Steroids and Child Behavior
This handout will explain how certain steroid medicines may cause changes in your child’s behavior and moods.
What are steroids?
Steroids are used for many reasons. Steroids help suppress the immune system. They can be used to help prevent nausea or as part of treatment for many diseases. They can be given as pills, liquids, or in an IV.
Children may have very few symptoms from steroids, or they may have more marked symptoms. It is hard to predict how they will affect your child. Once your child starts taking steroids, symptoms may not begin for a few days. Symptoms may show up more if the child is on a steroid for a longer time. Steroids can be slow to leave the bloodstream, so side effects may go on for weeks after treatment is stopped.
Behavior side effects of steroids
- Mood changes, such as being fussy, tearful, sad, or depressed
- "Roller coaster" mood swings, shifting rapidly and sometimes unpredictably.
- Increased hunger, which makes it appear that the child is very focused on food
- Problems falling or stay asleep. (Giving the last dose late in the afternoon instead of bedtime may help with this. Discuss this first with your child’s nurse or doctor.)
- Nightmares
- Feeling nervous or anxious
- Feeling restless
- Hyperactivity
- Seeing or hearing things that are not there. Your child’s doctor should be told if this occurs.
- Trouble staying on task
- Acting withdrawn
- Easily frustrated
- Feeling more angry or quick to strike out with words or actions
Physical side effects (These may also have an impact on your child’s mood and self-esteem.)
- Change in looks such as weight gain, holding on to extra fluid, rounded face, fuller belly, and acne in teens
- Pain (such as muscle cramps)
- Indigestion
- Extreme sensitivity to lights, sounds, motion
- Itching
- Red/flushed cheeks
- Growth of body hair
How parents can help
Showing extra tender care and support will help when your child is on steroids. While structure and limits need to be maintained, parents should know that children taking steroids might have reduced control over their moods and behavior. Parents can think about limits they feel need to be maintained and which limits can be “relaxed” during this time.
Tips for helping your child while on steroids
- Try to distract your child, such as playing a special game, having them help cook or bake, reading a book, watching a movie or doing a craft. This will help your child focus away from their upset or angry mood. if the child's safety is at risk, setting limits may be needed.
- “Time out” to unwind and settle may help your child if it is not used as punishment. The rule of thumb is that the “time out” should last the number of minutes that equals your child’s age. Be aware that this method may also make his/her mood more extreme.
- Try to help your child avoid extreme emotional events. Watch for “triggers,” which might cause a certain mood change.
- As a parent, you may need to remove yourself from a very stressful time (when it is safe to do so and only for a short time).
- Avoid extra noise, events, or activities that may excite your child too much.
- Help your child prepare for stressful times (for instance, you may help your child think ahead about how they may handle it or try to avoid these times).
- Provide reassurance, support, and understanding to your child.
- Teach your child techniques to relax such as deep breathing, calming music, imagining peaceful places/activities or relaxing his/her muscles.
- Have your child get plenty of sleep.
- Provide a set routine when you are able.
- Teach the older child calming self-statements such as, “I can feel better by taking some deep breaths.” “Counting to ten may help me calm down.” “The medicine I’m taking may be making me feel cranky.”
Note: Certain medicines may be helpful to manage extreme behavior caused by steroids. Discuss this option with your doctor if you are concerned with your child's behavior.
Summary
Steroids can result in marked changes in your child’s moods. These changes can disrupt parent and family coping. Feel free to call members of your health care team (such as health psychologists, social workers, nurse practitioners, nurses, or doctors). They can provide you and your family with help and support.
Phone Number: 608-________________Monday – Friday 8:00am- 5:00pm
Toll free: 1-800-323-8942, and ask for your child’s UW Health clinic________________.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 02/19/2010
Copyright © 02/19/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6211
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