Stages of puberty: what happens to boys and girls

Puberty is when a child’s body begins to develop and change as they become an adult. Girls develop breasts and start their periods, and boys develop a deeper voice and start to look like men.

The average age for girls to begin puberty is 11, while for boys the average age is 12. But there’s no set timetable, so don’t worry if your child reaches puberty before or after their friends. It’s completely normal for puberty to begin at any point from the ages of 8 to 14. The process takes about four years overall.

Late or early puberty

Children who begin puberty either very early (before the age of 8) or very late (after 14) should see a doctor to rule out an underlying medical condition.

Read more about puberty problems.

This page covers:

• Signs of puberty in girls
• Signs of puberty in boys
• Mood changes during puberty
• Puberty support for children
• Puberty support for parents and carers

First signs of puberty in girls

• The first sign of puberty in girls is usually that their breasts begin to develop. It’s normal for breast buds to sometimes be very tender or for one breast to start to develop several months before the other one
• Pubic hair also starts to grow and some girls may notice more hair on their legs and arms.

Later signs of puberty in girls

After a year or so of puberty beginning, and for the next couple of years:

• Girls' breasts continue to grow and become fuller.
• Around two years after beginning puberty, girls usually have their first period. Read more about starting periods.
• Pubic hair becomes coarser and curlier.
• Underarm hair begins to grow. Some girls also have hair in other parts of their body, such as their top lip. This is completely normal.
• Girls start to sweat more.
• Girls often get acne – a skin condition that shows up as different types of spots including whiteheads, blackheads and pus-filled spots called pustules.
• Girls have a white vaginal discharge.
• Girls go through a growth spurt. From the time their periods start, girls grow 5-7.5 cm (2-3 inches) annually over the next year or two, then reach their adult height.
• Most girls gain weight – and it’s normal for this to happen – as their body shape changes. Girls develop more body fat along their upper arms, thighs and upper back; their hips grow rounder and their waist gets narrower.

After about four years of puberty in girls

• Breasts becomes adult-like.
• Pubic hair has spread to the inner thigh.
• Genitals should now be fully developed.
• Girls stop growing taller.

First signs of puberty in boys

• The first sign of puberty in boys is usually that their testicles get bigger and the scrotum begins to thin and redden.
• Pubic hair also starts to appear at the base of the penis.

Later signs of puberty in boys

After a year or so of puberty starting, and for the next couple of years:

• The penis and testicles grow and the scrotum gradually becomes darker. Read more about penis health.
• Pubic hair becomes thicker and curlier.
• Underarm hair starts to grow.
• Boys start to sweat more.
• Breasts can swell slightly temporarily – this is normal and is not the same as "man-boobs".
• Boys may have "wet dreams" (involuntary ejaculations of semen as they sleep).
• Their voice "breaks" and gets permanently deeper. For a while, a boy might find his voice goes very deep one minute and very high the next.
• Boys often develop acne – a skin condition that shows up as different types of spots, including whiteheads, blackheads and pus-filled spots called pustules.
• Boys go through a growth spurt and become taller by an average of 7-8cms, or around 3 inches a year, and more muscular.

After about four years of puberty in boys

• Genitals look like an adult’s and pubic hair has spread to the inner thighs.
• Facial hair begins to grow and boys may start shaving.
• Boys get taller at a slower rate and stop growing completely at around 16 years of age (but may continue to get more muscular).
• Most boys will have reached full adult maturity by 18 years of age.

Mood changes in puberty

Puberty can be a difficult time for children. They're coping with changes in their body, and possibly acne or body odour as well, at a time when they feel self-conscious.

Puberty can also be an exciting time, as children develop new emotions and feelings. But the "emotional rollercoaster" they’re on can have psychological and emotional effects, such as:

• unexplained mood swings
• low self-esteem
• aggression
• depression

For more information on what to expect and how to handle puberty-related mood changes, read our articles on teen aggression, coping with your teenager and talking to your teen.

Puberty support for children

If children are worried or confused about any part of puberty, it may help them to talk to a close friend or relative.

• ChildLine’s website answers boys' common questions about puberty and girls' common questions about puberty. It also offers free and confidential advice on its telephone helpline, which can be reached on 0800 1111. Children can also look at its puberty message board for girls and puberty message board for boys to see what other young people are asking about.
• 4You is a leaflet for boys and girls that explains body changes at puberty, sex and how babies are made, in a down-to-earth way.
• "Periods - what you need to know" is an FPA (formerly the Family Planning Association) leaflet that is helpful for older girls who are just about to or have just started their periods.
• Contact a Family’s booklet "Growing up, sex and relationships" is for disabled children.

Puberty support for parents and carers

• "Surviving Adolescence – a toolkit for parents" is a leaflet that gives parents and carers clear information on what to expect when children hit adolescence, including why they’re likely to become sulky, suddenly start dieting, have crushes on friends, and crave excitement.
• The FPA (formerly the Family Planning Association) has a range of online leaflets that give advice on talking to your children about growing up, sex and relationships.

The recipe for strong bones for life

Bone health is a bit like saving for your pension: hard to get excited about when you're young but the sooner you start, the better.

Taking care of your bones is a lifelong investment that will pay dividends by helping you to stay fit and independent later in life.

Like pensions, it's never too late to start. There's plenty you can do to keep your bones fit for purpose, whatever your age.

Let's be clear: bone health isn't just about bones. "It's about your quality of life as you get older," says Ruthe Isden of charity Age UK.

"Bone health is about staying fit and well as we get older so we can continue to do the things we enjoy," she says.

As we live longer, more and more of us will become vulnerable to weak bones (osteoporosis) and breaking bones from falls.

