last years lockdown proved to be a life changing experience for sevenyearold shanvi and her parents who live in delhi the little girl started undergoing bodily changes associated with puberty like breast enlargement and sprouting of body hair alarmed shanvis mother consulted a specialist who got a battery of tests and an mri done the diagnosis was precocious puberty in india a healthy puberty starts between 11 and 12 for girls but if puberty hits before the age of 8 in girls and 9 in boys its called precocious pubertypaediatricians are reporting an increase in the number of cases of precocious puberty pp in the past year or so some of them feel this could be an effect of the lockdown which saw kids holed up in their homes for months lonely gaining weight and eating unhealthy food dr vaishakhi rustagi paediatric endocrinologist in delhi said that between june 2020 and feb 2021 she saw 67 cases of pp before covid i would see about 25 cases of pp in a year i think its the stress of the pandemic that is causing this rise stress causes hormonal imbalance said rustagi who consults at max hospital shalimar bagh and patparganj delhimy daughter is so small she was confused and disturbed by these changes she kept asking me why she had body hair when none of her friends did said barkha verma mother of shanvi barkha took her to a doctor at the right time before shanvi started menstruating now she is on medicines that have suppressed her hormones till the time she is older and more mature to handle puberty but the changes that happened will remainglobally pp is estimated to affect 1 in 500 girls and 1 in 2000 boys in girls pp is typically idiopathic no apparent cause while in boys pp is often due to the presence of adrenal or pituitary tumours prevalence of pp is 10 times higher in girls than in boys all the cases that rustagi saw since last year were idiopathicat narayana health city in bengaluru dr pavithra nagaraj said she got 12 cases of pp between april last year and now higher than the five odd cases she got from 20182020 weight gain is definitely a contributing factor as is hypothyroidism said nagaraj a consultant paediatric endocrinologistglobally too doctors are reporting this trend in a study recently published in the italian journal of paediatrics researchers found that in a tertiary hospital in italy in 2020 246 patients were referred for suspected precocious puberty compared with 118 consultations recorded in 2019while the age of puberty has been gradually dropping in india in the past 20 years dr tusshar parikh feels that covid seems to have lowered it even further pp is seen more in children who are overweight and physically inactive said dr parikh paediatrician motherhood hospital kharadi punepsychological impacts of pp like eating disorders antisocial behaviour and substance abuse are well documented but a greater concern for parents and children is height