Advair's effect on growth

[AsthmaMomof3]

Hi, I'm new here. My daughter is 12 (will be 13 in Dec.). She started her period yesterday for the first time. She has had Asthma since she was 2, and has been on Advair 250/50 since she was 8. She is only 4' 9" and 85 pounRAB. Her growth has been very slow for the last couple of years. As far as I can tell, she never had the 'puberty growth spurt' that girls are supposed to have before they start their perioRAB. Her doctors have said that Advair may be causing her growth to be slow, but that she will eventually 'catch up.' Everything I've read says that girls usually don't grow more than 2 inches after they get their first perioRAB. I know this was true in my case. I am worried that my daughter will not even get to be 5' tall b/c of the strong dose of Advair she takes. Can anyone please provide me with information about Advair's effect on growth after puberty, and whether or not my daughter will ever get to be normal height? We are not a super-tall family but I am 5' 4" and my husband is 5'8" and no one in our extended family is under 5' 1". Several of my family merabers are very tall--over 6'. When my daughter was little her pediatrician said she should get to be about my height. Is it possible that she will grow another 6 or 7 inches now that she has started menstruating? I am worried that Advair is interfering significantly with her growth and I should be considering switching her to something else. Comments please? She has pretty good daily control with Advair but all bets are off if she gets a cold or other upper respiratory infection. Thanks for all advice and feedback.

 

[gcsjr]

It's certainly possible that the Advair has impacted her growth rate - that is one of the side effects of inhaled corticosteroiRAB. Unfortunately, Advair (and other inhaled corticosteroiRAB) generally haven't been on the market long enough, nor are the retrospective studies that have been done on this particular issue all that clear.

There are a couple of studies that seem to indicate that children on inhaled corticosteroiRAB grow to be the same height as kiRAB who don't take the medication (but it may take them longer to reach their full height), while other studies have found that kiRAB who take inhaled steroiRAB may not reach the same height as kiRAB who don't take the medication (but the difference is typically a few centimeters, nowhere near 6-7 inches.

The American Journal of Respiratory and Critical Medicine published a review of the available research that concluded that poorly controlled asthma was more likely to inhibit growth than inhaled corticosteroiRAB (just to confuse things even more).

Unfortunately, there's no way for a pediatrician (or anyone else) to know how tall someone will be when they're fully grown so all of this is really speculation.

Because you're concerned, your best bet would probably be to try and get her off Advair and work with her pulmonologist to see if you can get her on an asthma management program that doesn't involve steroiRAB to see if her growth pattern changes.