Inhalers for children

Asthma inhalers for children

The most common way of inhaling asthma medication for both children and adults is to inhale it through the mouth using an asthma inhaler. The medicine will mostly come as a spray or a dry powder, but is also available as a liquid, which is inhaled through a nebulizer.

Both 'preventer' (brown inhaler) and 'reliever' (blue inhaler) types of medication can be inhaled. The preventer medication (anti-inflammatory corticosteroid) needs to be taken regularly, whereas the reliever medication (bronchodilator) can be taken when needed. The benefit of using an inhaler is that it delivers the medication straight into the lungs so that the symptoms may ease quickly. There are a variety of inhalers for children, different sizes and functions, which to different degrees will guide the child to use them correctly. The age and coordination skills of your child will also decide which inhaler is the most suitable.

In order to increase the chances of a successful asthma treatment, it is important to let the child try out an inhaler so that you will know immediately if the child can handle it. Let him or her get familiar with the inhaler before it is time to take the first dose. Then try to make the usage of the inhaler a part of everyday life, just like brushing teeth and explain why it is important to keep up the medication. In order for the medicine to reach its full effect, it is important that you feel comfortable in handling the inhaler and know how to do it correctly. Do not hesitate to contact your doctor or your pharmacy if you are in need of advice or are unsure if your child is receiving the correct dosage.

How do I know if my child is receiving the medication?

All inhalers available today have a relatively good capacity for delivering the asthma medication to the lungs. But not all of them give feedback on if they are being used correctly or not. That may lead asthmatic people to not getting the needed treatment in spite of using the inhaler every day. As a parent you should therefore choose an inhaler with a feedback function for your child. Such an inhaler is capable of both telling you when the right dose has been prepared in the inhaler and if the correct dose has been sufficiently inhaled. This makes it possible to know when you have to inhale more than once in order to receive the dose and thereby avoid inadvertent under-treatment. This is no less important when children are using their dry powder inhalers.

How are asthma inhalers for children used?


For children under the age of six years old, a spray inhaler connected to a breathing tube called a spacer usually works well. Using a spacer with a puffer makes it easier to take the medicine, and also gets more of the medicine into the lungs so it works better. A spacer is a plastic container with a mouthpiece (or mask for very young children) at one end and a hole for the inhaler at the other. The medicine is ‘fired’ from the puffer into the spacer and is then inhaled. The medication is first pumped into the spacer tube and the child may inhale it in his own pace. Generally, using a spacer with a puffer is much better than using a puffer alone.

Very young children may even need to use a tight mask around the mouth and nose but from three years old they are able to use the mouthpiece without wearing a mask. Some sprays devices are even activated by the inhaling and that may be a good option for younger children.

If two doses are needed, they should be taken separately. If the child has inhaled corticosteroid, the mouth should be rinsed in order to avoid fungus infections of the mouth and throat. If the child has been using a mask, it should be washed, as well as the facial skin. Some common sprays have no dose counters and it is therefore important to keep track of how many doses the child has taken and to keep a new inhaler in storage for when you are running out of doses. Always follow the instructions carefully.

Dry powder inhaler

From about six years old most children with asthma are using dry powder inhalers activated by their breathing. For adults, dry powder inhalers are usually easier to handle than spray inhalers but for small children it may be difficult to get a proper inhalation and therefore dry powder inhalers are not used under the age of five or six years old. Some dry powder inhalers you have to load yourself, while others come ready loaded with up to 200 doses.

If two doses are needed they should be taken separately, one after the other, just like when using a spray inhaler. Some powder inhalers have feedback functions showing if the child has been receiving the correct dose or not. This makes the parent able to make sure that the child has received their medication. It may for example, be a clicking sound or a viewing window changing colour based on if the child has inhaled the right dosage or not. Some inhalers even give off a sweet flavour after having been used. Some modern dry powder inhalers have dose counters showing how many doses are left. Make sure to have a new inhaler ready in your house before you run out of doses.


A nebulizer transforms liquid medicine into a fine aerosol inhaled through a mouthpiece or a mask. It is suitable for children since you may continue breathing normally taking the medicine. Ask your doctor or other health care professional to show you how to use the nebulizer.

UK/GEN/15/0056c       Date of preparation: December 2015 

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