There is a lot of discussion by parents and physicians about the use of daily inhaled steroids (the “preventers” that you mentioned). When used at low dose, I feel there is robust data to support that they are very safe, even if used for years. There are good long-term studies that show there is not any significant effect on achieved height or growth velocity, and no effect on things that are associated with use of oral steroids, such as diabetes, hypertension, and immune suppression. At low dose, they won’t cause bone shrinkage. Most pediatric asthma specialists choose to decrease doses of any inhaled steroids used about every three to six months if they achieve good symptom control.

Answered by John Carl, MD. Dr. Carl is a pediatric pulmonologist at Cleveland Clinic Children’s. He specializes in growth and development of the lung, airways, and respiratory function in children, and uses a variety of invasive and noninvasive diagnostic techniques on young patients.