At the age of three, Bhavna (name changed) has the physical appearance of a 16-year-old girl. The child, a resident of Nalasopara in the suburbs of Mumbai, has reached puberty owing to a rare medical condition.
Bhavna was diagnosed with precocious puberty when she was a two-year-old. "She suddenly gained weight, but we neglected it. But one day, she started menstruating and we took her to the hospital where doctors told us about her condition," said the child's mother.
Owing to precocious puberty, a child starts displaying certain physical and hormonal characteristics including pubertal development at an early age, doctors said.
Doctors classify girls who hit puberty before the age of eight as having precocious puberty.
"We were initially shocked and thought it was bad omen, but doctors told us that it was a medical problem. We are worried about her schooling," the mother added.
There is treatment that can reverse and slow down the sexual maturation, but the girl's parents are finding it tough to arrange money.
"I had pawned my wife's jewellery which we lost after failing repay a loan. I even sold a piece of land we had bought and are now staying on rent," said the father, a rickshaw driver who drives for long hours for extra money.
The expensive hormonal injections required to slow down the child's growth is out of his reach. Bhavna's parents have knocked on the doors of various trusts and non-governmental organisations, but have received little help.
"She needs injections costing Rs. 14,000 every month. These are necessary so that her bones don't fuse together (a condition that starts at puberty). This will restrict the growth in her height. Also, it's traumatic for a young child to experience puberty as such a young age," said Anil Patil, a doctor at Bhabha Hospital in Bandra, who is treating the child.
Endocrinologists say in about 80% of the precocious puberty cases among girls, there was no specific reason that triggered the condition.
"Brain tumour or other brain-related conditions can result in precocious puberty... Treating these children is very vital for their overall physical growth. We have seen that instead of seeking medical attention, parents feel that puberty at the age of six and seven is acceptable," said Dr Abhishek Kulkarni, paediatric and adolescent endocrinologist at Jaslok Hospital and Research Centre on Peddar Road.