Girls tend to have a major growth spurt between the ages of 10 and 14. Most will have reached their adult height by the time they are 14 or 15 years old. Show This major growth spurt happens during the phase of physical and psychosocial development known as puberty. Everyone starts puberty at a different time, and genetics largely determines growth patterns. This means “normal” growth rates in humans occur within a range. During puberty, teenagers tend to experience a growth spurt that takes them to their adult height. Puberty is the transition from childhood to adulthood. It describes a series of changes people go through as their bodies start to increase the production of certain hormones. In females, puberty tends to start between the ages of 8 and 13. The average age for females to start puberty is about age 9-10 . However, it is different for everyone. Once it has started, puberty tends to last for about 4 years. Starting puberty before the age of 8 is considered early in females. Puberty is late if breasts have not developed by age 13, or periods have not started by age 15. While there is often no cause for concern, it is recommended to consult with a doctor when signs of puberty are early or late. The start of menstrual periods, known as menarche, happens on average around age 12. However, the observed range of ages at which periods can start is much wider, from ages 9 to 15. Acne is a common sign of puberty. Body hair typically increases and may become darker. The hormones associated with puberty may also make teenagers feel emotional or moody. This is a normal and expected part of this time of life. Females usually experience their fastest growth spurt around age 11 or 12. After menstruation starts, it is typical to grow another 7 cm (2.75 inches) in height. It is also typical for females to gain weight during puberty. Usually, females reach adult height around age 14 or 15. However, this can vary. Other factors that can have an impact on height include:
Because growth patterns are largely determined by genetics, there are a lot of variabilities when it comes to “normal” height. Expectations for overall growth based on age come from studies of healthy populations of children. The Centers for Disease Control and Prevention (CDC) recommend the use of growth charts from the World Health Organization (WHO) until age 2 to guide expectations. CDC growth charts are then used for ages 3-19. If there are concerns about a child’s growth, a doctor can use growth charts to help determine whether their rate of growth is typical. Breast development (thelarche) is usually the first sign of puberty in females. The earliest sign of breast growth happens when bumps develop under the nipple, called breast buds. As these buds grow, they will form breasts made up of mammary glands and fatty tissues. Breasts can start to develop from around age 9 or 10. For some, the earliest stages of growth can start as young as ages 6 to 8. Doctors define signs of puberty before age 8 as precocious (early) puberty. In most cases, early signs of puberty are benign and do not require treatment. Breast growth typically continues throughout puberty. Certain aspects of breast size are hereditary, meaning it runs in the family. Breasts will also vary in size depending on a person’s weight. After puberty, breast tissue continues to change and respond to hormones throughout life, including during the menstrual cycle, pregnancy, breastfeeding or chestfeeding, and menopause. Teenagers can sometimes feel self-conscious about this element of growing up. However, it is normal to:
A well-balanced diet and regular physical activity will support growth and healthy development. However, puberty and subsequent growth can be delayed for a variety of reasons. Constitutional delay, or “being a late bloomer,” describes a pattern of later development that runs in families and is nothing to worry about. These teenagers will fully develop, just later than their peers. Children with long-term conditions, such as diabetes, cystic fibrosis, or kidney disease, may also experience delayed puberty. This may be less likely if the condition is well-controlled, with limited complications. Conditions affecting the pituitary or thyroid glands, which produce the hormones the body needs to grow and develop, can also delay puberty. Likewise, some genetic conditions can interfere with the process. Intensive training and restrictive eating may delay the onset of puberty in young female athletes. In contrast, obesity is associated with an earlier start to puberty. These variations may be due to changes in hormone levels associated with activity levels and body composition. NutritionNutrition is important, and someone who is malnourished can develop later than their peers. Severe malnutrition as a child can contribute to growth delays, which can have ongoing effects if not corrected. Malnutrition can cause children to be underweight, low in height, or both. Worldwide, the WHO reports that in 2020, 149 million children under the age of 5 were too short for their age, and 45 million were too thin for their height. These conditions can cause delayed puberty, as well as other developmental complications. Puberty and gender-affirming care Puberty is a time of major transition in a child’s life, and they may experience a rollercoaster of emotions. It can sometimes be difficult to know whether these changes are normal, or a sign of conditions such as anxiety and depression. When thinking about how to support a teen during puberty, the National Alliance on Mental Health (NAMI) suggests considering questions such as:
If a child seems moody or irritable, but they have solid supports in place, then they may be experiencing normal puberty-related changes. If a child appears to be struggling and lacks support, or if there are concerns about a child’s wellbeing, talking with a doctor is a good place to start to get help. If there is an immediate risk to a child’s safety, get emergency help. According to NAMI, parents and caregivers of teens can support their mental health by:
Puberty and growth patterns are different for everyone. If there are concerns about a child’s progression through puberty, families can talk with a doctor or pediatrician. If puberty appears to be early or late, a doctor can find out more using tests such as a physical exam, an evaluation of eating habits, blood tests to screen for medical conditions, and X-rays that look at how the bones grow. |