Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Early Puberty Question: My 6 year old has hair starting to grow on her vagina on the lips. Is this where pubic hair starts to grow first during puberty or is this something else, my daughter also has little breasts which I thought was just baby fat until I say the hair on her vaginal lips. Is my daughter starting puberty? Tara Answer: Dear Shelley, It's not unusual these days to see puberty starting early, however, age 6 years is considered to be premature. Your description of physical signs of puberty are on target for the beginning of puberty. Genetics plays a very important part in the age and rate at which children will develop both mentally and physically. Environment is important also. Overweight children tend to mature earlier, as well as children who are on certain medications. These are just a few causes for premature puberty. Whatever the cause, it would be appropriate to discuss this with your daughter's pediatrician. He or she may feel that it needs to be followed up more closely, possibly consulting a specialist in this field (endocrinologist). There are a certain percentage of children who do go into puberty at an early age, without a specific cause. There are also a percentage of children that are found to have an underlying cause leading to premature puberty i.e.: abnormal hormone levels resulting from different causes. (This is why it is important that you discuss this with your child's pediatrician) Make a list of questions that you have and keep a diary. List the symptoms that would be helpful i.e.: deodorant use, acne and other physical changes related to puberty. Discuss these with the pediatrician. Dr. Betti Also see: Plantar's warts Is it safe for an 11-year-old to use tampons? Ask Dr. Betti your questions Recently asked questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.