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Do African-American Girls Reach Puberty Earlier?
Q: My five-year-old African-American daughter has begun to develop underarm odor. I've heard some things about premature puberty in minority children.
My pediatrician suggests that I give her organic foods because the early onset of puberty comes from all the chemicals in her food. My husband says I should put deodorant on her, but I don't think deodorant is safe for children. What do you suggest?
A: You raise a number of important questions. First of all, the onset of puberty is somewhat earlier in African-American girls in this country. Taken as a group, African-American girls start their periods about 9 months sooner that Caucasian girls. The reasons for this are not totally clear. Currently, the average age for starting periods in African-American girls is about 12.2 years, and for Caucasian girls it's 12.9 years. There is still quite a range, however, and girls can start their periods as young as 9 or as old as 15.
Separate from this, however, the frequency of premature adrenarche (early development of pubic hair) is also higher in African-American girls. The adrenal gland controls the hormones that are involved in the changes of puberty. It is not clear why some children have an early spurt of these hormones, which cause growth of pubic and underarm hair, as well as underarm odor. Also, you can have the odor before there are any obvious physical changes that you can see. Girls with premature adrenarche can have these changes as early as 5 or 6 years of age. When a girl has premature adrenarche, it does not mean that she is going through the rest of puberty, and the periods still start within the normal time range. It is important, however, to make sure a girl has a thorough examination when she shows any of these early changes, in order to make sure it isn't due to a specific hormonal problem.
As far as what to do about the odor, the most important thing is to have her take daily baths, or at least wash daily under the arms with mild soap and water. A body powder with baking soda may be all that is necessary to control the odor. Avoid powders that have talc, however. If the odor persists, she can safely use a deodorant, but one that doesn't have an antiperspirant combined with it. You can usually find a small number of these in most drug stores, and a larger variety of them in stores that sell organic foods and natural products.
I have not read anything to suggest that body odor is caused by chemicals in food.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.