Medicine: Maturing Early

A puzzle in Puerto Rico

The symptom is alarming to the parents and bewildering to the affected children: breast development in girls six months to seven years old, and sometimes in young boys. Ordinarily, premature thelarche, as doctors call the condition, is a rare disorder, occurring in less than one out of 1,000 children. But in recent years doctors in Puerto Rico have reported more than 700 cases, mostly in children under two. Some slightly older patients display a fuller range of adult sexual traits, including menstruation at age seven. "When you see four...

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