One of the side-effects of the steroids is a huge increase in the patient’s appetite and calorie consumption. Hence, the child or young person frequently experiences large weight gain over a short period of time and develops the typical cushingoid features (moon face) that are associated with steroids. Even very small children can develop stretch marks. Unfortunately, as with adults, stretch marks in children and young people will never fully disappear but may fade with time and the use of creams. It is common for the child or young person to require a new wardrobe as none of their old clothes fit. This weight gain, when coupled with hair loss and the thought of returning to school and facing their peers, when they hardly recognise themselves, is often reported by the teenage group as one of the hardest aspects of treatment.
Unfortunately when the steroids are weaned and stopped, the child or young person’s appetite can disappear and they can then develop anorexia until their appetite evens out. Many parents/carers worry about over-feeding and then under-feeding, causing more anxiety at an already stressful time.
How we can support the child or young person and family:
- Reassurance that weight gain is temporary – link to nutrition section
- Dietetic input is available for all patients but it is very difficult to avoid weight gain and weight loss on certain protocols
- Staff are always available to discuss areas of concern and offer advice as appropriate
- The child or young person may be referred to the psychologist or play therapist
- Teenage and young adult (TYA) support group.
- Information for families to help manage children’s behaviour on steroids