How to help your child use an inhaler?
As I wrote in the important post – “inhalations or inhalers – a guide for beginners“, inhalers have an advantage on inhalation in almost every medical indication.
What is a spacer?
A spacer is a container used for dispensing the particles of the medication to the lungs of a child, who cannot use the inhaler directly with a synchronized breath.
In one end of the spacer there is a space for inserting the different inhalers, and on the other end a mask that covers the mouth and nose of the child. Using a spacer eliminate the need for synchronized breath (which is needed when using an inhaler).
So how do you use an inhaler?
Go with the specific directions from your physician, but usually the administration order will be like so:
Always start with Salbutamol (Ventolin/Salamol/Albuterol sulfate) inhaler, in a constant dose of 100 mcg. Start by sealing the mouth and nose of the child with the mask, until he is calm (though it is not the end of the world if he is not calm when starting). Then, press the inhaler attached to the other side of the spacer and wait with the mask on the child’s face for about 10 seconds. Then press the inhaler for the second time and wait 10 more seconds.
After that you can go on and use the Flixotide inhaler (comes in a variety of beige color, depending on the dosage). Dosage can be 50/125/250 mcg, as per the decision of your physician. I do not have a solid opinion on the dosage, since the consumer pamphlet and the manufacturer are very vague about it. So what do I do? In young infants (younger than one year old) I recommend using 50 mcg. In older children (1-4 years) 125 mcg, and in children older than 4 years, where there are alternatives to this inhaler, I recommend using the 250 mcg inhaler.
The process is the same as it was with the Salbutamol inhaler (pressing the inhaler, waiting 10 seconds and repeating the process).
At the end of each treatment you should let the child drink a little water (or formula) to wash the rest of the steroids from the mouth, and prevent the development of oral Candida.
The treatment with inhaler is usually given twice a day. If needed – the physician can recommend additional treatments throughout the day, though it will usually be just Ventolin, without steroids.