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Do Steroids Cause Stunted Growth?

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: Is it true that the steroid medicine being prescribed for my asthmatic child may cause her not to grow as well? Should I be concerned?

A: Steroid medicines are used frequently to combat asthma and allergies. These medicines have been wonderful in helping to control asthma symptoms. For example, by reducing inflammation and swelling in the lungs, steroids have made a big difference in helping children with asthma breathe much better, so that they can lead more normal lives.

Doctors are always concerned about the side effects of the medicines they prescribe. It is true that some controversy has been raised about steroids possibly stunting a child's growth. The long-term effects of steroids on a child's final adult height are not clear.

However, in the case of steroids, I believe the benefits tend to outweigh the risks, assuming the medicine is used as recommended. Doctors tend to use the lowest effective dose of these drugs, monitor the frequency with which they are used, choose a delivery method that minimizes side effects, and closely monitor children's growth rates while they are taking steroids. Sometimes the medicine can even be given directly into the lungs (by inhaling it) or directly into the nose (by squirting it). These ways of taking steroids tend to have fewer systemic side effects when compared with taking them by mouth.

I recommend that you use the steroids in concert with your daughter's physician and that she be closely monitored for any side effects that may be associated with using these medicines. Although I share the concern you raise, I think steroids are generally very beneficial when used appropriately.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.


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