https://www.gosh.nhs.uk/conditions-and-treatments/medicines-information/how-help-your-child-use-inhaler-0/

How to help your child use an inhaler

This page from Great Ormond Street Hospital (GOSH) explains how to help your child use an inhaler, with or without a spacer device. If you have any questions about your child’s medicine, please ask your family doctor (GP) or local community pharmacist.

What to do

Using a spacer device

Spacer devices can be used by children of any age, but are particularly recommended for those under the age of five years.

  1. Wash your hands. 
  2. Remove the cover from the inhaler mouthpiece and check for any obstruction.
  3. Hold the inhaler upright and give it a shake.
  4. Insert it into the end of the spacer device. 
  5. Hold the spacer at a 45 degree angle. 
  6. Place the mask over your child’s mouth or the mouthpiece in their mouth. 
  7. Press the top of the inhaler to give a dose of medicine. Ask your child to breathe in deeply a few times. 
  8. Wait at least a minute before giving another dose. 
  9. When you have finished, remove the inhaler from the spacer and put the cover back over the mouthpiece. 
  10. Keep the inhaler and spaced somewhere handy. 

Without a spacer device

Older children may have the coordination skills to be able to use the inhaler without a spacer.

  1. Wash their hands
  2. Remove the cover from the inhaler mouthpiece and check for any obstruction.
  3. Hold the inhaler upright and give it a shake while breathing out fully.
  4. Keeping the inhaler upright, put the mouthpiece in their mouth and close their lips around it so there are no leaks. 
  5. Press the top of the inhaler to give a dose of medicine. 
  6. Breathe in slowly and deeply through their mouth. 
  7. Hold their breath for about 10 seconds. 
  8. Breathe out and wait for at least a minute before taking another dose. 
  9. When they have finished, put the cover back over the mouth piece and keep the inhaler somewhere handy. 

Note: If your child is using a corticosteroid medicine inhaler, it is important to avoid a build-up of medicine in the mouth. We advise that your child rinse their mouth or brush their teeth after each dose.

Storing the inhaler and spacer safely

  • Keep all medicines out of the reach of children. 
  • Keep the inhaler handy at all times but out of direct sunlight. 
  • Check the package for instructions about cleaning the spacer device. 
  • Read the instructions on the label and only use the inhaler as directed.
  • Always check the expiry date of the medicine before you give it to your child.
Compiled by:
The Pharmacy department in collaboration with the Child and Family Information Group
Last review date:
April 2020
Ref:
2020F0749

Disclaimer

Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.

For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.  

For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.