Do you know what a bone age is? If you’ve ever found yourself spiraling over early puberty headlines or wondering if plastic cups and lavender lotion are harming your child’s hormones this episode is for you.

I’m joined by Dr. Sarah Hart Unger, a pediatric endocrinologist, mom of three, and co-host of the Best of Both Worlds and Best Laid Plans podcasts. Together, we cut through the confusion and misinformation around early puberty, endocrine disruptors, and what’s actually backed by science.

We dive into:

• What early puberty actually looks like including what’s normal vs. concerning, the difference between true puberty and adrenal changes, and when to seek evaluation.

• Real vs. rumored causes like the roles of body fat, genetics, and endocrine disruptors like BPA and lavender without spiraling into fear or guilt.

• When medical treatment is needed, when reassurance is enough, and why chasing puberty “delays” can sometimes do more harm than good.

To connect with Sarah Hart-Unger check out all her resources at ⁠https://linktr.ee/the_shubox⁠

And enjoy our previous episode: ⁠https://pedsdoctalk.com/podcast/i-wish-my-kid-was-a-little-bit-taller-height-and-kids/⁠ 

00:00 – Intro: Why earlier puberty headlines are everywhere
01:45 – Meet Dr. Sarah Hart-Unger: Pediatric endocrinologist and mom
04:30 – What is actually considered early puberty?
06:10 – The rise in early puberty: Is it real or just more noticed?
08:00 – Are endocrine disruptors to blame?
10:45 – The role of stress, trauma, and environment
13:10 – What “normal” puberty looks like across ages and genders
15:40 – Should you be worried about lavender lotion and plastic cups?
18:30 – What parents Google vs. what pediatricians actually test for
21:00 – What’s a bone age scan, and when is it helpful?
23:00 – When to worry: True red flags for early puberty
25:40 – The problem with over-testing and over-fearing
28:10 – Why Dr. Hart-Unger prioritizes calm, not panic
30:00 – Navigating puberty in boys vs. girls
32:45 – Language for talking about puberty without shame
35:00 – Helping your child feel confident in a changing body
37:10 – Final thoughts and what Dr. Hart-Unger wants parents to remember

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00;00;00;03 – 00;00;20;00

Dr. Sarah Hart-Unger 

In girls basically before age eight. You shouldn’t really have much in the way of true puberty. Look for, you know, subtle signs. In girls, I think it’s easier because, like, you know, at some point you might see some breast tissue. And if you if you’re worried about it, get it, get it looked at, especially if it’s prior to age eight.

 

00;00;20;03 – 00;00;37;02

Dr. Sarah Hart-Unger 

If a kid is of like a bigger build or carrying a little bit of excess fat tissue, it can actually be very hard to tell. What’s the difference between what we call lipo masya, which is just a little extra fatty tissue in that area versus through puberty. But you can always have it looked at, and then the provider can then like look for other signs and see whether there’s a concern or not.

 

00;00;37;04 – 00;00;56;07

Dr. Sarah Hart-Unger 

In is it can be really difficult. But I would say if you are noticing like early acne, significant amount of acne or like body hair or something like that, it’s always a good idea to bring it up because I think it’s not something you’re going to want to excavate on your own at home. To check out their testicular volume.

 

00;00;56;07 – 00;01;05;02

Dr. Sarah Hart-Unger 

But if it were happening early, you would want to know about that.

 

00;01;05;04 – 00;01;27;18

Dr. Mona

Hi, it’s Doctor Mona, your favorite online pediatrician. I hope mom friend, and someone who cannot believe we’re still blaming occasional aluminum foil use for early puberty. Welcome back to the PedsDocTalk podcast. And hey, before we dive in. Hit that follow and download button. Yes, it helps the show grow, but more importantly, it helps you stay informed with content that’s based in science, not social media fear.

 

00;01;27;20 – 00;01;46;20

Dr. Mona

So let’s talk about what I’ve been seeing all over TikTok lately how to delay puberty tips that sound helpful but don’t always hold up. You’ll hear things like don’t let your child drink cold water. Say no to nail polish. Never pack food in foil. Wash fruit with vinegar and baking soda. Don’t let them use a laptop on their lap.

 

00;01;46;22 – 00;02;14;09

Dr. Mona

Now listen, early puberty is happening more often, but these hacks, they’re mostly noise. Cold drinks don’t trigger hormones. Nail polish and some cosmetics may contain endocrine disrupting chemicals, but occasional use isn’t the same as chronic exposure foil minimal exposure on random occasions. I’m not worried about foil fruit washing. Good for cleaning, not a magic hormone filter. Laptops. There’s no strong evidence linking them to puberty changes.

 

00;02;14;14 – 00;02;40;11

Dr. Mona

Do I still want them on someone’s lap? No. Use a pillow. Maybe that direct heat is not great for our bodies. So what is going on? And what can parents actually do to support their child through these changes? To unpack all of it, I brought in Doctor Sarah Hart Unger, a board certified pediatric endocrinologist. We’re talking about the role of weight stress environment, endocrine disruptors, family history, and how to approach this whole topic without guilt or fear.

 

00;02;40;14 – 00;02;50;12

Dr. Mona

So before you panic over nail polish or toss the foil, take a breath and let’s get into it. This conversation.

 

00;02;50;15 – 00;02;53;03

Dr. Mona

Thank you for coming back on the show today, Sarah.

 

00;02;53;05 – 00;02;55;19

Dr. Sarah Hart-Unger 

Thank you so much for having me. I’m excited to be back.

 

00;02;55;26 – 00;03;05;28

Dr. Mona

Well, we were chit chatting for like an hour before actually recording, about other life stuff. I love chatting with Sarah. She was on the show now three years ago, right.

 

00;03;06;00 – 00;03;06;13

Dr. Sarah Hart-Unger 

Like, yeah.

 

00;03;06;14 – 00;03;31;20

Dr. Mona

Yes, we talked about height and kids. The title of that episode was I wish my kid was a little bit taller, like that song from I forget who sang it from the 80s or 90s, but, we talked about growth. We talked about when to be concerned, and now we’re talking about puberty. But before we get into it, tell our listeners who are not familiar with who you are a little bit more about yourself, what you do as a pediatric endocrinologist and maybe even more about your podcast.

 

00;03;31;22 – 00;03;57;15

Dr. Sarah Hart-Unger 

Sure. So my name is Sarah Hart Unger. I practice pediatric endocrinology in South Florida, but I have been in practice over ten years now. Not counting all of my training. So I feel like I’m in that sort of seasoned place in my career, and I am a part time practitioner because I have this love for sharing about planning and helping women kind of make the various parts of their lives fit together.

