The following are two case studies. The names have been changed for privacy's sake.
Ahead of her time
Mrs Wee was amazed that her four-year-old daughter, Melissa, was outgrowing her clothes and shoes so quickly.
Then she noticed the breast development in her child. Their family doctor referred her to Professor Loke Kah Yin at the National University Hospital.
After performing several tests, including X-rays, an ultrasound scan, blood tests and an MRI scan of the brain,
Prof Loke found no underlying medical condition which brought on the signs of puberty. He diagnosed Melissa's case as precocious puberty.
The girl was then given monthly injections to block her puberty. This will go on until she is 10 or 11 years old, which is about the age when puberty usually takes place in girls.
Catching up with big brother
Joshua was only seven years old when he started having pimples on his face and a faint moustache, like his older brother, who was 14.
His parents also noticed his sudden surge in height, the deepening in his voice and the appearance of pubic hair. Alarmed, they took him to a polyclinic where the doctor referred him to Prof Loke.
After a battery of blood tests and X-rays, Joshua was diagnosed with precocious puberty caused by a tumour in the brain.
He had to undergo surgery to remove the tumour. His parents were relieved that the source of his medical condition was discovered and treatment was started early.