Life-changing fracture

About one in three people over 65, and half of people over 80, fall each year in the UK. One in two women, and one in five men over 50, will break a bone, typically in the wrist, hip and spine, as a result of osteoporosis.

A fall later in life can be life-changing, leading to distress, pain, injury, loss of confidence, loss of independence and even death.

Half of older people never regain their former level of function after a hip fracture and one in five dies within three months.

According to a blog by Professor Kevin Fenton, Public Health England's national director for health and wellbeing, "Falls are the number one precipitating factor for a person losing independence and going into long-term care,".

What you can do

But it doesn't have to be this way, says leading bone and joint expert Professor Anthony Woolf, a rheumatologist at the Royal Cornwall Hospitals NHS Trust. "Osteoporosis and falls are not an inevitable part of ageing and much can be done to prevent them," he says.

Preventing osteoporosis starts in childhood, if not earlier, when our bones are growing, and continues throughout life. "Building healthy bones actually starts in the womb where the baby's skeleton is developing," says Professor Woolf. "A real life course approach is needed to help people have bones fit for purpose as they age."

The recipe for lifelong strong bones includes:

• a healthy balanced diet that includes calcium
• vitamin D, from sunlight, food and supplements
• regular exercise
• avoiding smoking, too much alcohol and other risk factors

The same lifestyle advice applies to people with the menopause, osteoporosis or who are at risk of fracture as it will help reduce the rate of bone loss and their risk of falling.

Get diet advice and exercise tips to help people of all ages build and maintain strong bones.

Bone-building years

The key bone-building years are those up to our mid-20s, when the skeleton is growing. For example, the bone accumulated in girls aged 11 to 13 is about the same amount lost during the 30 years following the menopause. Research has shown that gymnasts aged 10 have much stronger bones than inactive youngsters of the same age.

The gains achieved during youth put the skeleton in a better position to withstand the bone loss that occurs with age. Get tips on boosting your child's bone health. After about 35, bone loss gradually increases as part of the natural ageing process.

Work out if you're at risk of developing osteoporosis and breaking a bone in the next 10 years.

Get tips on maintaining strong bones as you get older.

Read how Judi Paxton beat osteoporosis by making some simple changes to her lifestyle.

Preventing falls

People with osteoporosis have weak bones, but it's falls that break bones. Work out if you're at risk of falling.

While it is impossible to prevent all falls, there are lifestyle and practical measures that can reduce their occurrence.

The most effective measures to prevent falls among people considered at risk involve:

• strength and balance exercises
• checking the home for trip and other hazards
• checking eyesight
• reviewing medication, which may affect balance

For more fall prevention tips download Get Up and Go: A Guide to Staying Steady (PDF, 2.6Mb).

"Physical activity and exercise can turn back the clock on some of the losses in bone strength caused by age and disease," says Professor Woolf.

Research suggests that a programme of strength and balance exercises tailored to the individual can reduce the risk of falls by 35% to 54% (PDF, 309kb).

Age UK says that fall prevention exercises could prevent 7,000 unnecessary deaths a year – 19 a day – from hip fractures.

Spotting signs of child sexual abuse

One in 20 children in the UK will experience child sexual abuse. Here are the signs to be aware of and what to do if you suspect a child is being sexually abused.

What is child sexual abuse?

What are the signs that a child is being abused?

How do I report child sexual abuse?

Who commits child sexual abuse?

Which children are at risk of child sexual abuse?

What are the effects of child sexual abuse?

What is child sexual abuse?

Child sexual abuse is illegal in the UK and covers a range of sexual activities, including:

• possessing images of child pornography
• forcing a child to strip or masturbate
• engaging in any kind of sexual activity in front of a child, including watching pornography
• taking, downloading, viewing or distributing sexual images of children
• encouraging a child to perform sexual acts in front of a webcam
• not taking measures to protect a child from witnessing sexual activity or images
• inappropriate sexual touching of a child, whether clothed or unclothed
• penetrative sex

Both boys and girls can be victims of sexual abuse, but girls are six times more likely to be abused.

What are the signs that a child is being sexually abused?

Children often don't talk about sexual abuse because they think it is their fault or they have been convinced by their abuser that it is normal or a "special secret".

Children may also be bribed or threatened by their abuser, or told they won't be believed.

A child who is being sexually abused may care for their abuser and worry about getting them into trouble.

Here are some of the signs you may notice:

Changes in behaviour – a child may start being aggressive, withdrawn, clingy, have difficulties sleeping or start wetting the bed.

Avoiding the abuser – the child may dislike or seem afraid of a particular person and try to avoid spending time alone with them.

Sexually inappropriate behaviour – children who have been abused may behave in sexually inappropriate ways or use sexually explicit language.

Physical problems – the child may develop health problems, including soreness in the genital and anal areas or sexually transmitted infections, or they may become pregnant.

Problems at school – an abused child may have difficulty concentrating and learning, and their grades may start to drop.

Giving clues – children may also drop hints and clues that the abuse is happening without revealing it outright.

How do I report child sexual abuse?

It's best not to delay if you suspect a child is being sexually abused.

You can talk directly to the police or your local children's social services and this can be anonymous. You can also get advice or report your concerns anonymously to the NSPCC by phoning their free helpline on 0808 800 5000. Or you can report sexual abuse to the NSPCC via email or online.

If you are a health professional and suspect a child you are caring for is experiencing abuse or is at risk of abuse, you can seek advice from the "named nurse" or "named doctor" in your hospital or care setting.

The NSPCC has more information and advice about child sexual abuse.

If you are concerned about your own thoughts or behaviour towards children, you can phone Stop It Now! in confidence on 0808 1000 900 or email help@stopitnow.org.uk.

If you are a child and someone is sexually abusing you, you can get help and advice from ChildLine – phone 0800 1111, calls are free and confidential.

Who commits child sexual abuse?

Child sexual exploitation

Raising low self-esteem

We all have times when we lack confidence and don't feel good about ourselves.

But when low self-esteem becomes a long-term problem, it can have a harmful effect on our mental health and our lives.

What is self-esteem?

Self-esteem is the opinion we have of ourselves.

When we have healthy self-esteem, we tend to feel positive about ourselves and about life in general. It makes us able to deal with life's ups and downs better.

When our self-esteem is low, we tend to see ourselves and our life in a more negative and critical light. We also feel less able to take on the challenges life throws at us.

What causes low self-esteem?

Low self-esteem often begins in childhood. Teachers, friends, siblings, parents, and even the media send us messages about ourselves, both positive and negative. For some reason, the message that you are not good enough is the one that stays with you.

Perhaps you found it difficult to live up to other people's expectations of you, or to your own expectations.

Stress and difficult life events, such as serious illness or a bereavement, can have a negative effect on self-esteem.

Personality can also play a part. Some people are just more prone to negative thinking, while others set impossibly high standards for themselves.

How does low self-esteem affect us?

If you have low self-esteem or confidence, you may hide yourself away from social situations, stop trying new things and avoid things you find challenging.

"In the short term, avoiding challenging and difficult situations makes you feel a lot safer," says Chris Williams, Professor of Psychosocial Psychiatry at the University of Glasgow.

"In the longer term, this can backfire because it reinforces your underlying doubts and fears. It teaches you the unhelpful rule that the only way to cope is by avoiding things."

Living with low self-esteem can harm your mental health, leading to problems like depression and anxiety.

You may also develop unhelpful habits, such as smoking and drinking too much, as a way of coping.

How to have healthy self-esteem

To boost your self-esteem, you need to identify the negative beliefs you have about yourself, then challenge them.

You may tell yourself you are "too stupid" to apply for a new job, for example, or that "nobody cares" about you.

Start to note these negative thoughts and write them down on a piece of paper or in a diary. Ask yourself when you first started to think these thoughts.

Next, start to write down evidence that challenges these negative beliefs: "I am really good at cryptic crosswords" or "My sister calls for a chat every week".

Write down other positive things about yourself, such as "I am thoughtful" or "I am a great cook" or "I am someone that others trust".

Also write down good things that other people say about you.

Aim to have at least five things on your list and add to it regularly. Then put your list somewhere you can see it. That way, you can keep reminding yourself that you are OK.

"You might have low confidence now because of what happened when you were growing up," says Professor Williams. "But we can grow and develop new ways of seeing ourselves at any age."

Other ways to improve low self-esteem

Here are some other simple techniques that may help you feel better about yourself.

Recognise what you are good at

We are all good at something, whether it's cooking, singing, doing puzzles or being a friend. We also tend to enjoy doing the things we are good at, which can help to boost your mood.

Build positive relationships

If you find certain people tend to bring you down, try to spend less time with them, or tell them how you feel about their words or actions.

Seek out relationships with people who are positive and who appreciate you.

Be kind to yourself

Professor Williams advises: "Be compassionate to yourself. That means being gentle to yourself at times when you feel like being self-critical.

"Think what you'd say to a friend in a similar situation. We often give far better advice to others than we do to ourselves."

Learn to be assertive

Being assertive is about respecting other people's opinions and needs, and expecting the same from them.

One trick is to look at other people who act assertively and copy what they do. "It's not about pretending you're someone you're not," says Professor Williams. "It's picking up hints and tips from people you admire and letting the real you come out."

Start saying 'no'

People with low self-esteem often feel they have to say yes to other people, even when they don't really want to. The risk is that you become overburdened, resentful, angry and depressed.

"For the most part, saying no doesn't upset relationships," says Professor Williams. "It can be helpful to keep saying no in different ways until they get the message."

Give yourself a challenge

We all feel nervous or afraid to do things at times. But people with healthy self-esteem don't let these feelings stop them from trying new things or taking on challenges.

Set yourself a goal, such as joining an exercise class or going to a social occasion. Achieving your goals will help to increase your self-esteem.

Where to find help for low self-esteem

Help is available if you feel you need support to start seeing yourself in a more positive light.

• Talking therapies, such as counselling or cognitive behavioural therapy (CBT), can help. Your GP can explain the different types and tell you what's available in your area. Read more about the different types of therapy.
• You can refer yourself for talking therapies in some areas. Check whether you can refer yourself to your local psychological therapies (IAPT) service.
• You can also pay privately for talking therapies – find the right therapist for you.
• Hear Dr Williams' podcast about tackling unhelpful thinking.
• Visit healthtalk.org to hear young people talking about their experiences of low self-esteem.

How to involve your child in being healthy

Children are more likely to keep to a healthy lifestyle if it's made fun for them. Here are some ideas for how to help them prepare, and even cook, their own meals and choose activities they enjoy.

Recommended physical activity levels

• Children aged under 5 should do 3 hours every day
• Older children (5-18) should do 1 hour every day

As a general rule, children should aim to include in their daily diet:

• at least five portions of a variety of fruit and vegetables (5 A DAY)
• meals based on starchy foods, such as potatoes, bread, pasta and rice – choose wholegrain varieties when possible
• some milk and dairy products – choose low-fat options where you can
• some foods that are good sources of protein, such as meat, fish, eggs, and beans and lentils

Educate your children about food

Whether your child is in reception or year 6, it's always a good time to teach them how to take care of their bodies.

• Take your child food shopping with you and help them prepare a meal by themselves.
• Get your children used to cooking healthy food by letting them help with these Change4Life healthy recipes.
• Explain to your child how to get the balance of their diet right using the eatwell plate. It shows how much you should eat from each food group.
• Show your child how to read food labels – for example, to check the sugar and fat in snacks. Even small children can understand the traffic light coding on some food packs.
• Cooking tips on Change4Life can be used by children to learn simple techniques.
• Young children (aged five to six) can make their own cookbook, choosing their favourite healthy recipes, getting tips on being a top chef, and even making a shopping list.

Make physical activity fun for children

Physical activity is an important part of achieving a healthy weight. It's recommended children have at least 60 minutes of physical activity a day.

For more on how much activity children should do and what counts as activity:

• if your child is under five, read physical activity guidelines for children
• if your child is aged 5 to 18, read physical activity guidelines for children and young people

If your child isn't used to being active, encourage them to start with what they can do and build up to 60 minutes a day.

They're more likely to stick to their new activity levels if you let them choose the type of activity they're comfortable with.

• Older children might like to use their smartphone to increase their activity levels. There are lots of great fitness apps. Map My Walk is a free app that counts your steps when going for a walk (or jog) and counts the calories used, too. Or they could use a pedometer or step counter to keep track of how many steps they're taking.
• Look for little ways to get your child moving throughout the day, such as playing hide-and-seek and tag (for younger children), and walking or scootering to school.
• Be sensitive to your child's needs. If they feel uncomfortable participating in sports, help them find an activity they will enjoy without feeling embarrassed, such as dancing, skipping or cycling. Some will prefer to take part in a team activity rather than solo pursuits.

How school can help keep your child healthy

The school your child attends should provide opportunities for physical activity and healthy food at lunchtime.

Some schools will help ensure your child does not bring unhealthy foods to school by working with parents to set guidelines on healthy packed lunches.

Schools also often offer a range of after-school activity clubs in football, netball, dancing, martial arts, gymnastics and so on. These are a great way for your child to boost their activity levels.

• Check with your child's school exactly how much time they spend on physical activity each day so you have an idea of the shortfall (if any) they need to make up on school days.
• Read about dancing for fitness and find out more about cycling for beginners.
• Join Change4Life for free and your child will get their own personalised activity plan full of good ideas for getting moving.

Get healthy as a family

Any changes to your child's diet and lifestyle are much more likely to be accepted if they involve the whole family.

Use these 10 tips to help the whole family embrace a healthier lifestyle:

1. Eat at the table together – studies show families who have regular meals at the table with no distractions (such as television) are more likely to be a healthy weight.

2. Include children in family activities – such as walking the dog, washing the car, mowing the lawn, or a family bike ride. They won't see it as exercise, just fun. Get more ideas for free family activities.

3. Ban "sweetened" drinks from the home – persuade your children to drink water instead. Fizzy drinks, fruit drinks, sports drinks, milky drinks with added sugar, and even 100% fruit juice are high in calories. Children tend to drink fewer sweet drinks when they're not freely available in the home. Find out more about healthy drinks for children.

4. Make sure the whole family eats breakfast every day – children who eat breakfast are less likely to overeat later in the day. If time is an issue, choose speedy yet healthy items such as peanut butter on wholemeal toast, or porridge and fruit. For inspiration, here are five healthy breakfasts.

5. Decrease screen time – and put physical activity in its place. Drag the kids away from the TV, computer and games console, and instead get active as a family by walking, cycling, going to the park or playground, or swimming together. Here are 10 ways to get active with your children.

6. Get active on holiday – it's the perfect opportunity to get fit and have fun. You could try a specific activity-focused break, such as cycling or hiking, or choose a destination where you can do a variety of activities.

Children generally love camping holidays. There's lots of scope for activity for children of all ages, from putting up the tent to nature hikes. Read more about family activity holidays. Use the Change4Life activity planner to get children active during school holidays at home.

7. Prepare more meals at home – it takes a little longer, but this way you can control what you put in food. You can read food labels, use healthier ingredients, and control how much sugar and salt you use. Here are some tasty, quick and healthy recipes ideal for midweek evening meals.

8. Have healthier takeaways – you don't have to give up takeaways completely, just make smarter choices. For instance, have mushy peas with your fish and chips and don't eat all the batter around the fish. Order lower-fat pizza toppings like vegetables, ham and prawns instead of salami and four-cheese. And with Indian takeaways, go for tomato-based sauces such as madras instead of cream-based kormas and masalas. Read more about healthier takeaways.

9. Avoid over-sized portions – portion sizes have increased over the years and it's one of the reasons children become overweight. Start meals with small servings and let your child ask for more if they're still hungry. Avoid giving adult-sized plates to younger children – it can encourage them to eat too much.

10. Walk for charity – doing regular charity walks is a great way for the whole family to get fit. Events are held across the country and are aimed at all ages, levels and abilities. Google "charity walks" to find local events.

What can I do if my child is very overweight?

If your child is very overweight, there's lots you can do to help them become a healthy weight as they grow.

Weight checks

Every so often, check whether your child is moving into a healthy weight range with our Healthy weight calculator.

Very overweight children tend to grow up to be very overweight adults, which can lead to health problems such as type 2 diabetes, heart disease and certain cancers.

Research shows children who achieve a healthy weight tend to be fitter, healthier, better able to learn, and are more self-confident. They're also less likely to have low self-esteem and be bullied.

As a parent, there's lots you can do to help your child become a healthier weight. Getting them to be more active and eat well is important. Here's practical advice to help you.

Listen to your child's concern about their weight. Overweight children often know they have a weight problem, and they need to feel supported and in control of their weight.

Let them know that you love them, whatever their weight, and that all you want is for them to be healthy and happy.

Steps for success

Medical help

If your child is very overweight, or if they have other health conditions, it’s a good idea to ask for support. See suggested support networks at the bottom of the page.

Here are five key ways to help your child achieve a healthy weight. You can read this whole page or click on the links below to go directly to the topic you want to know about:

• Be a good role model
• Encourage 60 minutes of physical activity a day
• Keep to child-size portions
• Eat healthy meals, drinks and snacks
• Less screen time and more sleep!

If your child has a medical condition, the advice in this article may not be relevant. You should check with their GP or hospital doctor first.

Be a good role model

One of the best ways to instil good habits in your child is to be a good role model. Children learn by example. One of the most powerful ways to enourage your child to be active and eat well is to do so yourself.

Set a good example by going for a walk or bike ride instead of watching TV or surfing the internet. Playing in the park or swimming with your children shows them being active is fun.

• Any changes you make to your child's diet and lifestyle are much more likely to be accepted if the changes are small and involve the whole family. Here are 10 ways to get healthy as a family.
• If you're not sure what activities you'd like to try as a family, try this Which sport are you made for? tool to find out what you're best suited to.

Get active

Very overweight children don't need to do more exercise than slimmer children. Their extra body weight means they will naturally burn more calories for the same activity.

All children need about 60 minutes of physical activity a day for good health, but it doesn't need to be all at once. Several short 10-minute or even five-minute bursts of activity throughout the day can be just as good as an hour-long stretch.

For younger children it can take the form of active play, such as ball games, chasing games like "it" and "tag", riding a scooter, and using playground swings, climbing frames and see-saws.

For older children it could include riding a bike, skateboarding, walking to school, skipping, swimming, dancing and martial arts.

If your child isn't used to being active, encourage them to start with what they can do and build up to 60 minutes a day. They're more likely to stick to their new activity levels if you let them choose the type of activity they're comfortable with.

Walking or cycling short distances instead of using the car or bus is a great way to be active together as a family – and you'll save money, too.

• Find out the amount and type of physical activity recommended for under-5s.
• Find out the amount and type of physical activity recommended for children and young people aged 5 to 18.
• Join Change4Life for free and your child will get their own personalised activity plan full of good ideas for getting moving.

Child-size portions

Try to avoid feeding your child large portions. A good rule of thumb is to start meals with small servings and let your child ask for more if they're still hungry.

Try not to make your child finish everything on the plate or eat more than they want to. And avoid using adult-size plates for younger children as it encourages them to eat oversized portions.

Beware of high-calorie foods. Calories are a measure of the energy in food – knowing how many calories your child consumes each day, and balancing that with the amount of energy they use up in activity, will help them reach and stay at a healthy weight.

• This article helps you and your child understand calories.
• Keep track of your child's daily calorie intake with MyFitnessPal's free online calorie counter (also available as an app).
• Find out how many calories children aged 7 to 10 need and how many calories teenagers need.
• Explain to your child how to get the balance of their diet right using the eatwell guide – it shows how much they should eat from each food group.
• Read more about what counts as a balanced diet.
• Get ideas for healthy packed lunches.

Eat healthy meals

Children, just like adults, should aim to eat five or more portions of fruit and vegetables everyday. They're a great source of fibre and vitamins and minerals.

Getting 5 A DAY shouldn't be too difficult. Almost all fruit and vegetables count towards your child's 5 A DAY, including fresh, tinned, frozen and dried.

Juices, smoothies, beans and pulses also count.

Be aware though that unsweetened 100% fruit juice, vegetable juice and smoothies can only ever count as a maximum of one portion of their 5 A DAY.

For example, if they have two glasses of fruit juice and a smoothie in one day, that still only counts as one portion.

Their combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day – which is a small glass.

For example, if they have 150ml of orange juice and 150ml smoothie in one day, they’ll have exceeded the recommendation by 150ml.

When fruit is blended or juiced, it releases the sugars which increases the risk of tooth decay so it’s best to drink fruit juice or smoothies at mealtimes.

Discourage your child from having sugary or high-fat foods like sweets, cakes, biscuits, some sugary cereals, and sugar-sweetened soft and fizzy drinks. These foods and drinks tend to be high in calories and low in nutrients.

Aim for your child to get most of their calories from healthier foods such as fruit and vegetables, and starchy foods like bread, potatoes, pasta and rice (preferably wholemeal). And switch sweetened drinks for water.

• Fussy eater? Not a problem with these tips to help your kids enjoy their 5 A DAY.
• Tasty 5 A DAY family-friendly recipes.
• Find out more about healthy drinks for children.
• Swap high-fat foods for these healthier alternatives.
• Try these sugar swaps – healthier swaps for breakfast, snacks and puddings.
• Ideas for sugar swaps when you shop.

Less screen time and more sleep!

Help your children avoid sitting and lying around too much, as it makes it more likely for them to put on weight. Limit the amount of time your child spends on inactive pastimes such as watching television, playing video games and playing on electronic devices.

There's no hard and fast advice on how much is too much, but experts advise children should watch no more than two hours of television each day – and remove all screens (including mobile phones) from their bedroom at night.

It also helps children stay trim if they sleep well. It's been shown that children who don't have the recommended amount of sleep are more likely to be overweight. The less children sleep, the greater the risk of them becoming obese. Lack of sleep can also affect their mood and behaviour.

• Find out how much sleep children need according to their age.
• How screens impair children's sleep.
• Sleep tips for children.
• Hidden causes of weight gain.

Getting support

If you've received a letter about your child's weight after they were measured at school, you can use the contact number on the letter to speak to a health worker and get more information about what you can do and what support is available in your area.

Your GP or practice nurse can give you further advice. They also may be able to refer you to a local weight management programme for children, such as those run by MEND and More Life.

These programmes are often free to attend through your local health authority, and typically involve a series of weekly group workshop sessions with other parents and their children. You'll learn more about the diet and lifestyle changes that can help your child achieve a healthy weight.

What can I do if my child is overweight?

