramping prior to their first period, similar to period cramping one might experience monthly after menstruation begins.

The first period can take different forms. Some may experience only spotting with a red-brown discharge, and some may experience a full period. The length of the first period can also vary, lasting anywhere from a day to several days. It's also not uncommon for menstruation to be irregular during the first 15 months as the body learns to regulate this process.

As the brain learns to communicate with the ovaries, menstrual cycles will become more regular. Be sure to track periods and contact your teen’s pediatrician if periods are lasting longer than seven days or coming more often than 21 days. Excessive menstrual blood loss can increase the risk of iron deficiency and anemia. Be sure your teen is getting enough dietary iron in the form of meats, beans/legumes, dark leafy greens, quinoa and iron fortified breads and cereals.

Talking points

• If you can, try to talk to your child about this important change their body undergoes before it happens so they are prepared with what to expect. This can be important for eliminating or reducing any worry or fear that can come from experiencing a first period. Despite our best efforts, some teens will not tell their parent about their period when it first happens. It’s important parents remember this is a normal response and not to feel rejected.
  
  
• Your child will also need help understanding proper hygiene while menstruating. Purchase some teen-friendly pads and tampons and teach them how to use both. These products are designed for new users and smaller bodies and can help normalize the experience. The products can be adjusted later based on flow and personal preference and comfort. Make sure to teach them how to properly dispose of them, too, especially to avoid flushing down toilet. Discuss ahead of time where to keep menstrual products in case a period occurs at school or away from home.
  
  
• Encourage use of heating pad if there is pain with periods. Reach out to your child’s doctor if there is pain not relieved by heating pad or over the counter pain relievers, especially if it is interfering with school attendance or social functions.
  
  
• Remember, some teens find this topic embarrassing, so it’s important to allow your child to learn at their own pace. Having books or pamphlets on puberty available in your child’s room to view with you or alone can be very helpful.

Discussing body changes with your child

As your child experiences these changes, it's important to emphasize that these changes are a normal part of growing into an adult. Role model being calm and confident about the process.  It's important to continue to respect your child's privacy, but you also want to make sure you're giving all the support they needs as their body changes.

Depending on your child, you may need to be a bit creative with some of the support they’ll need, but this can also create great opportunities to bond with them (like going shopping together for new clothes or having a 1-on-1 "spa night" where you practice shaving together).

The best way to begin these conversations is by opening the door for communication. As your child approaches puberty, explain the upcoming physical changes, ensuring that you are always available to talk about feelings or body changes. Check in with them from time to time and ask how they’re feeling, giving them the opportunity to share their feelings (physical and emotional) with you. And if you have any questions you're unable to answer, you can always consult your primary care doctor or the Children’s Wisconsin Teen Health Clinic for answers and additional support. 

Melissa Vukovich, APNP Family Nurse Practitioner Teen Health Clinic

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.