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Monday Medical: Navigating puberty


Susan Cunningham
For Steamboat Pilot & Today

From baffling emotions to a range of physical changes, puberty can feel like a roller coaster for kids and their parents.

Below, Dr. Sheila Fountain, a pediatrician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center, answers questions about puberty and how parents can help their kids through it.

When does it happen?



The timing of puberty is influenced by genetics and environmental factors. Girls generally go through puberty between 10 and 12 years old, while boys are later at 12 to 14 years old. But two years before or after those ranges is also normal, which means girls can start showing signs of puberty as early as 8 years old, and as late as 14 years old.

“It can be quite interesting to see a group of 11-year-old boys and girls, all in a different stage of puberty. Some girls will tower over the boys,” Fountain said. “Reassure your child that each experience is unique and okay.”



If you have concerns that changes are happening too early or too late, talk with your medical provider.

What’s going on?

Puberty is a complex change that begins in the brain. “Hormones are produced in the pituitary gland that stimulate production of testosterone or estrogen, which cause physical and emotional changes,” Fountain said. “Often, we see the emotional changes first.”

Physical changes occur over a period of two to three years. In girls, changes begin with breast development, changes in body shape, growth of pubic hair, then a growth spurt in height followed by menstruation.

In boys, physical changes begin with the growth of the scrotum and testes, changes in voice, growth of pubic hair and lengthening of the penis, then changes in body shape and a growth spurt.

The social and emotional changes of puberty include development of identity and the growth of independence and responsibility.

“Your child will question and form their values and learn what respectful relationships look like,” Fountain said. “Parents can help by modeling respectful relationships and encouraging children to make their own choices without pressure, treat each other equally and fairly, know mistakes are normal and okay, communicate openly, know it’s okay to say ‘no,’ and feel valued and accepted for who they are.”

A parent’s role

Parents should start having conversations with kids about puberty before it begins.

“Help them develop a vocabulary for their feelings, and be respectful and listen,” Fountain said. “When the tough stuff comes up, they will be accustomed to talking with you.”

Reassure kids that the changes they’re experiencing are normal and make sure they have the right information.

“Kids talk to each other and share information. Sometimes they get it right, and sometimes they don’t,” Fountain said. “Parents can help by providing factual information about puberty. Give your child a book or show them videos about puberty.”

Fountain recommends “The Care and Keeping of You” (from the American Girl library) and “Boy’s Guide to Becoming a Teen” by the American Medical Association. The website kidshealth.org also has helpful articles and videos.

And know that the emotional changes can be especially challenging for kids.

“They often don’t know why they feel as they do,” Fountain said. “As parents, we can listen, recognize what they are feeling and acknowledge it. Remind them that they’re not alone and teach them coping strategies — to breathe, count to 10, exercise, get enough sleep, do something creative, cry or just wait it out.”

Fountain also recommends giving your child a journal where he or she can write down thoughts and feelings, and then share with you. You can reflect on their thoughts and answer their questions in writing.

“Sometimes it’s easier to write than talk about something,” Fountain said. “When they are ready to talk and ask questions, listen well and answer the question. Then ask, ‘Do you want to know more about that?’ Sometimes they don’t even know what to ask.”

And don’t forget to keep it light.

“Be positive and supportive,” Fountain said. “And enjoy the journey.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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