They Say: Steroids No Help With Wheezing

So, your young child has had a cold for a few days and starts wheezing. Time for the doctor to prescribe one of the many steroid-based asthma treatments they typically use, right? Not so, according to studies published this week in the New England Journal of Medicine.

Apparently it’s not uncommon for a non-asthmatic child to develop wheezing as a symptom of a viral infection, and in most cases treating with steroids is no more helpful than giving a placebo. This non-asthmatic wheezing accompanying a cold can affect about one-third of young children, but the study reports that at least 75% outgrow it by the age of six.

In another study, a steroid treatment for wheezing was found to be helpful, but carried a risk of suppresion of growth. In an experiment comparing Flovent with a placebo, 129 children aged one to six were gien either Flovent or a placebo after presenting with an upper respiratory infection. The drug was found to be effective in many of the kids, but those treated with Flovent grew less — a small amount, but one that doctors worry could be magnified over time in kids who are frequently prescribed the drug.

As a doctor friend once told me, a very good question to ask when being prescribed any drug or treatment is, “what’s the downside of doing nothing?” It seems that, as with the demise of cold medicines for kids under six, wheezing treatments as well may soon be replaced by a simpler class of care: rest, fluids, and plenty of TLC.