Does Pulmicort Reduce Height? What Research on Inhaled Steroids and Growth Shows

Inhaled corticosteroids such as budesonide (Pulmicort) are a mainstay of treatment for persistent asthma in children. They can slightly slow growth, mostly in the first year of use. The best long-term study found that children who took budesonide daily for several years ended up about 1.2 cm (roughly half an inch) shorter as adults than children on placebo, and the effect did not keep growing over time.

This guide explains what the studies found, how dose affects growth, and how families and doctors balance a small height effect against the benefits of controlling asthma. For more, see our asthma guides.

Jump to: Quick answer · The CAMP study · What reviews of many trials show · Dose matters · Weighing the risks · Tips for parents · FAQ

Quick answer

• Small, lasting effect: in the CAMP study, adults who took budesonide daily as children were 1.2 cm shorter on average than those who took placebo.
• Not progressive: the height difference seen after 2 years of treatment (1.3 cm) was about the same in adulthood; it didn’t keep adding up.
• Mostly in year one: a Cochrane review found growth slowed by about 0.5 cm in the first year, with no significant difference in the second year.
• Dose matters: higher doses were linked to more growth slowing, so doctors aim for the lowest dose that controls asthma.
• Don’t stop on your own. Talk to your child’s doctor before changing any asthma medicine.

The CAMP study: effects on adult height

The Childhood Asthma Management Program (CAMP), published in the New England Journal of Medicine in 2012, followed children who started treatment at ages 5 to 13. They were randomly assigned to 400 micrograms of budesonide a day, nedocromil (a non-steroid medicine) or placebo for 4 to 6 years. Researchers measured adult height in 943 of the original 1,041 participants, at an average age of about 25.

The researchers concluded that the early drop in height persisted into adulthood, but that it was not progressive or cumulative.

What reviews of many trials show

A 2014 Cochrane review pooled 25 trials with 8,471 children with mild to moderate persistent asthma. Compared with placebo or non-steroid medicines, inhaled corticosteroids reduced growth by about 0.48 cm per year during the first year of treatment. In the second year, there was no significant difference in growth rate. The size of the effect varied between different steroid medicines.

Dose matters

A companion Cochrane review looked at dose. In school-aged children, those on a higher dose grew about 0.2 cm per year less than those on a lower dose over 12 months. The authors concluded that, for prepubescent children with mild to moderate asthma, the results favor using a low dose.

Weighing the risks and benefits

For most families, the question is not whether to treat asthma, but how to treat it with the lowest effective dose. Uncontrolled asthma carries its own risks, including attacks, missed school, emergency visits and limits on physical activity. The height effect found in research is small, about half an inch, and doesn’t keep growing over years of use.

Talk with your child’s doctor about:

• Whether the current dose is the lowest that keeps asthma controlled
• Stepping down treatment once asthma has been well controlled for a while
• Reducing triggers at home to help keep the dose low

For home trigger control, see mattress and pillow covers, humidity control and spray cleaners and asthma. Our asthma FAQ covers the basics.

Tips for parents

• Keep giving the medicine as prescribed unless your child’s doctor changes it.
• Ask for height checks at regular visits so growth is tracked over time.
• Use the inhaler correctly, with a spacer if prescribed, so the dose reaches the lungs.
• Rinse the mouth after inhaled steroids if your doctor recommends it.
• Watch for night symptoms; see why kids’ allergies and asthma get worse at night.

This guide is general information, not medical advice. Read our medical disclaimer.

Frequently asked questions

Does Pulmicort stunt growth?

It can slow growth slightly, mostly in the first year. In the CAMP study, children who took budesonide for 4 to 6 years were about 1.2 cm shorter as adults than those on placebo.

Is the height loss from inhaled steroids permanent?

The CAMP study found the small height reduction persisted into adulthood, but it did not increase with longer treatment.

Do all inhaled steroids affect growth equally?

No. A Cochrane review found the size of the effect differed between steroid medicines, and higher doses had more effect.

Should I stop my child’s Pulmicort?

No, not without talking to the doctor. Uncontrolled asthma has its own risks. Ask whether the lowest effective dose is being used.

How much does budesonide affect height?

About 1.2 cm, or roughly half an inch, in adult height in the CAMP study, with a dose of 400 micrograms a day for 4 to 6 years.

Sources

• Kelly HW, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med. 2012;367(10):904-912.
• Zhang L, Prietsch SO, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: effects on growth. Evid Based Child Health. 2014;9(4):829-930.
• Pruteanu AI, Chauhan BF, Zhang L, et al. Inhaled corticosteroids in children with persistent asthma: dose-response effects on growth. Evid Based Child Health. 2014;9(4):931-1046.

Last reviewed: October 21, 2026.