If your child is overweight, there's lots you can do to help them become a healthy weight as they grow.

No diets!

Don’t be tempted to put your child on a weight-loss diet. Forcing an overweight child to go hungry can backfire, making them crave food even more.

Your child's still growing, so try to maintain their weight while they continue to grow in height. This way they will grow taller without necessarily adding pounds, and their weight could move into a healthier range.

As a parent, it can sometimes be difficult to tell that your child is overweight. A child may not look particularly heavy to be overweight. And because more children are becoming heavier at a younger age, we've become used to seeing bigger children.

Research shows children who achieve a healthy weight tend to be fitter, healthier, better able to learn, and more self-confident. They're also less likely to have low self-esteem or be bullied. And they're much less likely to have health problems in later life.

As a parent, there's lots you can do to help your child become a healthier weight. Getting them to be more active and eat well is important. Here's lots of practical advice to help you.

If your child has a medical condition, the advice in this article may not be relevant and you should check first with their GP or hospital doctor.

Steps for success

Weight checks

Every so often, check whether your child is moving into a healthy weight range with our Healthy weight calculator.

Here are five key ways you can help your child maintain a healthy weight. You can read this whole page or click on the links below to go directly to the topic you want to know about:

• Be a good role model
• Encourage 60 minutes of physical activity a day
• Keep to child-size portions
• Eat healthy meals, drinks and snacks
• Less screen time and more sleep!

Be a good role model

One of the best ways to instil good habits in your child is for you to be a good role model. Children learn by example. One of the most powerful ways to encourage your child to be active and eat well is to do so yourself.

Set a good example by going for a walk or bike ride instead of watching TV or surfing the internet. Playing in the park or swimming with your children shows them being active is fun, and it's a great way for you all to spend time together.

• Any changes you make to your child's diet and lifestyle are much more likely to be accepted if the changes are small and involve the whole family. Here are 10 ways to get healthy as a family.
• If you're not sure what activities you'd like to try as a family, use this What's your sport? tool to find out what you're best suited to.
• Physical activity may be more appealing for your child if you do something as a family. Here are 10 ways to get active with your kids.
• Get ideas for getting children involved in switching to a healthier lifestyle.

Get active

Overweight children don't need to do more exercise than slimmer children. Their extra body weight means they will naturally burn more calories for the same activity.

All children need about 60 minutes of physical activity a day for good health, but it doesn't need to be all at once. Several short 10-minute or even five-minute bursts of activity throughout the day can be just as good as an hour-long stretch.

For younger children, it can take the form of active play, such as ball games, chasing games like "it" and "tag", riding a scooter, and using playground swings, climbing frames and see-saws.

For older children it could include riding a bike, skateboarding, walking to school, skipping, swimming, dancing and martial arts.

Walking or cycling short distances instead of using the car or bus is a great way to be active together as a family – and you'll save money, too.

• Find out the amount and type of physical activity recommended for under-5s.
• Find out the amount and type of physical activity recommended for children and young people aged 5 to 18.
• Join Change4Life for free and your child will get their own personalised activity plan full of good ideas for getting moving.

Child-size portions

Try to avoid feeding your child oversized portions. There's very little official guidance on precisely how much food children require, so you'll need to use your own judgement.

A good rule of thumb is to start meals with small servings and let your child ask for more if they're still hungry.

Try not to make your child finish everything on the plate or eat more than they want to. And avoid using adult-size plates for younger children as it encourages them to eat oversized portions.

It may also help if you encourage your child to eat slowly and have set mealtimes. You can use mealtimes as an opportunity to catch up on what's happened during the day.

• Explain to your child how to get the balance of their diet right using the eatwell guide – it shows how much they should eat from each food group.
• Read more about what counts as a balanced diet.
• Knowing the calorie content of foods can be useful – here's information to help you and your child understand calories.
• Get ideas for healthy packed lunches.

Eat healthy meals

Children, just like adults, should aim to eat five or more portions of fruit and vegetables everyday. They're a great source of fibre and vitamins and minerals.

Getting 5 A DAY shouldn't be too difficult. Almost all fruit and vegetables count towards your child's 5 A DAY, including fresh, tinned, frozen and dried.

Juices, smoothies, beans and pulses also count.

Be aware that unsweetened 100% fruit juice, vegetable juice and smoothies can only ever count as a maximum of one portion of their 5 A DAY.

For example, if they have two glasses of fruit juice and a smoothie in one day, that still only counts as one portion.

Their combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day – which is a small glass.

For example, if they have 150ml of orange juice and 150ml smoothie in one day, they’ll have exceeded the recommendation by 150ml.

When fruit is blended or juiced, it releases the sugars which increases the risk of tooth decay so it’s best to drink fruit juice or smoothies at mealtimes.

Discourage your child from having sugary or high-fat foods like sweets, cakes, biscuits, some sugary cereals, and sugar-sweetened soft and fizzy drinks. These foods and drinks tend to be high in calories and low in nutrients.

Aim for your child to get most of their calories from healthier foods such as fruit and vegetables, and starchy foods such as bread, potatoes, pasta and rice (preferably wholemeal). And switch sweetened soft drinks for water.

• Fussy eater? Not a problem with these tips to help your kids enjoy their 5 A DAY.
• Tasty 5 A DAY family-friendly recipes.
• Find out how many soft or fizzy drinks children can have a day.
• Find out more about healthy drinks for children.
• Swap high-fat foods for these healthier alternatives.
• Try these sugar swaps – healthier swaps for breakfast, snacks and puddings.
• Ideas for sugar swaps when you shop.

Less screen time and more sleep!

Alongside the advice to get them moving more is the need to reduce the time they spend sitting or lying down in the day. Help your children avoid sitting and lying around too much as this makes them more likely to put on weight. Limit the time they spend on inactive pastimes like watching TV, playing video games and playing on electronic devices.

