What should I look for in a child with precocious puberty?

  1. Avoid eating: poultry raised with synthetic feeds (instant chickens, etc.), anti-seasonal vegetables and fruits, soy products, sweet potatoes and other foods containing phytoestrogens, supplements (snapper, oyster, pollen, royal jelly), synthetic foods, high-protein supplements, etc. Please pay attention to media reports on food and “environmental endocrine hormone disruptors”.  2. Avoid: cosmetics containing vitamin E and placenta (sunscreen, skin whitening, skin rejuvenation, etc.), brightly colored TV programs, video games, etc. (to prevent early activation of the gonadal system through retinal stimulation). Try to avoid plastic toys, plastic drinking bottles, etc.  3. Note: Put away the birth control pills used by parents and read the side effects of the medicines used by children. Pay attention to the ingredients of baby baths.  4.Strengthen: physical activity to help growth and prevent overweight.  5.Check-up items: abdominal ultrasound (uterus, ovaries), bone age, serum gonadal hormone level; head MRI, liver function, hepatitis B, blood sugar, glycosylated hemoglobin, insulin-like growth factor are needed before starting GnRHa treatment.  6.Review time: every 3 months review abdominal ultrasound, half year review ultrasound and serum hormone level, bone age.  7. Treatment: (1) Chinese medicine “Fuyao Combination”, twice a day, 30-50ml each time, adjust the dose according to the child’s condition, but the Chinese medicine cannot suppress bone age.  (2) GnRHa, a gonadotropin-releasing hormone analogue, injected intramuscularly once every 4 weeks, and extend the treatment time according to medical advice for children weighing less than 30 kg.  Side effects may include vaginal bleeding about a week after injection in a small number of children, and a single menstrual period in mature children. For children who are quite mature or who have already had their first menstrual period, treatment should be intensified once every 2 weeks after starting treatment.  (3) For some children whose final height is affected by precocious maturity, additional growth hormone may be added if necessary. 8. Age of termination of treatment: after 11 years of age of bone.