are two different devices used to deliver
asthma medications directly into your child's lungs. Your
child's doctor will decide what type of device is best for your
Inhalers are portable, hand-held devices that are available in
Metered dose inhalers (MDI)
are the most commonly prescribed. Like mini-aerosol cans, these
devices push out a pre-measured spray of medicine. When the child
squeezes the inhaler, a measured "puff" of medicine is
Dry powder inhalers
deliver medicine in powder form, but it doesn't spray out. The
child must do more of the work, by inhaling the powdered medicine
quickly and quite forcefully (which is often difficult for very
If your child uses a metered dose inhaler, he or she may also
, which attaches to the inhaler and makes it easier to use. A
spacer is a kind of holding chamber for the medicine, which
eliminates the need to closely coordinate squeezing the inhaler and
inhaling the medicine. With an inhaler and spacer, the medicine can
be inhaled slowly when the child is ready. So, it's possible
for very small children and even babies to receive their
medications using an metered dose inhaler with a spacer.
Spacers also make inhalers more effective. When using an inhaler
without a spacer, the medicine may go into the back of the throat
but may not actually move down into the lower airways. A spacer
helps to deliver the medicine into the lower airways, which is
where it needs to go to work properly.
Babies and small children use a facemask (a plastic cup that
covers the child's mouth and nose) to inhale the medication
held in the spacer, whereas older children can use a mouthpiece. It
usually only takes a couple of minutes or less to give medication
by metered dose inhaler with a spacer.
During an office visit, your child's doctor may ask your
child to demonstrate using the inhaler. Then, the doctor can offer
advice, if needed.
Nebulizers are electric- or battery-powered machines that turn
liquid asthma medicine into a fine mist that's inhaled into the
lungs. The child breathes in the mist through a mouthpiece or
facemask. Nebulizers vary in size and shape, but they can be
somewhat bulky and noisy and may need to be plugged in.
A child doesn't have to "do" anything to receive
the medicine, except stay in one place and accept the mouthpiece or
facemask. It usually takes about 5 or 10 minutes to give a child
medication by nebulizer, and sometimes even longer. Nebulizers may
be less effective if a child is crying while they're being
used, since less medicine is inhaled when a child is crying.
Whichever device your child's doctor recommends, learn how
to use it so that you can teach your child to use it correctly.
Improper usage may result in less medicine getting into your
child's lungs. Your doctor can help educate you about how to
use these devices. Practice at home helps, too.
If you have any questions about the type of device your
child's doctor has recommended, or if you're concerned that
your child isn't getting the proper dose of his or her
medication, talk to your child's doctor.
Elana Pearl Ben-Joseph, MD
Date reviewed: May 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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