There's no hard and fast advice on how much is too much, but experts advise that children should watch no more than two hours of television each day. And remove all screens (including mobile phones) from their bedroom at night.

It also helps children stay trim if they sleep well. It's been shown that children who don't have the recommended amount of sleep are more likely to be overweight. The less children sleep, the greater the risk of them becoming obese. Lack of sleep can also affect their mood and behaviour.

• Find out how much sleep children need according to their age.
• How screens impair children's sleep.
• Sleep tips for children.
• Hidden causes of weight gain.

If your child has a medical condition, the advice in this article may not be relevant and you should check with their GP or hospital doctor first.

Healthy-weight children: advice for parents

If your child is a healthy weight, there's lots you can do as a parent to help them stay a healthy size as they grow.

Weight checks

Read more about your child's BMI (body mass index) and how it is measured.

Research shows children who stay a healthy weight tend to be fitter, healthier, better able to learn, and more self-confident. They're also much less likely to have health problems in later life.

Children whose parents encourage them to be active and eat well are more likely to stay a healthy weight and grow up healthy.

Check their BMI every now and then using using our BMI calculator to make sure they stay in the healthy range.

Steps for success

Here are five key ways you can help your child maintain a healthy weight. You can read this whole page or click on the links below to go directly to the topic you want to know about:

• Be a good role model
• Encourage 60 minutes of physical activity a day
• Keep to child-size portions
• Eat healthy meals, drinks and snacks
• Less screen time and more sleep!

Be a good role model

One of the best ways to instil good habits in your child is for you to be a good role model. Children learn by example. One of the most powerful ways to encourage your child to be active and eat well is to do so yourself.

Set a good example by going for a walk or bike ride instead of watching TV or surfing the internet. Playing in the park or swimming with your children shows them being active is fun. It's also a great opportunity for you all to spend time together.

• Any changes you make to your child's diet and lifestyle are much more likely to be accepted if the changes are small and involve the whole family. Here are 10 ways to get healthy as a family.
• Get inspiration with these 10 ways to get active with your kids.
• If you're not sure what activities you'd like to try as a family, use this What's your sport? tool to find out what you're best suited to.

Get active

Children need about 60 minutes of physical activity a day for good health, but it doesn't need to be all at once. Several short 10-minute or even five-minute bursts of activity throughout the day can be just as good as an hour-long stretch.

For younger children, it can take the form of active play, such as ball games, chasing games like "it" and "tag", riding a scooter, and using playground swings, climbing frames and see-saws.

For older children it could include riding a bike, skateboarding, walking to school, skipping, swimming, dancing and martial arts.

Walking or cycling short distances instead of using the car or bus is a great way to be active together as a family – and you'll save money, too.

• Find out the amount and type of physical activity recommended for under-5s.
• Find out the amount and type of physical activity recommended for children and young people aged 5 to 18.
• Join Change4Life for free and your child will get their own personalised activity plan full of good ideas for getting moving.

Child-size portions

Try to avoid feeding your child oversized portions. There's very little official guidance on precisely how much food children require, so you'll need to use your own judgement.

A good rule of thumb is to start meals with small servings and let your child ask for more if they are still hungry.

Try not to make your child finish everything on the plate or eat more than they want to. And avoid using adult-size plates for younger children as it encourages them to eat oversized portions.

It may also help if you encourage your child to eat slowly and have set mealtimes. You can use mealtimes as an opportunity to catch up on what's happened during the day.

• Explain to your child how to get the balance of their diet right using the eatwell guide – it shows how much they should eat from each food group.
• Read more about what counts as a balanced diet.
• Get ideas for healthier school packed lunches.
• Ideas for getting children involved in switching to a healthier lifestyle.

Eat healthy meals

Children, just like adults, should aim to eat five or more portions of fruit and vegetables everyday. They're a great source of fibre and vitamins and minerals.

Getting 5 A DAY shouldn't be too difficult. Almost all fruit and vegetables count towards your child's 5 A DAY, including fresh, tinned, frozen and dried. Juices, smoothies, beans and pulses also count.

Children, just like adults, should aim to eat five or more portions of fruit and vegetables everyday. They're a great source of fibre and vitamins and minerals.

Getting 5 A DAY shouldn't be too difficult. Almost all fruit and vegetables count towards your child's 5 A DAY, including fresh, tinned, frozen and dried.

Juices, smoothies, beans and pulses also count.

Be aware that unsweetened 100% fruit juice, vegetable juice and smoothies can only ever count as a maximum of one portion of their 5 A DAY.

For example, if they have two glasses of fruit juice and a smoothie in one day, that still only counts as one portion.

Their combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day – which is a small glass.

For example, if they have 150ml of orange juice and 150ml smoothie in one day, they’ll have exceeded the recommendation by 150ml.

When fruit is blended or juiced, it releases the sugars which increases the risk of tooth decay so it’s best to drink fruit juice or smoothies at mealtimes.

Discourage your child from having sugary or high-fat foods like sweets, cakes, biscuits, some sugary cereals, and sugar-sweetened soft and fizzy drinks. These foods and drinks tend to be high in calories and low in nutrients.

Aim for your child to get most of their calories from healthier foods such as fruit and vegetables, and starchy foods such as bread, potatoes, pasta and rice (preferably wholemeal). And switch sweetened soft drinks for water.

• Fussy eater? Not a problem with these tips to help your kids enjoy their 5 A DAY.
• Tasty 5 A DAY family-friendly recipes.
• Find out more about healthy drinks for children.
• Try these sugar swaps – healthier swaps for breakfast, snacks and puddings.
• Ideas for sugar swaps when you shop.

Less screen time and more sleep!

