Overview

A metered-dose inhaler lets your child breathe medicine directly into the lungs. Inhaled medicine works faster than the same medicine in a pill. An inhaler lets your child take less medicine than would be taken if it were taken as a pill.

"Metered-dose" means that the inhaler gives a measured amount of medicine each time your child uses it. This type of inhaler delivers medicine in the form of a liquid mist.

The doctor may want your child to use a spacer with the inhaler. A spacer is a chamber that attaches to the inhaler. The chamber holds the medicine before your child inhales it. That way, your child can inhale the medicine in as many breaths as needed. Doctors recommend using a spacer with most metered-dose inhalers. This is even more important when using corticosteroid medicines.

A regular spacer has a mouthpiece. Some younger children have a hard time using it. They may need a face mask with a spacer instead. Your child can use the face mask instead of the mouthpiece. The mask fits over the child's mouth and nose.

How does your child use a metered-dose inhaler?

To get started

• Ask the doctor, nurse, respiratory therapist, or pharmacist to watch your child use the inhaler the first time. It might help if your child practices using it in front of a mirror. Be sure your child uses the inhaler exactly as prescribed.
• Check that your child has the correct medicine. If your child uses several inhalers, put a label on each one so that your child knows which one to use at the right time.
• Keep track of how much medicine is in the inhaler. Check the label to see how many doses are in it. If you and your child know how many puffs to take, you can replace the inhaler before it runs out. Your doctor or pharmacist can teach you and your child how to keep track of how much medicine is left.
• Talk to your health care provider about your child using a spacer with an inhaler. Spacers make it easier to get the medicine into your child's lungs. Your child may need a spacer when using corticosteroid medicines. A spacer can also help if your child has problems pressing the inhaler and breathing in at the same time.
• If your child is using corticosteroids, have your child gargle and rinse their mouth with water after use. Or have your child brush their teeth and spit after using the inhaler. Do not let your child swallow the water. Swallowing the water will increase the chance that the medicine will get into the bloodstream. This may make it more likely that your child will have side effects from the medicine.

To use a spacer with an inhaler

1. Have your child shake the inhaler. Remove the inhaler cap, and place the mouthpiece of the inhaler into the spacer. Check the inhaler instructions to see if you need to prime the inhaler before you use it. If it needs priming, follow the instructions on how to prime it.
2. Remove the cap from the spacer.
3. The inhaler should be upright with the mouthpiece at the bottom.
4. Have your child tilt their head back a little and breathe out slowly and completely.
5. Place the spacer's mouthpiece in your child's mouth.
6. Have your child press down on the inhaler to spray one puff of medicine into the spacer. Then have your child take one deep, slow breath. Have your child hold their breath for 10 seconds. This will let the medicine settle in the lungs. Some spacers have a whistle. If you hear it, have your child breathe in more slowly.
7. If your child needs to take a second dose, wait 30 to 60 seconds. This lets the inhaler valve refill.

To use an inhaler without a spacer

1. Have your child shake the inhaler as directed. Remove the cap. Check the inhaler instructions to see if you need to prime your child's inhaler before you use it. If it needs priming, follow the instructions on how to prime it.
2. The inhaler should be upright with the mouthpiece at the bottom.
3. Have your child tilt their head back a little and breathe out slowly and completely.
4. The inhaler can be positioned in one of two ways:
   • The inhaler mouthpiece can be in your child's mouth. This method is easier for most children. It also lowers the risk that any of the medicine will get into the eyes.
   • Or the mouthpiece can be held 2.5 to 5 centimetres (1 to 2 inches) in front of your child's open mouth. With this method, the lips should not be closed over the mouthpiece. Instead, your child's mouth should be open as wide as possible. This method, with the mouthpiece in front of your child's open mouth, may be better for getting the medicine into the lungs. But some children may find it too hard to do.
5. Your child can start taking slow, even breaths through the mouth. Press down on the inhaler one time. Then have your child inhale fully.
6. Have your child hold their breath for 10 seconds. This will let the medicine settle in the lungs. If your child needs to take a second dose, wait 30 to 60 seconds to let the inhaler valve refill.