Navigating the recent articles on girls' puberty in Pediatrics:: What do we know and where do we go from here?

1. Data show that girls are maturing earlier than they did several decades ago and that there are substantial racial differences between white and black girls. 2. These "norms" are not the same as the condition of being "normal" in the sense of indicating optimal health. The association between earlier onset of puberty and being overweight is a clear example of this. 3. Despite the fact that the PROS study population was a convenience sample, there is considerable agreement between its findings and those from the NHANES on girls. 4. Consensus needs to be reached regarding the most accurate methods to assess the onset of puberty, in particular, whether breast palpation and testicular measurement is required. 5. The Centers for Disease Control and Prevention need to reinstitute the collection of pubertal data in their ongoing NHANES activities after a consensus has been reached regarding accurate methodology. The age for collecting pubertal data on boys and girls should be lowered. 6. Studies examining the relationship of obesity, diet, and exposure to environmental chemicals to the age of onset of puberty should continue. 7. Guidelines for which children with signs of early pubertal development should be referred should be modified as new population-based data become available.