 

00;03;57;20 – 00;04;21;02

Dr. Sarah Hart-Unger 

So basically three days a week I see patients, and then two days a week I do stuff related to. I’m actually part of two podcast specialty plans, and then I have another one on making work and life fit together called Best of Both Worlds, which I co-host with time management expert Laura Vander Kim. And then I have three kids speaking of, puberty, I have a 13 year old and 11 year old and a seven year old, and I’m married to a vascular surgeon.

 

00;04;21;02 – 00;04;22;19

Dr. Sarah Hart-Unger 

So lots of moving parts.

 

00;04;22;26 – 00;04;39;22

Dr. Mona

Yes, and a lot of connection. So I don’t know if y’all know this. So I’m also in South Florida, which you probably should know. People don’t think I live here, but I don’t know why. But I know Doctor Sara from obviously working as a general pediatrician. She’s a pediatric endocrinologist. We were at the same hospital at some point.

 

00;04;39;24 – 00;05;02;11

Dr. Mona

And so we have that connection. And so there’s not only a professional one, there’s a personal one as well. Being in the same area. And so really happy to have you back on. And this was a conversation that I really wanted to have, mainly because there’s been a lot of news stories about early puberty, like, you know, on mainstream media talking about kids in America are having puberty earlier than ever.

 

00;05;02;16 – 00;05;27;18

Dr. Mona

But then I was also seeing a lot of social media videos with moms, especially talking about how and what they’re doing to delay their kids puberty. And it was almost like a catchy gimmick, like, you know, to get people’s attention on, like, what they’re avoiding, what they’re, you know, what they’re doing it with diet. And I wanted to get an expert on to talk about what is actually causing early puberty.

 

00;05;27;21 – 00;05;53;10

Dr. Mona

And if there’s anything we can avoid or can do to delay that to the normal level, because it sounds like a lot of that videos are like, I’m delaying it until they’re 14, 15, like it’s this flex that, oh, I don’t want my kid to have it early. But we have to also understand that development is development. So the first the first question I have, whether it’s breast in six year olds or pubic hair in grade schoolers, you know, this early puberty concern is there and it’s valid.

 

00;05;53;10 – 00;06;03;15

Dr. Mona

It’s all over parenting forums. But what is hype and what’s real and how is early puberty defined? Would be the first question I have for you.

 

00;06;03;18 – 00;06;20;23

Dr. Sarah Hart-Unger 

What is early and what is actually normal. So that’s a great question. And I will say I do understand and empathize with people who feel like puberty is a little bit scary. I think maybe this conversation will help you to feel a little bit better about it, because I think there are certain things, certain myths out there.

 

00;06;20;26 – 00;06;37;21

Dr. Sarah Hart-Unger 

One being that the minute you see one side of puberty, your kid is going to like have their period tomorrow or have a voice change be done growing in three days or something like that, that this process is just this instantaneous once it starts going downhill, kind of a thing. And yet it is so much more nuanced than that.

 

00;06;37;21 – 00;07;04;29

Dr. Sarah Hart-Unger 

So let’s begin by talking about what is actually normal. So in girls, basically before age eight, you shouldn’t really have much in the way of true puberty. And I say true puberty because there is a distinction here. There is puberty that comes from the brain and then stimulates either the ovaries in girls or the testicles in boys to make estrogen in girls and testosterone in boys.

 

00;07;05;04 – 00;07;23;05

Dr. Sarah Hart-Unger 

And in reality, everyone does make a little bit of both. But we’re just going to keep things simple for today. So the true puberty is the brain giving these hormones called LH and age to stimulate those gonads. The ovaries are testes to make hormone. That’s going to cause breast development in girls, and it’s going to cause testicular enlargement in boys.

 

00;07;23;05 – 00;07;44;21

Dr. Sarah Hart-Unger 

And let me tell you, usually by the age that we’re talking about this, the kids are not really showing you those parts necessarily. So it can go a little bit under the radar, which is interesting. There’s also other signs which can be part of true puberty, like what I just talked about, but can also be part of something called Adran Aki, which doesn’t get talked about as much.

 

00;07;44;23 – 00;08;07;29

Dr. Sarah Hart-Unger 

And Atronach Aki is the process of the adrenal glands, which are two glands to sit on top of the kidneys, kind of waking up and starting to make some hormone of their own. And the interesting things are you can’t really tell the difference between the things that are part of Adran Aki and then the things that testosterone does because they’re a little bit similar, they can cause acne to start, just like a few little pimples.

 

00;08;08;07 – 00;08;28;28

Dr. Sarah Hart-Unger 

They can start some body hair to grow, especially under the arms or in the pubic region. And they can start with some body odor. Adrienne Janaki can begin a couple years before puberty and be normal. So a lot of times someone will get really, really nervous because they’re 6 or 7 year old, is starting to get a little stinky when they’re sweaty.

 

00;08;29;01 – 00;08;52;28

Dr. Sarah Hart-Unger 

That’s probably not the start of true puberty and is more likely going to be just normal. Adran Aki. Unless there are other concerning things that we’ll talk about. But again, going back to what is normal would be if we’re talking about signs of true puberty, which again, in girls are things like breast growth, vaginal discharge, having a really big growth spurt, or in boys testicular enlargement.

 

00;08;53;01 – 00;09;12;28

Dr. Sarah Hart-Unger 

Again, that growth spurt, the voice changes, kind of the ending phase. If you’re waiting for that, you’re kind of like towards the end of puberty, those are true signs of puberty and really shouldn’t start before age eight and girls or before age nine and boys with the caveat that there’s actually a sizable portion of the population, especially in girls.

 

00;09;13;04 – 00;09;40;02

Dr. Sarah Hart-Unger 

That does start with a little bit of breast development prior, and that can kind of be classified differently as something called benign. Premature Aki can happen in toddlers, can even happen in five, six year olds. But I would still say that’s something that you would not want to try to diagnose yourself. If you’re seeing breast growth in a kid less than the age of eight and a girl, then you probably should at least bring it up with the provider and see if they think you need further workup.

 

00;09;40;04 – 00;09;48;08

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;09;48;11 – 00;10;09;20

Dr. Mona

And with that, so I you already brought up the body odor because I have so many parents coming in at like that seven, eight or even nine like worried that that body odor alone means that their child is going through puberty. So now, you know, knowing what you mentioned. So just say a family has they noticed breast buds in their eight year old and they come into the the pediatrician and there’s no other signs.

 

00;10;09;20 – 00;10;21;03

Dr. Mona

Right. Meaning this is a obviously let’s say a female. There’s no, pubic hair. And the height growth is looking good. Is there anything that needs to be done at that point for just, you know, the start of some breast buds?

 

00;10;21;05 – 00;10;44;11

Dr. Sarah Hart-Unger 

So I would first ask the question as to when other family members went into puberty because, eight is a perfectly normal time to have breast buds. And to be fair, there has been a shift in the timing of breast buds, even in recent years to be a little bit younger. So if mom didn’t remember getting them until she was ten and her daughter’s getting them at eight, it’s probably, you know, normal.

 

00;10;44;12 – 00;11;08;17

Dr. Sarah Hart-Unger 

Because again, eight is kind of like the lower limit of normal. And again, we see a lot even before that that may be considered normal as well. So generally there wouldn’t be anything to do other than to have a discussion with the family about how long like this should take to progress, because I think that what’s what’s embedded in the fear when they bring them is not, oh my gosh, my eight year old has breast buds, but oh my gosh, my eight year old’s turning into a woman.

 

00;11;08;17 – 00;11;29;01

Dr. Sarah Hart-Unger 

Tomorrow is going to stop growing in two inches from her current height. And is going to get her period on Wednesday. And really there has been a shift in periods occurring earlier over time. Although the shift has not been quite as dramatic as the shift in breast putting. So if anything, puberty is kind of taking longer. It’s starting a little earlier.

 

00;11;29;01 – 00;11;48;23

Dr. Sarah Hart-Unger 

It’s starting a lot earlier. It’s ending a little earlier. And honestly, my rule of thumb is usually somewhere between 2 and 3 years from the onset of noticeable breast buds to the period, and I’ve seen it take a lot longer than that in some cases. So for me, if I saw a patient that was just eight years old and just starting to have breast buds, I would discuss that.

 

00;11;48;23 – 00;11;56;29

Dr. Sarah Hart-Unger 

That is normal. And, here’s what you can expect going forward. And here would be some concerning things to watch for.

 

00;11;57;02 – 00;12;10;12

Dr. Mona

So some definitions to get off the bat. So under eight years of age a sign of breast buds or any so sign of breast buds or pubic hair would be something that a parent should bring concern to their pediatrician. Yeah.

 

00;12;10;12 – 00;12;27;09

Dr. Sarah Hart-Unger 

Again pubic hair can be tricky because it can just be from the adrenal glands. But I think that would warrant having the pediatrician take a look at the growth chart, take a look to see if there’s testicular enlargement, if it’s a boy, because that is not something you’re going to want to try to figure out if your child has necessarily on your own.

 

00;12;27;09 – 00;12;49;10

Dr. Sarah Hart-Unger 

It could be fairly subtle. And believe it or not, as endocrinologist, we actually have standards to look to see. Okay, are the is the size reaching kind of the threshold where we can see if this is true puberty and true puberty in a boy before the age of nine, or even right at the age of nine, would spark a little bit more concern because, in boys especially, it’s not even just the thought.

 

00;12;49;10 – 00;12;49;28

Dr. Mona

Of the puberty.

 

00;12;49;28 – 00;13;04;10

Dr. Sarah Hart-Unger 

That’s concerning. But one of the reasons we care about these things is that in some cases, it can be a sign of an underlying problem in worst cases. And not trying to be alarmist, because this is not usually the answer, but like something like a tumor. And we just want to make sure that it’s not the case now.

 

00;13;04;10 – 00;13;19;13

Dr. Mona

So I think, you know, when I hear online is like a lot of people are worried about girls puberty being earlier. And I think it’s because of the menstruation starting earlier. Right. So is there an age threshold that is considered by definition to considered obviously like premature to start menstruation?

 

00;13;19;15 – 00;13;53;03

Dr. Sarah Hart-Unger 

Yeah. I mean, anything prior to age ten is definitely considered early. And we’ll talk about I don’t know if you want to get into it. Yeah. Oh, but you know, there are there are treatments that you would consider if someone is starting puberty so early, that you expect that they might have menstruation by age nine or, in that kind of rare case where a child comes to you at age nine and the parents were kind of caught by surprise that they’re already menstruating, I mean, that kind of situation would deserve a full workup to figure out, you know, why this is a case, to understand the timing of this puberty.

 

00;13;53;09 – 00;14;09;22

Dr. Sarah Hart-Unger 

Again, family history is so important here because if the mom says, oh, I also had my period at nine and so did my mom, you know, the kind of mom then you’re a little bit less concerned, but that is quite young. So it’s the kind of thing where you’d want to send labs and perhaps even consider things like imaging.

 

00;14;09;24 – 00;14;33;05

Dr. Sarah Hart-Unger 

And then there are medications that we use that can be used to block true puberty. I want to emphasize true puberty, because again, if it’s only the adrenal glands that have woken up, they’re actually really aren’t medicines to fix that unless it’s like a rare adrenal disorder. But I would kind of put that into another category, the run of the mill adrenal glands waking up at six, seven, eight, and it’s just the pubic hair or the odor.

 

00;14;33;12 – 00;14;52;28

Dr. Sarah Hart-Unger 

And you’ve gotten the labs checked and they’re not scary through the roof or anything. There’s not a way to treat that except for reassurance. But the true puberty, the period starting at age nine or even before that? Definitely. There are treatment options available, and for the most part, they all work the same way by shutting off those hormones in the brain.

 

00;14;53;02 – 00;15;13;22

Dr. Sarah Hart-Unger 

That’s again why they don’t work for Janaki. They don’t work on the adrenal hormones, but they will quiet down the LH and the FSH coming from the pituitary and therefore the ovaries or testicles will no longer get the signal to make more hormone. And they kind of turn everything off at the source. They are either injectables. They used to be monthly, which was really hard for patients.

 

00;15;13;24 – 00;15;29;18

Dr. Sarah Hart-Unger 

It’s a big I am injections, so it had to be done in the office and these people would have to come in every month. But now there are options for six month injections, which is awesome. And then there’s also an implant which can be left in for a year and then off label. You can even leave it in for a little bit longer than that in some cases.

 

00;15;29;18 – 00;15;34;26

Dr. Sarah Hart-Unger 

So, just some really, more convenient treatment options for patients who need it.

 

00;15;34;29 – 00;15;49;03

Dr. Mona

And we are going to get into like why we are, why we may see early puberty. And I love that you talked about treatment, because I think a question that might come up for a lot of our listeners is why can’t we just let it happen early? What is the reason for treating. And maybe people don’t understand that.

 

00;15;49;03 – 00;16;21;25

Dr. Sarah Hart-Unger 

Yeah, yeah. So there’s two reasons as I see it, to treat early puberty. And I’m not saying to always treat it because actually two considerations to make. The first one is height. Now interestingly, the medicines that block puberty don’t necessarily protect height. If the kid is already kind of borderline age. Meaning if you have a ten year old, maybe, who just started right before age eight and they’re already nine and a half, and you think they’re about to get their period treating a child of that age, there may not be much of a height protection effect of treating that child.

 

00;16;21;25 – 00;16;46;11

Dr. Sarah Hart-Unger 

However, a child that is quite young is five years old and it’s having significant breast development, six years old, having, you know, a lot of progression, that kind of child would probably have a significant, growth spurt that would end early if they were not treated. And by slowing things down for several years, you can get, a higher, a taller height outcome, to prevent them from ending up stopping growth really prematurely.

 

00;16;46;11 – 00;17;06;10

Dr. Sarah Hart-Unger 

So that is one reason. And then the other reason is much more psychosocial, meaning it is hard to look very different from your peers. I know it hurts on both ends. Honestly. I have patients that are very late through puberty, patients that are very early through puberty. And both of them are like, oh, why can’t I just be closer to normal?

 

00;17;06;10 – 00;17;25;21

Dr. Sarah Hart-Unger 

So, you know, it’s just, tough on these kids. And then the act of actually having a menstrual cycle for a kid that isn’t old enough to really understand it or, you know, be hygienic with it can be really, really difficult. And so that is another reason to potentially, use these medicines to stop puberty.

 

00;17;25;23 – 00;17;31;28

Dr. Mona

Awesome. And how how long are the patients usually on these for? Just kind of like a few years to get them through that cycle. Yeah.

 

00;17;31;28 – 00;17;47;23

Dr. Sarah Hart-Unger 

Yeah. So if they’re really young they can be on it for quite some time. One of my youngest patients, I think was 3 or 4 when she was diagnosed. And we’re just talking about when to stop it. And she’s like 10 or 11, like ten and a half or so. And I think we’re thinking until she’s 11. So that’s been a lot of years of treatment.

 

00;17;47;23 – 00;18;10;04

Dr. Sarah Hart-Unger 

She’s been really lucky and that she hasn’t really. I could talk about some side effects from those treatments because they’re unfortunately not side effect free. I mean, they can be, but, there are potential side effects. So this patient tolerated it. Great. And so we’re just talking about going off of it after like seven years of treatment. But other times it’s going to be a lot shorter, especially if you’re starting somebody, you know, closer to maybe 8 or 9 or something like that.

 

00;18;10;06 – 00;18;26;23

Dr. Mona

I think my next question is going back to like what we had alluded to is, what are the more well supported risk factors for early puberty? I know, you know, you talked a lot about family history. And then we are also seeing a lot of misinformation online and like, hey, we’re going to avoid this or do this, but what is actually.

 

00;18;26;26 – 00;18;27;12

Dr. Sarah Hart-Unger 

True.

 

00;18;27;12 – 00;18;31;09

Dr. Mona

And which ones are speculation or misinformation and which ones actually fact.

 

00;18;31;12 – 00;18;57;13

Dr. Sarah Hart-Unger 

Yes. So the absolutely known, the main true variable that we 100% know for sure is obesity and sort of just a rise in BMI. And interestingly, this was thought to be positive for a while, meaning malnourished people don’t go through puberty normally. So it was seen as like great progress of society that, you know, if you go back 100 years that we’ve, you know, brought the age from menarche from like 1617 to 1213 through improved nutrition.

 

00;18;57;13 – 00;19;23;11

Dr. Sarah Hart-Unger 

But actually, once you kind of go past improved nutrition to obesity and excess fat tissue, that can actually, kind of spur things along a little bit quicker. And there’s evidence to, kind of suggest this not just correlation, but something corsetry there or positive there. And that’s more in females. In males it’s less clear. And in fact, there might be some evidence that excess body fat can slow down, the progression of puberty.

 

00;19;23;11 – 00;19;45;14

Dr. Sarah Hart-Unger 

So it’s just a little bit different. But in girls we know that it does spur it on. And so keeping a healthy weight and body composition is one of the things that is going to make it more likely that somebody has a more normal timing of puberty. I do want to say, though, that this does not mean that every patient who goes through early puberty or true precocious puberty is overweight.

 

00;19;45;14 – 00;20;05;07

Dr. Sarah Hart-Unger 

I’ve seen many entirely normal weight individuals do this. I’ve seen people who have others in the family that were that were normal weight. And then I’ve seen people who it comes out of the blue and they were very thin or normal weight. So this is not like a, you know, you did it or causative. It’s just okay, we know that’s one factor that can spur it along.

 

00;20;05;10 – 00;20;36;04

Dr. Sarah Hart-Unger 

The second is that I think has evidence but is like a little bit more fuzzy in terms of like exact dosages and exposures. And things are things like BPA and other plastic components and things like phthalates that are in shampoos, soaps, all the things we use. And even when you’re like, well, I get BPA free, you had to be very careful with that statement because a lot of the alternatives used, things like BPA, F are probably similar to BPA, but just now it’s BPA free.

 

00;20;36;04 – 00;21;03;00

Dr. Sarah Hart-Unger 

They’re able to say it is because it’s a different compound to the point where unfortunately, it’s almost impossible to blanket avoid. Yeah, every single type of exposure. I think that this can become a point of real guilt and shame in parents where if their child does go through puberty a little bit on the early and they’re like, oh my gosh, I did something wrong, I expose them to something toxic.

 

00;21;03;07 – 00;21;27;13

Dr. Sarah Hart-Unger 

Unfortunately, a lot of these compounds are in the air we breathe. They are in the cleaners that are used in every public space, like there is a certain point where you just don’t have control there. You can draw some really good boundaries for yourself, like, oh, I’m not going to microwave and plastic, or I’m going to choose to use glass dishes and metal water bottles and you know, I’m going to buy organic when possible.

 

00;21;27;13 – 00;21;47;14

Dr. Sarah Hart-Unger 

And that’s great. Whatever you can do and decide to do can be helpful. But I think the idea that you’re going to somehow avoid every harmful exposure, is simply, it’s one of those things where it’s almost like, if you did it, you’d be living in such a bubble that the side effects of that bubble would be worse than the exposures.

 

00;21;47;14 – 00;22;04;16

Dr. Mona

I was just going to say that I’m like, I talk about this all the time, that the anxiety is worse than the actual thing you’re trying to avoid, right? Stress and anxiety over. I can’t touch this. My kid touched a receipt. I don’t know if you heard that going right. Like, yeah, I’m all receipts. Do I want kids eating thermal receipts and touching them every day and rubbing them on their body like a tissue?

 

00;22;04;22 – 00;22;37;18

Dr. Mona

Absolutely not. But I touched the one the other day. My son wanted to touch one. I’m not. Oh my God, he’s going to get T and all this stuff. But I guess, you know, like things like, for example, tea tree oil or lavender. I guess my question for you is, as a endocrinologist, are there certain things that you think about to make it less stressful for you and your family living in this world that, like you said, that we cannot avoid everything, but we can be more just conscious for what we do know.

 

00;22;37;20 – 00;22;45;23

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;22;45;26 – 00;23;07;18

Dr. Sarah Hart-Unger 

Will you mention the two compounds that have a good amount of evidence around them? And I’ve actually clinically seen, particularly with lavender, there was a time that it was very popular to use some lice, repellent sprays that had a lavender base, and they were real essential oils. And the interesting thing about those sprays is that you were spraying them on and they were staying on your skin.

 

00;23;07;18 – 00;23;23;12

Dr. Sarah Hart-Unger 

This wasn’t a soap that you were going to wash off. This was like soaking in, and a lot of people were using them every day because like, who wants their kid to get lice? I don’t want my kid to get lice. So I get it. And honestly, the smell of lavender is lovely. So it’s so lovely that the the the desire don’t.

 

00;23;23;12 – 00;23;25;01

Dr. Mona

Do this to me. Yeah, yeah.

 

00;23;25;04 – 00;23;25;14

Dr. Sarah Hart-Unger 

But there.

 

00;23;25;22 – 00;23;26;17

Dr. Mona

Is.

 

00;23;26;19 – 00;23;45;13

Dr. Sarah Hart-Unger 

Some evidence that that compound has some similarity to estrogen. And I have seen at least one case where I do believe it was the lavender spray, because when we took it away, it was a boy. He had little buds and they went away. So. Right. And there’s, there’s, there’s some papers talking about this. There’s also some people who don’t believe the evidence is very strong.

 

00;23;45;15 – 00;24;02;13

Dr. Sarah Hart-Unger 

I feel like there are enough other remedies for lice and stuff out there that I personally just feel like if you just avoid the pure essential oils of those two oils, tea tree and lavender, I honestly don’t think there’s probably real lavender in like the Aveeno.

 

00;24;02;15 – 00;24;17;24

Dr. Mona

Lavender, like honest the honest baby like we I mean, again, this is not. But like we use the honest baby lavender for a while. And to your point, I told myself I was like, you know what? I’m not. I don’t have to have it be lavender. Kind of what you said, right? Like there’s ten other scents I could choose from.

 

00;24;18;00 – 00;24;18;14

Dr. Mona

So like.

 

00;24;18;14 – 00;24;20;07

Dr. Sarah Hart-Unger 

Sweet almond. Lovely. Yeah, exactly.

 

00;24;20;07 – 00;24;38;08

Dr. Mona

So we went to the sweet almond, right. And I said to myself, and I’m like, do I need to really do this, knowing that there may be a small chance? And so it’s kind of one of those things that I don’t regret using the lavender for however long we used it. But my postpartum brain forgot to think about like, oh yeah, lavender has that maybe questionable, you know, interaction.

 

00;24;38;08 – 00;24;55;06

Dr. Mona

And I’m not even worried that it’s true lavender in this thing, you know? But like you said, I think the essential oils, the, the active tea tree oil for the developing, you know, pre pubertal body is something to consider. And I again do not lose sleep. But I just think it’s reasonable to look at if you have other options that are smell good.

 

00;24;55;06 – 00;24;57;27

Dr. Mona

And lavender can just take a little backseat for a little bit. Yeah.

 

00;24;57;28 – 00;25;14;20

Dr. Sarah Hart-Unger 

Exactly. And this is not even to say that like essential oils in general are bad. Just yeah, those two in particular. And then if you’re knowledgeable and you’re getting purely sourced oils, go go for it with the rest of the stuff. So yeah, those two in particular. And then yeah, I think just deciding which boundaries are the most important to you.

 

00;25;14;20 – 00;25;31;07

Dr. Sarah Hart-Unger 

Yeah, I mean I gave examples, but those happen to be some of the ones that I use, like, yeah, I really just don’t give my kids plastic containers for school lunches. I definitely don’t microwave in plastic. We love those glass Pyrex, containers and love things like that. The water bottles. If I can get metal, I prefer that.

 

00;25;31;07 – 00;25;50;27

Dr. Sarah Hart-Unger 

So you decide kind of what makes the most sense to you and where you want your boundaries to be. And you can always reevaluate that every once in a while as new evidence comes out. But make those boundaries things that will not make you crazy. I have a friend who I don’t know if there’s a lot of evidence behind this or not, but she does not want to use the microwave for anything, and for her it doesn’t bother her.

 

00;25;50;28 – 00;25;57;16

Dr. Sarah Hart-Unger 

For me, my head would explode. So like again, we all have to decide where we’re going to draw our individual lines.

 

00;25;57;16 – 00;26;15;18

Dr. Mona

Yeah, I mean, there was some stuff about certain air fryers and things like that, and I’m like, listen, this air fryer is sorcery. And for me and my family, it makes sense to occasionally use the air fryer for things versus, you know, eliminating completely. And what I warn families about is falling into the extreme on either side. Right.

 

00;26;15;18 – 00;26;33;01

Dr. Mona

Like not caring at all and saying, I’m just going to eat and touch everything. It doesn’t matter. Or the extreme of like, well, everything’s a threat because both of those are not are not safe for the family. Right. And so that middle ground, which is I know what you’re doing, what I’m doing of the sort of balanced approach of I can only control what I can control.

 

00;26;33;01 – 00;26;41;29

Dr. Mona

And this is what makes sense for my family, my resources, my money. What I want to choose my brain is spending time on is really important.

 

00;26;42;01 – 00;26;45;14

Dr. Sarah Hart-Unger 

Yes. And in terms of things like Wi-Fi signals.

 

00;26;45;14 – 00;26;46;09

Dr. Mona

And stuff, oh my gosh.

 

00;26;46;09 – 00;27;07;03

Dr. Sarah Hart-Unger 

Yes. It’s there’s a lot of speculative stuff out there. Listen, are our screens wonderful and is having another reason to do less of them? Maybe. Fine. Sure. But like, I don’t think there’s anything, you know, causative that’s been proven. So I don’t think this in particular unless you’re using the indirect link of screens equals obesity equals early puberty.

 

00;27;07;03 – 00;27;14;14

Dr. Sarah Hart-Unger 

If you’re using it that way, then maybe. But otherwise I would not drive yourself crazy on. I let my kid watch Bluey and another in puberty.

 

00;27;14;20 – 00;27;29;09

Dr. Mona

Not well. I mean that’s what’s happening on social. And that’s kind of why I wanted to have this conversation with you, is that there is a extremism of like, like EMF. And, you know, you know, whether it’s from phones or, you know, like the plastic and like how they don’t I’ll never do this and I’ll never do this.

 

00;27;29;09 – 00;27;45;19

Dr. Mona

And I think I tend to try to not use those never words because like, you talk about the plastic and, you know, obviously I don’t warm plastic in the microwave, but sometimes my mom has plastic Tupperware and I may have to use it, but does that mean it’s the the norm that we do know? I’m Pyrex obsessed as well.

 

00;27;45;24 – 00;28;06;03

Dr. Mona

And then now there’s information that Pyrex isn’t good and I’m like, everything is. Someone is always going to come up with something. And then also those news headlines will also make it seem like everything’s a threat, like forever chemicals in our in our body or like, you know, saying those kind of things like plastics live forever. And it’s like, I get it.

 

00;28;06;03 – 00;28;12;29

Dr. Mona

But then we’re not going to consume anything and we’re not going to be there, like, what do we want here? Like, you cannot live in a bubble like it’s true.

 

00;28;13;01 – 00;28;16;04

Dr. Sarah Hart-Unger 

Yeah. And there would be downsides even if you could that.

 

00;28;16;04 – 00;28;32;14

Dr. Mona

Well, you know, I love this because I think that, you know this. I have a really good friend who’s a pediatric endocrinologist as well. Oh, yes. And and I love her. Yeah. And yeah. And she, she and I have spoken about this as well. And I asked her about the lavender and tea tree and same concept. She was like, listen, I there’s other options, so why do I need to use that?

 

00;28;32;19 – 00;28;53;28

Dr. Mona

And if I used it and if I went to my mom’s house and I had it, am I going to have like a big meltdown? No. Like it’s not the end of the world. But in our home there are other options. And that is why I think you and myself are not losing sleep when we get these headlines come in of like, oh my God, now this is an endocrine disruptor and this is that we are understanding that, hey, we’re going to follow this evidence.

 

00;28;54;04 – 00;29;07;04

Dr. Mona

I go to my endocrinologist, I’m like, what are y’all seeing? Tell me, what should I know? And I will report back to you all if I find anything that is coming back. That is like a true harm across the board in high volumes.

 

00;29;07;06 – 00;29;27;27

Dr. Sarah Hart-Unger 

And I think there’s also you mentioned something about like, you know, delaying puberty being a okay. And I do feel like that’s just like a marker of our society right now. Right. Like anything can be taken to some extreme and like I can do it more and that’s what’s going to get the most views and therefore that’s what’s going to it kind of gets more and more.

 

00;29;27;27 – 00;29;42;22

Dr. Sarah Hart-Unger 

Yes. Serene. Thankfully, I don’t feel like I’ve seen that too much in my office. Like someone coming in and being like, okay, I know it’s normal for my kid to have a breast at 11, but like, I want him to be 40 or something. I haven’t seen that yet, but I guess we do have to, yeah.

 

00;29;42;22 – 00;30;05;02

Dr. Sarah Hart-Unger 

Gain an appreciation for the fact that there are major genetic differences here, and some of this is going to be beyond our control. I’m not talking about letting a six year old go through puberty naturally without intervention or anything like that, but a child that maybe starts at nine and has their period at 11 isn’t like worse than some equivalent child who starts at 11 and has their period at 14.

 

00;30;05;02 – 00;30;22;21

Dr. Sarah Hart-Unger 

And actually, socially, that second kid might feel more left out than the first kid. So I guess I would just maintain, perspective here. I think that’s the key word. And obviously that’s kind of true with so many things in parenting, right? But like, there’s no there’s no winning the puberty game.

 

00;30;22;26 – 00;30;38;18

Dr. Mona

Right. And I think to your point, a lot of those videos will say, you know, that here’s here’s what I’m doing to, you know, to delay my kids puberty. But in reality, it’s like them saying like they’re avoiding plastics or they’re avoiding, you know, what we talked about, right? Like the maybe lavender. Fine. Yes. To some degree that makes sense.

 

00;30;38;18 – 00;30;53;26

Dr. Mona

But I love that we’re talking about what the evidence does have and what we don’t have. And then a lot of them are trying to sell some sort of course, or some sort of like follow my what I’m doing by commenting e-book. And it’s like a $19 e-book and I’m like, you don’t need an e-book for this information.

 

00;30;53;26 – 00;31;11;27

Dr. Mona

Like here, here’s this episode that we’re going to talk about. You know, one of my final questions for you is like, so what do we do from here? You know, but, you know, the next question I have is you mentioned about obesity, but then you also talked about like fat, right? Like excess fat. Is there a reason why excess fat in particular?

 

00;31;11;27 – 00;31;22;12

Dr. Mona

Because I know it’s not just about BMI because some kids can just be muscular, like we have some certain in the city. But is there a reason why fat can speed this up if maybe someone does understand that physiology?

 

00;31;22;19 – 00;31;58;02

Dr. Sarah Hart-Unger 

Yes, it’s actually a leptin link. Yeah. So it is not actually pounds or BMI that matters here. It is more of a body composition thing, which is actually why a quote normal weight like gymnast there may be normal weight, but they do not have very much body fat is more likely to have delayed puberty because their leptin levels are going to be very low, and leptin acts on the hypothalamus to kind of start the sort of chain reaction that then leads to these pulses of the LH and MSH stimulating the ovaries, the testicles, like I talked about.

 

00;31;58;04 – 00;32;15;19

Dr. Sarah Hart-Unger 

And so when those leptin levels are very high, that can kind of kick the machine into gear early. And when those leptin levels are very low, that can prevent the machine from going into gear at a normal time. So you’re right, it’s not about actual weight. There used to be some crazy myth. It was like when your kid is 100 pounds, they will get.

 

00;32;15;20 – 00;32;35;23

Dr. Sarah Hart-Unger 

Yes, I know that’s not yes. Not a thing. I mean, and also 100 pounds can look very, very different in a very short child or a very tall athletic child, etc. there probably is more truth to the idea that a certain amount of fat mass is necessary in order for most bodies to kickstart into, into true puberty.

 

00;32;36;00 – 00;32;52;10

Dr. Mona

Oh, I love that. Thank you so much for explaining that, because again, we like to get into science here. And, and I love how you talked about the alternative, which was low body fat or low body fat composition and delayed puberty in some gymnasts or other athletes as well, which we could get into a whole other conversation about that.

 

00;32;52;12 – 00;33;14;00

Dr. Mona

This is such a great, great conversation. I know you already talked about some of the treatments, and I think that’s a great you know, we don’t need to go into so much detail on that. In terms of I want to just kind of summarize for everyone listening. So if they see their child, when should they bring up a concern or more so how do they communicate the concerns if their child is more private about things?

 

00;33;14;00 – 00;33;36;11

Dr. Mona

Right. I know at the pediatrician we I do, you know, talk to the family about how I’m just checking boobs and pubes. So like but I don’t say that. But, you know, I’m checking the breast area. I’m checking the, pubic area just to see if there’s any signs of early puberty. But how can a parent kind of approach that if their child is more private to know if they need to bring a child in for anything that’s happening prematurely?

 

00;33;36;16 – 00;33;42;20

Dr. Sarah Hart-Unger 

Yeah. And it’s interesting because I feel like most of the referrals I get for early puberty are after a pediatrician visit.

 

00;33;42;20 – 00;33;43;21

Dr. Mona

That makes sense. This is good.

 

00;33;43;22 – 00;34;00;06

Dr. Sarah Hart-Unger 

Not we’re doing something most parents like uncover on their own. And I think kids when they start seeing changes to their body, unfortunately, that’s tends to be when they become the most private about it. Like, oh, I have a change. And I instinctively like therefore now I’m using my towel and I’m not like running around the house naked.

 

00;34;00;06 – 00;34;19;03

Dr. Sarah Hart-Unger 

I mean, that varies. Some kids are actually not shy at all and they do not like. So this is very individual. But I would say, definitely at the pediatrician visits, make sure it’s checked because every office is different. And I have heard stories where people are not not at your office, doctor. Yeah, like that would never happen with you.

 

00;34;19;03 – 00;34;38;25

Dr. Sarah Hart-Unger 

But like, at other places, sometimes people are not thoroughly examined, and even a 6 or 5 year old should be examined because you know, otherwise you might never see certain things. So make sure they are checked at their doctor visits and then otherwise look for, you know, subtle signs. And girls, I think it’s easier because like, you know, at some point you might see some breast tissue.

 

00;34;38;25 – 00;34;55;17

Dr. Sarah Hart-Unger 

And if you if you’re worried about it, get it, get it looked at, especially if it’s prior to age eight, if a kid is of like a bigger build or carrying a little bit of excess fat tissue, it can actually be very hard to tell. What’s the difference between what we call lipoma ratio, which is just a little extra fatty tissue in that area versus true puberty.

 

00;34;55;17 – 00;35;21;13

Dr. Sarah Hart-Unger 

But you can always have it looked at and then the provider can then like look for other signs and see whether there’s a concern or not. And boys it can be really difficult. But I would say if you are noticing like early acne, significant amount of acne or like body hair or something like that, it’s always a good idea to bring it up because I think it’s not something you’re going to want to excavate on your own at home, to check out their testicular volume.

 

00;35;21;13 – 00;35;38;09

Dr. Sarah Hart-Unger 

But if it were happening early, you would want to know about that. And it’s funny that, like, so much of the panic is about girls, because I think sometimes in boys it can be scarier, number one, because it’s like less likely to be something benign. And number two, and this is very sexist, but, you know, a lot of people worry more about their boys height than their girls height.

 

00;35;38;09 – 00;35;39;15

Dr. Mona

So it’s valid.

 

00;35;39;15 – 00;35;55;07

Dr. Sarah Hart-Unger 

You know, I hear it a lot. So I think if you’re worried then to have them, you know, formally check to see if they’re in puberty early is a good idea. And then if it turns out, you know, it’s just a couple of hairs, then it might not be anything to worry about, but I think the segues nicely into like, what would the workup potentially look like?

 

00;35;55;09 – 00;36;15;11

Dr. Sarah Hart-Unger 

And a lot of, pediatricians would actually start things by maybe ordering a bone age. And what a bone age is, is it’s an X-ray of the child’s left hand. I don’t know why it’s left versus right. It’s just what our standards are based on. That looks to see how mature the bones look. And this is interesting because patients always think it’s.

 

00;36;15;11 – 00;36;35;05

Dr. Sarah Hart-Unger 

How big is the hand like, no it’s no. Yes use are those bones versus how much cartilage is there because it’s actually a marker of whether there have been abnormal levels of circulating puberty type hormones because they will make the bones look older than the kid is. This is not to get someone super panicked if their kid is nine and the bones look ten.

 

00;36;35;05 – 00;37;00;26

Dr. Sarah Hart-Unger 

It’s just based on historical standards, and not every kid’s bones are going to exactly match their age. But that initial screening can make sure it’s not wildly off from their age because if it is, I definitely would recommend seeing an endocrinologist to potentially do further lab workup. Even imaging in some cases. We’ll do a MRI to look at the pituitary, or we’ll look at the pelvis and girls or the testes in boys via ultrasound.

 

00;37;00;29 – 00;37;08;28

Dr. Sarah Hart-Unger 

Yeah. Because, you know, if something is going on enough to advance the bone age significantly, we’d want to figure out what, if anything, that is.

 

00;37;09;01 – 00;37;23;15

Dr. Mona

I love a good bone age. So like you said, like I actually never realized it was always the left hand. And now I’m like, oh my God. And we, you know, pediatrician, general pediatricians, we don’t read bone ages. They’re usually read by someone like an endocrinologist or someone who knows how to read them. But we get the we get the results back.

 

00;37;23;15 – 00;37;52;24

Dr. Mona

And like she said, if it’s showing a, mismatch between what, the chronological ages of the child and what the if the bones are looking a lot older than the child is, then it would prompt warning. And I will be honest, I have picked up a handful of concerns when, you know, I’m looking at, early puberty, which goes back to that point of why I do believe that it’s so important that a pediatrician is checking down there because and you know, the, the, breast area as well as the pubic area because also online there’s also big movement.

 

00;37;52;24 – 00;38;10;20

Dr. Mona

Why is my pediatrician checking my kid’s genitalia? Like, what do they need to check for? And I went on some threads and I was like, here’s why. Like, I’m going to tell you, because if your child is now taking showers on their own and you’re not doing their bath time, I have seen early puberty that you have missed and that’s our job.

 

00;38;10;20 – 00;38;28;03

Dr. Mona

That’s nothing more. And I’m like, there’s always consent there, right? The whole thing about, you know, kids should have consent and all of that. And I’ve had many, some parents sometimes refuse or the child refuse and I document. But it is there’s a benefit versus anything more than that. Right. I mean we are just making sure we it’s a it’s not that long.

 

00;38;28;03 – 00;38;44;04

Dr. Mona

It doesn’t take me long now having done this for ten years, to check the genitalia and check the breast area and move on. And we didn’t talk about that. But we look for Tanner staging, which is kind of the level of puberty. You know, a child is going through, which I think is not needed to kind of dive into in this conversation.

 

00;38;44;04 – 00;38;56;06

Dr. Mona

But it’s important as medical professionals that we can stage your child as to where they are in their pubertal development, which is how we kind of gauge, okay, where are they at in this puberty? Landscape.

 

00;38;56;09 – 00;39;18;09

Dr. Sarah Hart-Unger 

It’s as important as the growth chart. You know, it’s sort of a vital sign in some ways, especially in the older Adrian’s. But even in the I mean, I don’t want to fear monger, but like, every so often it is something concerning underlying whether it’s an adrenal disorder or, you know, very rarely, a tumor that’s producing hormone and it is something that should be checked.

