Author: Nicole Maxwell, NMD

Has your child developed early pubic or underarm hair?  Premature pubarche (PP) is when girls under 8 and boys under 9 have premature development of pubic and/or axillary hair. It tends to happen more in girls.  It is different from “precocious puberty” because it does not include breast buds or testicular development and there usually isn’t increased linear growth (height). One thing to note, PP is a diagnosis of exclusion – meaning we have to rule out other possibilities first, and once that is done, PP is considered a normal variation of development.

What could it mean for the patient long term? PP has been associated with a higher risk of a variety of conditions including obesity, insulin resistance, PCOS, metabolic syndrome, cardiovascular issues; and mental health issues (even during childhood).  

If one has PP then we can start helping that child to avoid these potential health issues with diet and lifestyle changes, reducing chemical exposures, appropriate supplementation, monitoring and providing education for the child and the family.

Taking care of kids is a passion of mine.  If you have concerns about your child’s development, please reach out for an appointment. 

Constipation is a fairly common issue in children that often resolves itself with a few lifestyle changes.  But left untreated, it can become a chronic problem and even lead to encopresis (involuntary passing of stool, often due to impaction).  Naturopathic health care really shines in helping these children have healthy bowel movements. 

The difference between constipation and encopresis:

When a child is constipated, he or she has fewer bowel movements than normal (<3 times per week) or delay or difficulty in passing stool. Bowel movements can then become hard, dry, and difficult to pass. Your child may avoid going to the bathroom because it hurts. Stool becomes backed up (impacted) in the rectum and the large intestine (colon). When the stool can’t move forward, the rectum and intestine can become enlarged. Over time, liquid stool can start to leak around the hard, dry, impacted stool. This soils your child’s clothing and is called encoporesis

Ruling Out Underlying Health Conditions 

• Primary care visit (we can do this at BNHC) to rule out other pathologies – this may include referrals for testing like an abdominal x-ray and/or barium enema, and bloodwork.
• Stool test to rule out bacterial imbalances, parasites, poor digestive function.  Here’s an example of one we run at BNHC: https://www.diagnosticsolutionslab.com/tests/gi-map)

Actions to consider:

• Food intolerance testing can be very helpful in finding a potential cause of the constipation.  It may take several weeks of avoiding the offending food/s before change takes place.  In general, avoid a high fat, low fiber, high sugar, junk-food diet
• Read Are Foods Causing Your Symptoms: Understanding Testing Options
• Fluid intake is essential.  Track the amount your child has and have water available around the house. Avoid soft drinks and fruit juices. If they don’t like plain water, consider herbal teas or snacks of juicier fruits like watermelon or even sucking on ice cubes.
• Fiber – think legumes, vegetables, and whole grains.  If your child has a dry constitution then think moist fibrous foods vs dry fiber (apple sauce, whole fruit, oatmeal vs bread).
• Exercise helps the body create motion in the bowels to push stool forward and out.
• Abdominal massage – gently and slowly rub castor (or another oil) in a clockwise fashion.  Heat can sometimes be useful
• Try relaxation training or mindfulness techniques.  Constipation and subsequent encopresis may be from stress in the family or with friends or at school.  Mindfulness helps decrease stress and gives the child a tool for life.
• Encourage a sense of humor among the family to help ease any tension that may have built up around pooping.
• It’s really important to do child-led potty training to decrease the risk of constipation/encopresis in the future.
• Biofeedback can be used to help get on a stooling schedule and to help re-learn the body’s signals.
• Chiropractic care can help rule out or correct structural contributors.

There are a number of supplements that might be helpful:

• Kid-friendly digestive aids instead of laxatives
• Probiotics can help to diversify the normal flora and compete with overgrowth bacteria which will aid the mucous layer lining the gut and promote better digestion.
• Homeopathy can be useful, especially if there is a strong emotional component. 
• Demulcents and gentle GI herbs can restore rhythm and function.  
• Calcium and especially magnesium can help.  Some find help by adding fish oil.  

There are so many options to consider as you see in the list above.  Consider scheduling an appointment at Boise Natural Health Clinic and we can guide you through the process and help your child have bowel movements successfully again.