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  • Growth & Puberty Pediatrician/Endocrinologist

    Joyce Mbogo MD FAAP

  • Outline

    •Growth • Factors influencing growth • Determinants of growth in different stages

    •Puberty: • Triggers of puberty • Tanner Staging

  • GROWTH

    Growth:

    • An increase in body size both weight and height over a period of time.

    • A sensitive indicator of health and well-being.

    Factors involved in Growth

  • 4

    Main Factors Involved in Phases of Normal Growth

    Growth hormone

    Thyroid hormone

    Sex steroids

    Growth hormone

    Nutrition

    Rapid

    deceleration

    Slow

    deceleration

    Rapid

    acceleration

    then

    deceleration

    Infancy Childhood Puberty Phase:

    Pattern:

    Major

    factor(s):

    Clark PA, et al. Endocrinol Metab Clin North Am. 1996;25:665. Karlberg J, et al. Acta Paediatr Scand. 987;76:478,337(suppl):12. Kuczmarski RJ, et al. Adv Data. 2000;314:1.

  • 5

    Female vs. Male Pubertal Growth Spurt

    Girls Boys

    Peak

    11.5 yr

    Peak

    13.5 yr

    • Female vs. male – starts, peaks, ends ~1.5 – 2 yr earlier – peak velocity ~ 1–2 cm lower

    Start

    9.5 yr

    End

    14.5 yr

    Start

    11.0 yr

    End

    16.5 yr

  • PUBERTY

  • PUBERTY

    Developmental stage characterized by: • Maturation of gametogenesis • Secretion of gonadal hormones • Development of secondary sexual characteristics and

    reproductive organs

  • Average age of Puberty Onset

    Average Age of Puberty Onset: Girls 8.0 - 13.0 years Boys 9.0 - 14.0 years

  • What triggers puberty?

    Source: http://flipper.diff.org/app/pathways/info/3997

    Males Testicular Enlargement

    Females Breast development

  • Tanner staging: Breast Development

    Engebretsen L et al. Br J Sports Med 2010;44:476-484 Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.

  • Tanner staging: Testicular Development

    Engebretsen L et al. Br J Sports Med 2010;44:476-484 Copyright © BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine. All rights reserved.

  • In Conclusion: Adolescents

    •Growth • Pubertal spurt

    •Puberty: • Normal puberty

    • Females: 8-13 years

    • Males: 9 -14 years

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