Q: I've heard some asthma medications may stunt growth. How do these drugs work, and are they safe?
A: Most kids with asthma use either a bronchodilator inhaler (for acute symptoms) or daily-inhaled corticosteroids to control their asthma symptoms preventively. It's these daily steroid meds that parents worry most about, but studies show that they're very safe in proper doses. Here’s how they work:
• Bronchodilators, like albuterol and Xopenex, are used during an asthma attack to quickly relax the muscles around the airway, relieving wheezing, coughing, breathlessness, or other symptoms. They're usually delivered through a metered-dose inhaler or a nebulizer. They can't alleviate chronic lung inflammation. If you find that your child needs her bronchodilator more than twice a week, she should probably be on a daily-inhaled steroid to keep her asthma under control.
• Daily-inhaled steroids, like Flovent, Asmanex, and Pulmicort, reduce airway inflammation to prevent asthma attacks. These drugs are inhaled into the lungs either once or twice a day depending on the severity of the symptoms.
Don't confuse these steroids with anabolic steroids (the kind some athletes use to bulk up). Long-term studies have shown that in proper doses, inhaled corticosteroids do not adversely affect a child's growth or bone development. And they produce far fewer side effects than the oral versions like prednisone, which is used to control inflammation in acute attacks that can be brought on by not taking a daily inhaled anti-inflammatory.
If you're very worried about using these meds daily, your doctor may also recommend an over-the-counter leukotriene medication, like Singulair, which may help keep inflammation in check for kids with very mild cases. But if the condition worsens, corticosteroids will be your safest option. --Marguerite Lamb
Originally published in American Baby magazine, April 2005. Updated 2009