Using a spacer with your child

Why spacers are important

A spacer has a mouthpiece at one end and a hole for the aerosol inhaler at the other. Spacers only work with an aerosol inhaler. If your child is under the age of three, or unable to use the mouthpiece, you will probably need to use a face mask as well.

There are several different brands of spacer that fit different inhalers and are available on prescription (including Volumatic (pictured), Nebuhaler, AeroChamber and Able Spacer)

Spacers are very important because:

• they make aerosol inhalers easier to use and more effective
• you get more medicine into your lungs than when just using the inhaler on its own
• they are convenient and compact and work at least as well as nebulisers at treating most asthma attacks in children and adults
• they help to reduce the possibility of side effects from the higher doses of preventer medicines by reducing the amount of medicine that is swallowed and absorbed into the body.

How do I use a spacer with my child?

When you first get the spacer, wash it in warm soapy water and leave to drip-dry.

1. Fit the mask on to the spacer if necessary.
2. Shake the inhaler well.
3. Fit the inhaler into the opening at the end of the spacer.
4. Place the mask over your chld's face so it seals around the nose and mouth.
5. Press the inhaler once and allow your child to take five slow breaths in and out of the spacer. This is called tidal breathing.
6. Remove the inhaler and shake again.

Repeat steps two to six for each dose of medicine. Your doctor or asthma nurse will tell you how many puffs are needed. Always check with them if you are not sure and ask them to write this down on a personal asthma action plan for your child.

Remember:

• Only put one puff of medicine into the spacer at a time. If you put in more than one puff, the droplets of spray stick together and coat the sides of the spacer so your child actually gets less medicine.
• Wash your spacer once a month - leave it to drip-dry as this helps to prevent the medication sticking to the sides.
• Spacers should be replaced at least every year, especially if you use them daily.

Using a spacer and mask with babies

If you are finding it difficult to use a spacer and mask when giving medicine to your baby, try the following.

• Cuddle your baby on your knee or cradle the baby in your arms. