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Friday, March 7, 2014
my 9 year old daughter has been complaining about her nipples hurting for the last couple of days, she has not gotten hit there or anything and she does not have breast yet, what could this be?
Hi! The two most likely reasons her nipples are sore are either friction/abrasion from either massaging them or wearing a rough fabric in direct contact with her skin or the beginning of the hormonal surges of puberty. The latter is the most likely based on her age. This is the typical age at which breast buds begin to appear, signaling the arrival of puberty. It is common for there to be some tenderness as estrogen levels rise. Breast buds may also be uneven in size in the early months or even first year of changes. You may also notice a change in her body odor as her eccrine glands in the armpits become active and the appearance of acne on her face.
I know that you will have some level of worry about the possibility of breast cancer. This is extremely rare in girls before the mid-twenties. Breast cancer also typically is not at all painful. Most of us take pain or tenderness as a sign of a problem, and it often is. However, puberty also causes breast tenderness in girls. Even boys may experience a normal enlargement of breast tissue, called gynecomastia. It is also as normal in boys as girls, and both may have breast tenderness.
If you have not discussed the coming changes in her body and the additional hygiene measures she needs to use, now is the time. Many younger boys and girls are allergic to the aluminum hydroxide in antiperspirant deodorants, so it would be safest to start her with a deodorant product. Also, washing her face twice per day will help remove the additional skin oils produced with the onset of puberty and help keep pesky pimples away. Mild acne preventive face washes, such as Neutrogena products, are better than harsh ones such as many of the alcohol laden face wipes that are so popular with teens.
You may also want to look in the parenting section of the bookstore for books on the changes of puberty for girls, common questions and answers, and self-care tips. It takes a little time to sort through the many offerings and find one or two you feel represent your values and perspectives, so allow yourself enough time for perusing. Talk about the things she is finding interesting and helpful in the book. Don't just ask yes or no questions.
Research consistently shows that both boys and girls would rather learn about their changing bodies, self-care tips, and perspectives on their new feelings from their parents, not teachers or clergy. You definitely don't want her peers to be her source of information. They are frequently poorly informed and just as puzzled as she will be without your help.
Just as the hormone surges of puberty will change your daughter's body, they will also change her behavior. You may want to select some books for yourself with helpful tips on parenting the pubertal and adolescent child. It is a challenge to allow just the right amount of increasing freedom but not too much. Self-respecting pubertal children will never tell their parents they actually love the limits you maintain on their whereabouts and curfew. You can be the "mean parent" she blames for the limits she is relieved to have.
I honestly do not believe a health care appointment is necessary unless redness of her skin appears around her nipples or she develops a fever. Spend the money instead on good books for you both and congratulations on this new phase in your life as a parent and hers as a soon-to-be teen!
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University