asthma medication and slow growth?

[shelsco]

my 7 year old sDS has asthma and has taken beclamethasone for about 3 years. He was put on a new brand (although same generic name) las tyear and the inhaler changed to one that gives out 100mcg instead of 50mcg. The problem is that we were told to give him 2 puffs twice a day when he had a cold (which triggers his asthma) and every time we have tried to reduce it he seems to have started with a cough so what with swine flu lurking about etc we've just kept the dose the same. I'm now really worried because he's already tiny, the smallest in his class, and I've just read that inhaled beclamethasone is thought to slow growth by about 0.5-0.9cm per year. As he's likely to be little genetically anyway, i'm feeling terrible. Feel like I should have made a more conscious effort to reduce it now but it's just his asthma attacks are so terrifying i didn't want to risk it. Somebody please give me some reassurance.

Well DS (8) has been on it since he was 8 months old, if it stunts growth then he was obviously destined to be freaky tall as he's the tallest in his class! As for the increased dose, well for a bad attack he could have up to 4 puffs of 50mcg (in other words 200mcg) twice a day, he's been approved for that dose since he was 2.

Hope that helps!

my ds has been on it for yrs as well

He is kind of short for his age but has been on the 50th percentile .His dad is not tall though so I have neer worried.

But now you have said 'I've just read that inhaled beclamethasone is thought to slow growth by about 0.5-0.9cm per year' I am wondering if I should be worried.

Uncontrolled asthma will affect his growth negatively more than being on inhaled steroids. Also the dose he is on is pretty standard, only 400 micrograms a day which is 0.4 milligrams which really isn't a lot. If he didn't have his inhaler and got poorly enough to need oral steroids he would probably be on 10-30 milligrams per day (depending on his weight), so you can see the difference.

Far far better to manage his asthma well.

Thanks for the advice. Does put it in perspective a bit but still makes me feel he has choice of being very small or even smaller (!) IYSWIM. A U.S, site said that maximum dose per day should be 80mcg for 5 to 12 yr olds which seemed low and put me in a panic. i know that i shouldn't really believe all i read on the web. My DS is so small and hasn't really grown much in the past six months. He's dropped from following the 25th centile to the 9th which is why i'm panicking. If he's only destined to be about 5 foot 6 or less and then his height is affected on top of that, he could end up freakishly small. A couple of cm for someone of average or above height wouldn't be that noticable but on somebody already very small it would make quite a difference! Sorry to worry you ggirl. You DS sounds like he's following the line that he's supposed to. BTW study done was with nasal beclamethasone drops rather than inhalers but amounts were the same as inhalers. Anyone know if that would make a difference?

It might well do, as the steroids are being absorbed through the sinuses rather than through the lungs. Just to clarify, I have a biology/chemistry background but not specific medical training, so I can't say for sure that nasal drops are different to inhalers. From a scientific point of view though it's possible there's a significant difference between the two, so I wouldn't take the results of that study as necessarily being applicable to someone on inhaled steroids.

If you're still worried, it's a question you can ask your GP. Take along a printout or the website address and ask his advice, if he doesn't know ask him to find out and let you know, or if there's a specialist in your area you can talk to. You do sound quite worried, and they have a responsibility to make sure you understand the possible risks of any medication your DS is on.

Hi ya I'm no doctor so don't know any sort of medical details but me and my identical twin both had bad asthma at a young age about 7/8 years old. She had it worse than me and so was on a lot more medication, she ended up being a bit shorter than me and classmates and the doctor said that it may have been the inhalers etc. Just to let you know she is 23 now ,is taller than me and has well controlled asthma.

Thanks. Am seeing asthma nurse tomorrow so will take a print out along i think. Thanks mummyofthomas- what you said about your twin makes me hope that he might catch up one day!

mummyofthomas- is your sister still on inhalers for her asthma?

Hi ya, yes I'm pretty sure she still takes them on a daily basis, I think they are slightly stronger than the ones I take but she only needs them to keep it under control which it does very well. Hope all goes well with the nurse

thanks, feeling much less panic stricken now!