Teen Growth

Teen development: What parents should expect during the teen years

Parents should expect the following growth milestones during their children's preteen and teen years:

• Acne: Part of the physical changes that go along with puberty are changes in the endocrine system - the glands that, among other tasks, produce the oil that lubricates the skin. During the teen years, those glands seem to work overtime, and oily skin - or skin that is oily in some parts and fairly dry in other parts - becomes the rule. Often, the oiliness leads to blocked pores and pimples.

• Allergies: We've seen a huge increase in allergies of all kinds in recent decades. A common pattern is for allergies to show up in the preschool years, then diminish after age six or seven, and then reappear after puberty. Children who did not have asthma when they were younger may develop it in their teen years.
• Anemia: When girls menstruate each month, the amount of blood lost is actually quite small - a few teaspoons. However, that blood contains part of the body's store of iron. If your daughter's iron stores are not high to begin with, she may lose enough over a few months to become anemic. Boys, too, can become anemic if their diets are low enough in iron, although this is less common. Anemia's signs are pale skin and unusual tiredness.
• Breast size: Some young girls develop breasts that are uncomfortably large. If they are experiencing back pain and physical discomfort as a result, breast reduction surgery may be recommended. It's important, though, to wait until they finish growing, as some will "grow into" breasts that seemed abnormally large at first within a year or so.
• Cold sores: Cold sores are caused by a herpes virus and can be transmitted by kissing, sharing drinks and so on, so the teen years are a common time to pick these up. Like the more serious genital herpes virus, there is no cure for cold sores, and they will continue to recur at times of stress or illness. Topical medications may relieve the pain and reduce the amount of time that the cold sore is visible, but the virus remains dormant in the system until the next time the immune system is weakened.
• Growing pains: The rapid growth that is typical of puberty can produce growing pains as the muscles and bones are temporarily out of sync with each other. In some cases, the bones in the leg grow quickly and cause a condition known as Osgood Schlatter's disease, leading to pain in the knee area whenever the teen runs or walks.
• Menstrual problem: Irregular periods are normal in the early stages of puberty as the body sorts out menstrual cycles. Usually, things settle down into a more predictable pattern after the first year or so. In some sense, menstruation is a reflection of the body's general health. Irregular or absent periods often indicate that the girl is underweight, is under a lot of stress or has other health problems (a fever, for example, can delay or suppress ovulation for a time). Heavy periods can also be the result of stress and anemia. They are also common when the periods are irregular because the lining of the uterus (which is what makes up the blood lost during menstruation) has more time to build up.
• Cramps: Many women and girls have some twinges or odd sensations, but nothing they would describe as painful. For others, however, each monthly cycle brings one or more days of real pain.
• Menarche: Puberty is a time of changes. For young girls, a defining event during this developmental process is menarche, which is defined as "the beginning of the menstrual function." Menarche can be a stressful time for young girls, and the event is often met with mixed emotions. Like many other changes associated with puberty, it can be confusing. Many girls experience fear and anxiety related to the first menstrual cycle, largely because of misinformation, or more frequently, lack of information.
• Mononucleosis: Known as "the kissing disease," this virus is transmitted from one person to another by routes other than just kissing but does seem to strike teens at an age when they are just beginning relationships with the opposite sex. The symptoms include headache, swollen glands in the neck and throat - sometimes so swollen that swallowing is very painful - and extreme tiredness. Some have a high fever and aching muscles as well.
• Twelve-year molars and wisdom teeth: Perhaps you thought teething was over, but teens may experience considerable discomfort as these last permanent teeth emerge. The twelve-year molars usually appear early in the teen years but are sometimes delayed. Wisdom teeth can appear in the late teen years, and if they are emerging crooked or in a way that interferes with other teeth, they may have to be removed by the dentist.
• Twisted testicles: This sounds bad, and it is. When boys enter puberty, their testicles gradually descend further into the sac, which holds them in place. This is necessary to keep the testicles at a lower temperature than the rest of the body so that sperm can be produced successfully. However, sometimes, as the testicles descend, a twist or kink develops in the cord that attaches the testicles to the pelvic area. As you can imagine, this causes a great deal of pain in the groin.
• A lump in the breast: This is highly unlikely at this age. Your teen is probably feeling a breast bud - the firm tissue that is an early step in the normal development of the breast. It feels like a flattened round lump behind the nipple, and boys get them as well as girls.
• Fat: Both boys and girls usually gain some weight before they begin their growth spurt and get taller. If they don't gain that weight first, they may not reach their expected adult height. Reassure your teen that this is normal and they will soon "grow into" that extra weight. Girls also worry at times because, with puberty, they develop hips, and their jeans don't fit the way they used to.

Knowing what to expect as your child enters and navigates the teen years will allow both you and your teen to deal with these changes more comfortably. The most important thing is that you keep the lines of communication open so that your teen can ask questions and let you know if they are experiencing anything unusual.

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