Is Your Child Using Too Many Steroids to Manage Their Asthma?

A woman and a young girl are sitting on a couch having a serious conversation. The woman has dark hair and wears a checkered shirt, while the girl has curly hair with a pink bow and wears a pink shirt with overalls.

Researchers conducted an online survey to learn what parents know about OCS, how often they give it to their child, and the risks associated with frequent use over a child’s lifetime.

At-a-Glance: Understanding Oral Corticosteroids (OCS) for Children

  • The Cause: Severe asthma symptoms often lead to the use of strong oral corticosteroids (like syrups, pills, or tablets) to stop an attack quickly.
  • The Impact: Most parents (92%) say these steroids work well, but 92% of children taking them still have asthma that is not under control.
  • The Treatment: Steroids are meant for short-term help; they do not replace the daily inhalers that keep lungs healthy over time.
  • The Action: Talk to your doctor about a daily plan to help your child breathe well so they do not need to take strong steroids as often.
  • Special Note: Using steroids too many times can lead to other health issues, so always follow your Asthma Action Plan.

Asthma and OCS basics

Asthma is a common condition in children that causes the airways to swell and narrow. When a child has an asthma attack or flare-up, doctors often prescribe oral corticosteroids (OCS) to quickly reduce inflammation.

While OCS are good at stopping severe symptoms, they are intended for short-term “emergency” use. Taking OCS too often (even short courses over a lifetime) can lead to serious long-term health problems. Managing asthma effectively with “controller” medications (like daily inhalers) or biologic medicines is the best way to reduce the need for OCS.

  • Text graphic with a blue background that says: "Researchers conducted an online survey to learn what parents know about OCS and the risks associated with frequent use over a child’s lifetime." Allergy & Asthma Network logo at bottom.
  • Infographic comparing a fire truck and a smoke alarm. The fire truck is for emergencies, while the smoke alarm keeps you safe every day. Includes simple icons and text from the Allergy & Asthma Network.
  • Infographic titled "The Red Flag" with an image of a white flag and the number 2. Text says 2 or more steroid prescriptions in one year is a red flag for asthma, suggesting a plan review. Allergy & Asthma Network logo at bottom.
  • A graphic from Allergy & Asthma Network explains that steroids can make kids feel grumpy or scared, which is a side effect, and advises talking to a doctor if this occurs. An icon of a sad person is shown.
  • Informational graphic titled "Take home points" lists ways to stop the "steroid cycle": track steroid usage, learn the "Two Times" Rule, talk to a specialist, use daily controller inhalers. Allergy & Asthma Network logo at bottom.

What did the OCS Parent Perception Study find?

A group of researchers shared an online survey for parents of kids with asthma. Here is what they learned:

  • 92% of children had asthma that was considered “uncontrolled.”
  • Too much OCS: Many kids took steroids 3 or more times a year.
  • Parents feel they are safe: Most parents think these steroids are safe. They like how fast the steroids work.
  • Knowledge Gap: While 69% of parents knew about short-term side effects, only 54% were familiar with the long-term risks.

Why does this matter?

Steroids are like a “fire truck.” They are great for putting out a big fire (an asthma attack). But you don’t want a fire truck parked at your house every week.

If a child takes these steroids too often, it can lead to:

  • Mood changes: Feeling very angry, sad, or worried.
  • Growth issues: The child might not grow as tall as they could have.
  • Weak bones: Their bones could break more easily.
  • Other health problems: Like weight gain or heart issues.

What should parents do?

The goal is to stop the “steroid cycle.”

  1. Track steroid usage: Count how many times your child takes a “round” of steroids.
  2. The “Two Times” Rule: If your child needs these steroid rounds 2 or more times a year, their asthma is not controlled.
  3. Talk to a specialist: Ask your healthcare provider, “How can we stop my child from needing these steroid rounds?”
  4. Use daily inhalers: Make sure your child uses their daily “controller” inhaler every single day, even when they feel fine. This helps prevent the “fires” before they start. If they dont, you need to see your asthma specialist, you may need to change medicines.
A blue circular icon with a yellow border featuring two white, stylized human figures; one larger and one smaller, representing an adult and a child.

Insights on OCS Use and Safety

  • Mood Matters: Mood changes were the most common short-term side effect reported by parents.
  • Hidden Risks: Frequent “short rounds” of OCS can add up over time, increasing the risk of issues like bone density loss, growth suppression, and even cardiovascular disease later in life.
  • The Goal of “Zero OCS”: Modern asthma care aims to reduce OCS use to the lowest amount possible by using controller medications, improved inhaler techniques and when needed other treatments, such as biologics. .
  • Communication is Key: Many parents don’t realize that 2 or more OCS courses a year is a red flag. Always tell your specialist if your child received “steroids” from an urgent care or ER.
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“Can we get a quote from a parent about the subject?” 

— quote author.

Perception of Oral Corticosteroid Use for Children with Asthma in a Survey of US Caregivers
Ramirez, N.C., Hernandez-Trujillo, V., Sumino, K., Williams, D., Patel, M., & Gardner, D.D.
2025
Frontiers in Pediatrics.
DOI: 10.3389/fped.2025.1608425