The dilemma is how much information to give a six-year-old. Instinctively most of us would probably feel that a graphic description of the menstrual cycle isn't appropriate. Equally, you don't want to brush away what is a crucial aspect of female health, and one that Esme has every right to know about.

So what is the sensible middle ground? “Let the child run the agenda on what she wants to know,” says Christine Webber, a psychotherapist specialising in sexual health. “Keep it brief, give a proper answer but then don't elaborate - unless she wants to know more. When a child is 5 or 6 is not the right time for an explanation about the role of sperm and eggs,” she says. “Around 9 to 10 is better.”

Instead you could tell her: “Once a month grown-up women have a small blood loss and we wear something called a tampon or a pad to make sure it doesn't go on our clothes.” And leave it at that.

Of course Esme could look worried and ask if everyone has them. In which case, Webber advises, you can say: “‘All grown-up women have them and so will you when you're a big girl.' She might then ask if it hurts and you should say no, it doesn't. You may have to lie here if you do get severe period pain; I don't think it's necessarily a good thing to lay that on your six-year-old.”

Understandably there is still the underlying fear of upsetting children. As Dr Carol Cooper, family doctor and author, says: “It can be daunting for children to be told too much, especially when blood is involved.”

Historically it's not a subject we've ever felt comfortable discussing. As Janice Delaney, Mary Jane Lupton and Emily Toth write in their book, The Curse: A Cultural History of Menstruation: “Greater than his fear of death, dishonour or dismemberment has been primitive man's respect for menstrual blood.” This taboo still lurks to some extent. But any reluctance or anxiety to discuss it is something children will tune in to, so be aware of your own feelings and try to be as relaxed and open as possible.

Reassure yourself that your child will set her own limits. As Dr Cooper says: “I know one mother who tried to tell her young daughter and she put her hands over her ears, insisting, Stop mum. I'm not ready for this'.” At which point you can happily change the subject and talk about something else.

EMMA COOK

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