Dear Friends and Neighbors,

CentraCare and Carris Health care givers have been working around the clock for more than 20 months to care for you, your families and friends during COVID. We are committed to caring for every Minnesotan who needs us, and nothing will prevent us from doing so – even during these never-seen-before times.

The challenge of providing this level of care is that our hospital beds are often full. ERs in all of our hospitals are packed. And our clinical teams are exhausted. Early in the pandemic, our community stepped up in amazing ways to helps us. We ask that you again join us in fighting this pandemic together.

How can you help?

  • Please get your COVID vaccines and booster shots. They are proven safe and effective in reducing COVID illness, keeping people out of the hospital, and preventing death.
  • If your situation is not an emergency, please use other care options, including:
  • If this is a medical emergency, call 9-1-1, or visit the ER.

Together, we can do this. Thank you for your support.

Ken Holmen, MD
President and CEO

The “P” Word: Is Puberty Starting Earlier?

Published in Wellness, Pediatrics

A national study by the American Academy of Pediatrics recently found that boys are entering puberty at earlier ages – anywhere from six months to two years earlier than previously assumed.  Former studies have shown that girls also appear to be hitting puberty earlier, but this is the first time an accurate study has been conducted about the onset of puberty in boys since 1969.

Before this study published results, boys typically were considered to hit puberty around age 11 and a half. The study indicates that boys may reach puberty now as young as nine-years-old.  The study also showed that race plays a role in American boys and puberty. African Americans, generally, begin to hit puberty earlier than Hispanics or Caucasian boys.

As a father of four – three girls and one boy—who also happens to be a pediatrician, I’ve watched and guided my children as they went through the stages of puberty. However, some of these changes were so subtle I didn’t even know it was happening right away.  It is difficult for me to pinpoint when my son started to go through puberty.  With my girls it was a little more obvious.  Typically the onset of puberty in girls is when their breasts begin to grow.  But with boys, it becomes a much more private thing as their growth is onset by the development of pubic hair and testicular growth.

Despite the onset of earlier puberty in both boys and girls, breast development before the age of eight or testicular development before the age of nine is abnormal.  If you notice either, schedule an appointment with your pediatrician.

As your children get older, they tend to be more modest, and these changes can be subtle enough that parents may not even know when their child is entering puberty.  It’s important to listen to your child and let them know the changes they’re going through are normal.

As a pediatrician, I also have a special interest in childhood obesity.  Something most people don’t realize is that typically the more body fat a child has—boy or girl—the sooner their bodies may begin to mature.  It is possible that the cause of this trend in early onset of puberty is the rising rates of obesity in our youth.  This could mean that we are seeing children reach puberty at earlier ages because of lifestyle changes that have led to an increase in childhood obesity.

The impact on boys and girls differs.  For girls early puberty may mean they may end up being shorter. Many times parents will look at their child and think because they carry a little extra weight, the child is probably not done growing.  But when a girl’s menstrual cycle starts, they are done growing in height for the most part.  With boys the onset of early puberty doesn’t seem to affect their height, but boys are beginning to experience genital and pubic hair growth at younger ages.  The biggest affect this earlier onset of puberty seems to have on boys is to their social and psychological development.  Though their bodies are maturing sooner, their emotional and cognitive development is still developing at a normal rate.  For example, young boys may be perceived to be much older and more mature than they really are, which can lead to activities like dating that they may not be emotionally ready to handle.

At this point, many experts, myself included, aren’t sure of the significance of this report, or what implications it has for the long-term.  For now we simply know boys and girls seem to be experiencing puberty at an earlier age than in decades past.  This is important information for parents.  They need to pay attention to their own child’s development to determine when to start talking with them about the changes their body is going through and issues like sexual development that come along with puberty.

One final piece of advice parent to parent, puberty can be just as difficult on you as it is your children.  Work to keep the lines of communication open and eventually—it won’t happen overnight—you’ll get through it.