 

00;39;18;09 – 00;39;32;24

Dr. Sarah Hart-Unger 

Now, I definitely agree with making sure there’s consent and the parents should kind of I, as a parent, to be as actively involved. Oh yeah. When the kid is younger, like look with me, you know what I mean? Like, yes. When they’re older, then it’s kind of more up to the parent and the patient. But I want the parent in the room.

 

00;39;32;24 – 00;39;43;12

Dr. Sarah Hart-Unger 

You know, there are all kinds of practices you can have around this, but, as much as, you know, it would of course, be more comfortable for everyone to skip this part, but it’s actually, health wise, really important.

 

00;39;43;17 – 00;40;00;19

Dr. Mona

Yeah. And I have one last question for you. If this is real. So in I think in residency medical school, I can’t remember when we learned this sort of kind of simple way to remember the flow of how things happen in puberty. And I think, you know, it’s boobs, pubes flow. Girl, have you heard of this? Is it something that is.

 

00;40;00;21 – 00;40;04;23

Dr. Sarah Hart-Unger 

Not a good order? Because you definitely don’t grow after you flow. So.

 

00;40;04;25 – 00;40;12;00

Dr. Mona

Oh, no. Grow flow. Sorry, boobs. Pubes grow, flow like you have a nice growth spurt and then you flow. Is that legit? In some ways.

 

00;40;12;02 – 00;40;12;27

Dr. Sarah Hart-Unger 

So in some ways.

 

00;40;12;27 – 00;40;15;27

Dr. Mona

So I mean obviously there’s there’s nuances there. Yes.

 

00;40;15;27 – 00;40;33;06

Dr. Sarah Hart-Unger 

And girls usually you see the breast buds. Yes. Actually I feel like the hair is super variable and also very much dependent on how hairy the family is. Yeah. So like if you have a family that’s just like not hairy, the hair might be like almost like after the period or like really late. Like the hair is the hairs.

 

00;40;33;06 – 00;40;52;12

Dr. Sarah Hart-Unger 

I almost tell them I don’t care as much about the hair like past a certain point. So I’m like, it’s going to be there. It’s not. But yes, definitely. Boobs grow slow and in boys there’s no boobs. Well, yeah, that’s that’s actually not totally true because actually a very high proportion of boys in early to mid puberty get a little bit of breast enlargement that then goes away in later puberty.

 

00;40;52;12 – 00;41;08;01

Dr. Sarah Hart-Unger 

So just a little announcement of that. But in boys they really grow in the mid to late phases of puberty, which I also think is important for people to know because there’s a lot of panic of my kid has two pubic hair is and why aren’t they growth spreading.

 

00;41;08;01 – 00;41;09;00

Dr. Mona

Well, yeah.

 

00;41;09;02 – 00;41;18;06

Dr. Sarah Hart-Unger 

Who’s due in a boy. That spurt comes in Tanner you know, three four and even like into five versus girls. It’s coming like right after the breast bud. After two.

 

00;41;18;07 – 00;41;38;06

Dr. Mona

So it’s like all the junior high girls are like as in the boys. And then all of a sudden in high school, you’re like, oh, flip the script. Like, that’s literally just puberty in mind. I love it. So yeah, we’ll we’ll nix the pubes. But we can say boobs grow flow because it is. And what we mean by grow, you still have some growth obviously after the puberty, but it’s not the same.

 

00;41;38;12 – 00;41;55;22

Dr. Mona

Like there’s a very big growth velocity that happens before getting the period. Yeah. Correct. Very cool. Oh, well, I loved learning from you about my old lingo that I’ve learned. And where can everyone go to stay connected? And I know you have a book coming out that has nothing to do with endocrinology, but tell us more about that and where people can go to stay connected.

 

00;41;55;25 – 00;42;15;14

Dr. Sarah Hart-Unger 

Yes, I know, I have my like two year career is like so like singular. And my like very, very like divergent. But so I mean, you can see me as a patient if you live in South Florida. I’m at Joe DiMaggio Children’s Hospital and practice pediatric endocrinology. And then I also have a website. It’s like an old school website.

 

00;42;15;14 – 00;42;38;26

Dr. Sarah Hart-Unger 

It’s got my name and it’s for the issue, which is my initials, Vox.com. So the shoe box.com, I have a newsletter you can subscribe to there. And then I have the two podcasts, Best Laid Plans and Best of Both Worlds. And I have a book coming out in December, which is about how to plan your life or, the method that I love to teach people to use to plan their lives called Best Laid Plans, a simple system for planning the life that you love.

 

00;42;38;28 – 00;42;43;11

Dr. Sarah Hart-Unger 

Which again, is out in December. Basically wherever you can find books and super excited.

 

00;42;43;14 – 00;42;47;20

Dr. Mona

Always a pleasure. Did you know that Taylor Swift was at Joe DiMaggio? Were you there when she was?

 

00;42;47;26 – 00;42;54;02

Dr. Sarah Hart-Unger 

I was extremely devastated. I was on the top of a mountain in New Hampshire, and my friend texted me and I, like, died.

 

00;42;54;05 – 00;43;13;21

Dr. Mona

So yeah, oh my gosh. Yes, I know this episode might be coming out way, you know, after she was there, but, I, some of my residents met her and got pictures and I’m like, and she just brought so much joy. Anyways, we work we work at that hospital. I mean, there’s no there’s no surprise there because we, I’ve said that before, but yes, I’m very proud of her for going to this hospital.

 

00;43;13;21 – 00;43;33;07

Dr. Mona

She could have. You know, it just seems like Hollywood is not really on the map. Like Joe DiMaggio. Children’s hospital is not like, you know, UCLA how it is now. Because Taylor took her, took herself there. I mean, it was so awesome. But this is such a pleasure. That’s the episode, and I hope it gave you what? TikTok isn’t giving clarity.

 

00;43;33;09 – 00;43;56;22

Dr. Mona

Yes, early puberty is real. And yes, some things can increase the risk. There’s family history, which we can’t always control. There’s obesity, which is often tied to things like stress, low physical activity and diets, heavy and ultra processed foods. And then there’s the bigger picture how we talk to our kids about health, not in terms of fear or body shame, but in terms of feeling strong, supported and informed about their bodies, including menstruation.

 

00;43;56;25 – 00;44;23;03

Dr. Mona

This is actually the foundation of a book I’m writing on how we talk to our kids about their bodies, their sleep, their emotions, and their relationship with food. If this episode resonated and you want to learn more about this book that’s upcoming, make sure you sign up for our newsletter. And also make sure you share this episode with everyone who may find it interesting by sharing it on social and tagging at the PedsDocTalk and don’t forget, like I said earlier, subscribe and download.

 

00;44;23;05 – 00;44;31;01

Dr. Mona

That is what helps the show continue to grow, and it helps more families get the facts and not just fear. Thanks for listening and I’ll catch you all next time.