Steroid-containing asthma medications are one of the most effective treatments for both children and adults living with asthma. They’ve been shown to improve quality of life, minimize hospital visits, and most importantly reduce the number of asthma deaths. But according to two systemic reviews, they may come with a negative side effect-- suppressing growth in children.

The first review looked at 25 asthma drug trials participated in by over 8,400 children with mild to moderate asthma. They found that the children treated with steroid-based drugs grew 0.2 inches less over the course of their first year of treatment than the children treated with placebos or non-steroid drugs.

The second review looked at 22 drug trials where children were treated with low to medium doses of steroid-based drugs. These children still showed reduced growth, but not as much. They only grew 0.1 inches less than their non-steroid treated peers.

One of the experts who worked on the reviews, Francine Ducharme, said there needed to be more research done on the issue, but until then she and her team would recommend “the minimal effective dose” when treating children with steroid-based drugs.

But others disagree. As Jon Ayers, Birmingham University professor of environmental and respiratory medicine, puts it “These studies confirm what many have suspected, that inhaled steroids can suppress growth in children… However, the effect seems… small and non-cumulative and many may consider this a risk worth taking compared to the alternative, which is poorly controlled and therefore potentially life threatening asthma.”