Children taking the drug grow around half a centimetre (quarter of an inch) less a year than other children of the same age who don't use an inhaler.
Growth restriction is a problem common to all the popular corticosteroid inhalers, including beclomethasone and budesonide.
Scientists have suspected for years that inhalers restrict growth, but researchers at the University of Rio Grande in Brazil confirmed it when they analysed 25 trials involving 8,471 children aged up to the age of 18 years with mild to moderate asthma. The average growth rate was between six and nine centimetres a year in children not using an inhaler, and was on average half a centimetre less among those who did.
Growth problems seem to ease in subsequent years or if the dose is reduced.
(Source: The Cochrane Library, 2014; doi: 10.1002/14651858.CD009471.pub2)