Help your children avoid sitting and lying around too much, as it makes it more likely for them to put on weight.

Limit the amount of time your child spends on inactive pastimes such as watching television, playing video games and playing on electronic devices.

There's no hard and fast advice on how much is too much, but experts advise children should watch no more than two hours of television each day – and remove all screens (including mobile phones) from their bedroom at night.

It also helps children stay trim if they sleep well. It's been shown children who don't have the recommended amount of sleep are more likely to be overweight. The less children sleep, the greater the risk of them becoming obese. Lack of sleep can also affect their mood and behaviour.

• Find out how much sleep children need according to their age.
• How screens impair children's sleep.
• Sleep tips for children.

How to spot child sexual exploitation

Each year in England thousands of children and young people are raped or sexually abused. This includes children who have been abducted and trafficked, or beaten, threatened or bribed into having sex.

Media coverage of police investigations into the crimes of Jimmy Savile and other prominent figures have brought child sexual abuse and exploitation to public attention.

But while police tackle the problem, child sexual exploitation continues to happen every day. It's important to understand what child sexual exploitation is and to be aware of warning signs that may indicate a child you know is being exploited.

The age of consent

What is child sexual exploitation?

Before explaining child sexual exploitation, it is helpful to understand what is meant by the age of consent (the age at which it is legal to have sex). This is 16 for everyone in the UK. Under the age of 16, any sort of sexual touching is illegal.

It is illegal to take, show or distribute indecent photographs of children, or to pay or arrange for sexual services from children.

It is also against the law if someone in a position of trust (such as a teacher) has sex with a person under 18 that they have responsibility for.

Child sexual exploitation is when people use the power they have over young people to sexually abuse them. Their power may result from a difference in age, gender, intellect, strength, money or other resources.

People often think of child sexual exploitation in terms of serious organised crime, but it also covers abuse in relationships and may involve informal exchanges of sex for something a child wants or needs, such as accommodation, gifts, cigarettes or attention. Some children are "groomed" through "boyfriends" who then force the child or young person into having sex with friends or associates.

Sexual abuse covers penetrative sexual acts, sexual touching, masturbation and the misuse of sexual images – such as on the internet or by mobile phone.

Part of the challenge of tackling child sexual exploitation is that the children and young people involved may not understand that non-consensual sex (sex they haven't agreed to) or forced sex – including oral sex – is rape.

Which children are affected?

Any child or young person can be a victim of sexual exploitation, but children are believed to be at greater risk of being sexually exploited if they:

• are homeless
• have feelings of low self-esteem
• have had a recent bereavement or loss
• are in care
• are a young carer

However, there are many more ways that a child may be vulnerable to sexual exploitation, and these are outlined in a report by the Office of the Children’s Commissioner.

The signs of child sexual exploitation may be hard to spot, particularly if a child is being threatened. To make sure that children are protected, it’s worth being aware of the signs that might suggest a child is being sexually exploited.

Signs of grooming and child sexual exploitation

Signs of child sexual exploitation include the child or young person:

• going missing for periods of time or regularly returning home late
• skipping school or being disruptive in class
• appearing with unexplained gifts or possessions that can’t be accounted for
• experiencing health problems that may indicate a sexually transmitted infection
• having mood swings and changes in temperament
• using drugs and/or alcohol
• displaying inappropriate sexualised behaviour, such as over-familiarity with strangers, dressing in a sexualised manner or sending sexualised images by mobile phone ("sexting")
• they may also show signs of unexplained physical harm, such as bruising and cigarette burns

Preventing abuse

The NSPCC offers advice on how to protect children. It advises:

• helping children to understand their bodies and sex in a way that is appropriate for their age
• developing an open and trusting relationship, so they feel they can talk to you about anything
• explaining the difference between safe secrets (such as a surprise party) and unsafe secrets (things that make them unhappy or uncomfortable)
• teaching children to respect family boundaries, such as privacy in sleeping, dressing and bathing
• teaching them self-respect and how to say no
• supervising internet, mobile and television use

Who is sexually exploiting children?

People of all backgrounds and ethnicities, and of many different ages, are involved in sexually exploiting children. Although most are male, women can also be involved in sexually exploiting children. For instance, women will sometimes be involved through befriending victims.

Criminals can be hard to identify because the victims are often only given nicknames, rather than the real name of the abuser.

Some children and young people are sexually exploited by criminal gangs specifically set up for child sexual exploitation.

What to do if you suspect a child is being sexually exploited

If you suspect that a child or young person has been or is being sexually exploited, the NSPCC recommends that you do not confront the alleged abuser. Confronting them may place the child in greater physical danger and may give the abuser time to confuse or threaten them into silence.

Instead, seek professional advice. Discuss your concerns with your local authority's children’s services (safeguarding team), the police or an independent organisation, such as the NSPCC. They may be able to advise on how to prevent further abuse and how to talk to your child to get an understanding of the situation.

If you know for certain that a child has been or is being sexually exploited, report this directly to the police.

What health professionals can do to help exploited children

One of the best ways that health professionals can help a child who is at risk of sexual exploitation is to be aware of what to look out for. The Department of Health, together with Brook, has produced an online course, Combating CSE, which is designed for health professionals to help them identify children who are at risk of or have been sexually abused.

Revised guidance for professionals who come into contact with children was published by the Department for Education in March 2015, to help practitioners identify child abuse and neglect, and take appropriate action.

The National Institute for Health and Care Excellence (NICE) has updated its guidance on when to suspect child maltreatment.

How common is child sexual exploitation?

The Office of the Children’s Commissioner (OCC) estimates that between August 2010 and October 2011, around 2,409 children were confirmed as having been sexually exploited, with a further 16,500 being identified as at risk. However, the OCC says that evidence suggests the number is far greater.