Excerpt: 'Taking Care of Your Girls'

Breast experts provide a health guide for "girls, teens, and in-betweens."

Sept. 3, 2008 — -- Growing up can be hard. One of the most difficult parts is taking care of a changing body.

Dr. Marisa Weiss and Isabel Friedman want to help girls get through it and wrote "Taking Care of Your Girls," a "health guide" for growing girls.

Read an excerpt from the book below, and also read other excerpts featured on "Good Morning America" by clicking here.


Isabel's Take: From Me to You

It's not easy to talk to anyone about the changes your body is going through—especially the private changes. You want to know everything but you don't want to feel uncomfortable learning about it. So how do you get answers to your questions? How do you find the reassurance that everything is going okay and figure out what to expect next? This can all happen in a bunch of ways. Someone in your family might take you aside for "a talk." You might learn some of the things at school or from friends. A book might show up in your room that has a lot of answers (like this one). Or maybe you'll see something in a magazine or on TV. For me things were a little different. I grew up in a unique household. I'm not saying puberty wasn't a confusing time for me, because it was. But because both my parents are doctors (as are three of my grandparents), medical information has always been easy to get. I never had "the talk" because I heard talk about bodies all the time. I also have a very close and open relationship with my cousins and aunts of my mom's side of the family. Dinner conversations quickly get carried away, and we share lots of funny and embarrassing stories.

Years before my own breasts even started to develop, my mom and aunts would tell stories and pass down wisdom from their own experiences. Once my aunt Alice told my cousin Lena, eight, and me, ten, that when she was my age, she felt a bump in her breast. Worried that it might be breast cancer, Alice ran downstairs to tell her mother. Her mom—my grandmother—assured a panicked Alice that it was not breast cancer at all, but that her breast buds were starting to grow!

We all got a good laugh out of the story, but I had another feeling: huge relief! I'd had the same breast cancer scare with my breast bud as Aunt Alice did. That night, Lena and I stayed up late and talked and she said she had been scared too. Even two girls from a family of doctors could freak out about these big changes! From that point on, I knew how important it was to learn about what was going on with my own body; I did not want to be scared every time I noticed a change.

By the time I was eleven years old, I had read through books and talked to friends and family. But I was still not entirely satisfied with the information. My mother is a breast cancer doctor, so I figured that she mainly knew what could go wrong with breasts. My father is a pediatrician, but I wasn't going to ask him anything about my breasts. Lena, at nine, had not yet started puberty, although she was just as curious about all the changes that I was going through. I also wanted to be prepared to teach Lena when she would go through puberty herself. Our joint fascination and eagerness to learn led us to create "nipple books." These were books we kept that helped us explore and understand what was going on with our bodies.

That summer, I began to notice more and more how different women's breasts were from each other and from mine. There were so many different shapes and sizes! I was already used to looking at human bodies in a scientific way because of my doctor parents, and this was like my own little observational study. On the beach and aroundtown, Lena and I would observe the different kinds of breasts we saw, then come home and draw them in our nipple books. It was a fun way to spend time together and also to learn about our bodies. Most of my illustrations were realistic, others more imaginative, but in recording the "findings" of our "study," we came to one conclusion: every set of breasts is different and unique. It took me a while to realize that everything I had read about breasts and breast development applied to breasts that looked completely different. Lena and I thought that was pretty cool.

Then another question came to mind: how can you know you're normal when every girl and woman around you have breasts that look different from yours?

I learned then, and have come to realize even more now, that every girl experiences confusion and shared fears about her body as she grows up. Creating our nipple books helped Lena and me relieve those fears and make the best of all of the changes. Turning our worries into laughs allowed us to enjoy those exciting times in our lives. We weren't making fun of these different kinds of nipples and breasts; we were just being honest that the differences were there. Not everyone was going to look the same, and that was just fine.

It was five years later that I showed my nipple book to my mom. She thought it was great, and that just reinforced for me that my and Lena's curiosity was normal. Mom was pleased and surprised that we had taken notice of all the natural differences among women.

Now that I'm seventeen, I flip through my nipple book and giggle at some of the silly drawings I made, but I also appreciate how useful it was for me growing up. I know that not every girl is able to ask questions, express her concerns, or share her fears as easily as Lena and I did. Having this kind of relationship was so important to me—and would have a big positive influence on any girl.

And that's why I'm here for you. During puberty, your body can change faster than you can keep up with it, and it's not easy to find the answers to all the questions you have. This book draws upon my experiences and my mom's medical knowledge, and will help resolve your concerns and put your fears about breasts (your "girls") to rest with fun, easy-to-understand, reliable, meaningful information. Peppered throughout the book are tidbits of my perspective, for a girl-to-girl view, plus tons of other girls' stories, on all the subjects we cover. You're probably full of ideas and stories too. Please share them with me and other girls at our Web site, TakingCareOfYourGirls.com. Helping each other makes us all feel strong, smart, taken care of, and comforted. It feels much better knowing that we're all in this together. We hope you find our book helpful and enjoyable!

Isabel Friedman

Mom to Mom: A Word From the Weiss

The goal of our book, Taking Care of Your "Girls," is to take care of our girls by addressing their fears, questions, attitudes, and concerns about breast development and breast health. The information in this book is meant to empower them to become smart, healthy women with strength, confidence, and spirit.

Complete breast development, from the very start to the final finish, occurs over ten years. Growing breast tissue is more sensitive than full-grown breasts—since the food, water, beverages, and air our daughters take in become the building blocks for her new breast tissue, forming the foundation of her future breast health.

There is growing evidence that today's young girls have little knowledge about breast health, and this affects their physical and emotional well-being. From underserved young girls with limited access to health care and health/wellness information to the most educated and privileged girls in private schools, lack of information and misinformation about what it means to have healthy breasts are pervasive among girls today.

Our nonprofit organization, Breastcancer.org, together with the Lankenau Hospital, recently surveyed more than three thousand Philadelphia-area public and private school girls in the sixth through twelfth grades. The results were shocking:

• Although many girls are interested in hearing about breast health from their doctors, they often encounter different doctors with each visit and are unable to build a rapport enabling them to ask personal questions.

• About 90 percent of mothers say they'd like to talk to their daughters about breast health, but only about 30 percent have had the conversation.

• Over 30 percent of girls have perceived a normal change in their breasts to be a sign of breast cancer.

• More than 20 percent of girls think breast cancer is caused in part by infection, tanning, drug use, stress, breast injury, or bruising; however, none of these is a risk factor.

• Few girls know how to keep their breasts healthy.

The way in which girls and young women feel about themselves has a direct impact on the way they perceive themselves in every aspect of their lives. Self-confidence and self esteem especially empower young girls to take on the challenges of life and reach their fullest and greatest potential.

It's us—their moms or other key trusted people in their lives— whom our girls want to be their source of this essential information about breast health. So it's up to us to get the conversation started in an age-appropriate, sensitive, responsive, respectful, and accessible way. Plus we have to keep our ears and eyes wide open and tuned in to their circles of influence: the people they look up to, the images they aspire to, their media sources, and the always-changing technologies they use to plug into the outside world.

Your love and dedication, supported by the information in Taking Care of Your "Girls," can make a life-enhancing and life-saving difference in the lives of our girls today and better serve the health of our future generations.

Marisa C. Weiss, Mom and M.D.