In February, when Dr Pallavi Pathak was bathing her six year old daughter, Neha, she realised the child's right breast was slightly enlarged.
"Neha had also developed slight auxillary (pubic) hair. I was alarmed," said Dr Pathak, a general practitioner based in Virar.
Neha was diagnosed with precocious puberty, a condition where the body changes that take place during puberty occur earlier than normal. Puberty usually sets in between 10 and 14 years for girls, and 12 and 16 years for boys.
Neha was taken to Wadia Children's Hospital to be examined by a team of paediatric endocrinologists. After doing a series of tests, the MRI showed a cyst in her pituitary gland, the master gland that secretes hormones, which was speeding her maturity.
"In Neha's case, estrogen was being produced at an early stage. We had to give her hormone injections to stop the pituitary gland from producing the hormones. She will have her regular menstrual cycle between six months to two years once the injections are stopped," said Dr Sudha Rao, paediatric endocrinologist.
Though there is often no clear cause for precocious puberty, in some cases it is a result of changes in the brain, genetic defects, or growth of certain tumours that can lead to release of hormones. The disorder can strike about one in 10,000 children all over the world and is more prevalent in girls than boys.
"In most cases, especially in girls, very often no cause is found for the early onset of puberty. For boys, we have to look for an underlying cause in their bodies," said Dr Prisca Colaco, professor of pediatrics, MGM Hospital, Vashi.
"We usually need intervention by way of hormonal drugs to stem the progression of puberty in the child," said Dr Nikhil Bhagwat, consultant endocrinologist, Cumballa Hill Hospital.
The child who has precocious puberty grows in height sooner and stops growing earlier than his/her peers. The larger concern is that the child is usually not able to deal with the maturity in the body. "These children are mature physically, but are emotionally immature. They are usually not able to deal with the changes in their bodies," said Dr Rao.