Teenage Health: A Guide for Parents and Teens

When to Get Help Now

Most teenage ups and downs are normal. These signs are not, and some cannot wait.

If your teenager may have swallowed something harmful, see our first aid for poisoning and come to Limi Children's Hospital now, day or night. If you cannot get here quickly, go to the nearest emergency department. Have someone else drive if you can, so you can stay with your teenager, and call 0813 408 5400 on the way so the team can prepare. Remove tablets, blades, ropes and pesticides from the home if someone is at risk.

Puberty: When It Starts

Puberty is when the body changes from a child's to an adult's. It happens over several years, and the timing varies a lot between healthy children.

• Girls usually start between 8 and 13. The first sign is a small, sometimes tender lump under one or both nipples (breast buds), then hair under the arms and in the pubic area, and a growth spurt. Periods usually start about two years after breasts begin to develop, often around 12 or 13.
• Boys usually start between 9 and 14. The first sign is the testicles getting bigger, then pubic hair, the penis growing, and later a deeper voice, facial hair and a big growth spurt. Boys often keep growing until 17 or 18.

When to See a Doctor About Timing

• Signs of puberty before 8 in a girl or before 9 in a boy
• No breast development by 13 in a girl, or no growth of the testicles by 14 in a boy
• No period by 15, or more than three years after breasts started to develop
• Puberty that starts and then stops, or growth that stops

Boys often get a little breast swelling in puberty; it usually settles within two years. A lump in a testicle needs a doctor soon. Sudden pain in a testicle is an emergency: come to Limi Children's Hospital now, or go to the nearest emergency department if you cannot get here quickly. See our guide to testicle problems.

Periods

Talk to girls about periods before they start, ideally by age 9 or 10, so the first one is not frightening. In the first year or two, periods are often irregular. After that, for most girls:

• A cycle (from the first day of one period to the first day of the next) is 21 to 45 days in the early years
• Bleeding lasts up to 7 days
• Some cramping pain in the lower tummy or back on the first day or two is common

Heavy or Painful Periods

See a doctor if your daughter soaks through a pad in an hour or two, bleeds for more than 7 days, passes clots bigger than a coin, bleeds through clothes at school, or feels tired, dizzy or breathless. Heavy periods can cause anaemia and are sometimes the first sign of a bleeding disorder. See a doctor, too, for pain that stops her going to school or is not helped by pain relief — a treatable cause may be found.

For ordinary period pain: a hot water bottle on the tummy, gentle exercise, and pain relief such as paracetamol or ibuprofen, using the dose on the pack for her age. Ask a pharmacist or doctor first if she has asthma, stomach problems or kidney problems.

Pads, Hygiene and Missing School

Many girls in Nigeria miss school during their period because pads cost too much or there is nowhere private to change. Change a pad every 4 to 6 hours, or more often if it is full. If using cloth, use clean cotton, wash it with soap and water, and dry it fully in the sun. Wash the outside of the genital area with water; do not douche or put anything inside. Pack a small period kit for school bags: pads, clean underwear, a small bag for used pads.

Acne and Skin

Most teenagers get spots. Wash the face twice a day with mild soap and water, do not squeeze or pick, and use oil-free products. Gels containing benzoyl peroxide from a pharmacy help mild acne. See a doctor if spots are painful and deep, leaving dark marks or scars, or getting your teenager down — good treatments exist.

Avoid bleaching and "toning" creams. Many contain mercury or strong steroids, which damage skin and kidneys and can make acne worse. Do not use steroid creams on the face unless a doctor prescribes them.

Sleep

Teenagers need 8 to 10 hours of sleep a night. In puberty the body clock moves later, so teens genuinely feel awake late and struggle to get up — it is biology, not laziness. Early school runs and evening lessons squeeze sleep further. Too little sleep affects mood, memory, exam results, skin, weight and safety on the road.

• Keep bedtime and wake time within an hour or two, including weekends
• Screens off an hour before bed, and phones out of the bedroom overnight
• No coffee, energy drinks or cola after lunch
• A cool, dark room — a fan helps in the heat

Food, Growth and Sport

Teenagers grow faster than at any time since babyhood and need more food, not less. Three meals a day, including breakfast, give the energy to learn. Useful foods:

• Iron — beans, ugwu and other green leaves, meat, fish, liver and eggs. Girls lose iron each month in their periods.
• Calcium for growing bones — milk, yoghurt, small fish eaten with the bones such as sardines, and crayfish.
• Fruit and vegetables every day — oranges, pawpaw, banana, garden egg, okra.
• Water instead of fizzy drinks and energy drinks.

Worry about weight and appearance is common. Avoid comments on your teen's body or weight, and never put a growing teenager on a strict diet without a doctor.

Sport and Injuries

Teenagers should be active for at least an hour a day. In the heat, drink water before, during and after sport, and rest in the shade. Knee or heel pain in growing athletes is common and usually settles with rest. After a knock to the head with confusion, headache, vomiting or dizziness, stop play and do not return the same day; see a doctor. Painful swelling, a misshapen limb, or being unable to put weight on it needs an X-ray — see first aid for fractures.

Stress, Exams and Mental Health

WAEC, NECO and JAMB bring real pressure — from school, family and the teen themselves. Some stress helps focus. Too much looks like poor sleep, headaches, stomach aches, crying, anger, or giving up.

• Help plan revision in short blocks with breaks, meals and sleep. All-night study harms memory.
• Say that you love them whatever the result. Fear of disappointing parents is a heavy load.
• Tell them there is more than one route — resits, other courses and other universities.

Depression, Anxiety and Self-Harm

Depression is more than sadness: it is feeling low, empty, irritable or hopeless most of the day, for two weeks or more, often with changes in sleep and appetite, loss of interest in friends and things they enjoyed, and falling school work. Anxiety is worry that will not switch off, panic attacks, or avoiding places and people. Both are common and treatable, with talking therapy and sometimes medicine.

Self-harm — cutting, burning, hitting or poisoning oneself — is usually a way of coping with overwhelming feelings. If you find out, stay calm. Do not shout, punish or make them promise to stop. Say you are glad they told you, check whether the injury needs treatment, and get help from a doctor. Asking directly "are you thinking about suicide?" does not put the idea in their head; it often brings relief.

Eating Disorders

Anorexia, bulimia and binge eating affect boys as well as girls, in every country. Signs include skipping meals, eating in secret, rapid weight loss, disappearing to the toilet after meals, heavy exercise, and periods stopping. Eating disorders can be dangerous to the heart. Early help works best.

Alcohol, Codeine, Tramadol and Other Drugs

Nigeria has a serious problem with the misuse of prescription medicines. A national survey in 2018 found that about one in seven Nigerians aged 15 to 64 had used a drug other than alcohol or tobacco in the past year, and misuse of tramadol and codeine cough syrup was common. Cough syrup mixed with soft drinks is passed around at parties. Cannabis (including strong forms sold as "colorado" or "skunk"), alcohol in sachets, vapes and sniffing solvents are also common.

• Codeine cough syrup is an opioid. It causes addiction quickly and can slow breathing until it stops, especially mixed with alcohol or other drugs. Nigeria banned codeine cough syrups in 2018, but they are still sold illegally.
• Tramadol is an opioid painkiller. High-strength tablets are sold illegally. It causes addiction and can cause fits and death, even in young people with no history of fits.
• Cannabis harms concentration and memory while the brain is still developing, and strong cannabis can trigger psychosis — hearing voices, paranoia, confusion.
• Alcohol is especially dangerous for teens: drunkenness leads to accidents, assault and unsafe sex, and large amounts can cause fatal poisoning.
• Vapes contain nicotine, which is highly addictive, and other chemicals that harm the lungs.

Signs of drug use include sudden changes in friends, falling grades, money or items going missing, red eyes, drowsiness, slurred speech, and sweet-smelling syrup bottles. Talk calmly, without accusations, and book the adolescent clinic. Addiction is a health problem, and young people recover with treatment. Lock away medicines at home, including tramadol or codeine prescribed for an adult.

Online Safety and Bullying

Phones connect teenagers to friends, learning and support — and to bullying, scams and people who mean them harm.

• Never share nude or intimate images. Once sent, they cannot be taken back. Criminals pose as young people online, get images, then threaten to share them unless paid. If this happens, do not pay, stop replying, keep the evidence, and tell a trusted adult. It is not the young person's fault.
• Keep accounts private and do not share location, school or home address.
• Be wary of online friends who ask for secrets, gifts or to meet alone.
• Bullying, online or at school, is linked to low mood and self-harm. Take it seriously, keep screenshots, and involve the school.

Relationships, Sexual Health and the HPV Vaccine

Teenagers who get clear, accurate information from parents and health workers tend to start sex later and make safer choices. Talk about respect, consent (anyone can say no, at any time, and no means no), and that it is fine to wait. Make sure your teen knows they can come to you, or a doctor, if anyone pressures or hurts them. Our clinicians give confidential advice on puberty, periods, infections and contraception.

The HPV vaccine protects against the human papillomavirus, which causes most cancer of the cervix — one of the most common cancers in Nigerian women. Nigeria added it to routine immunisation in 2023 for girls aged 9 to 14, as a single dose. It is best given before any sexual contact. It is safe, has been given to hundreds of millions of girls worldwide, and does not affect fertility. Ask for it at your daughter's next visit or check the vaccine schedule.

Talking with Your Teenager

Teenagers still need their parents, even when they seem to push them away.

• Talk side by side, in the car, while cooking or walking. It is easier than face to face.
• Listen first. Ask "what was that like?" rather than jumping to advice or punishment.
• Stay calm with hard news. If they are punished for telling you, they will stop telling you.
• Be clear about the few rules that matter most — safety, respect, school — and explain why.
• Share your own feelings and mistakes. It shows that problems can be survived.

For teens reading this: if you cannot talk to your parents, talk to another adult you trust — an aunt, uncle, teacher, school nurse, faith leader or doctor. You deserve help, and asking for it is strong, not weak.

Seeing the Doctor Alone

In adolescent care, the clinician sees the parent and teenager together first, then the teenager alone for part of the visit. This is standard practice. It gives teens a chance to ask about things they find embarrassing — periods, spots, mood, relationships, drugs — and to learn to look after their own health.

What a teenager says in private stays private, with one exception: if the clinician believes the young person or someone else is at risk of serious harm, they must act to keep them safe. They talk with the teenager first about who needs to know, whenever it is safe to do so. Parents are always welcome to share their own worries with the clinician too.

Questions Families Ask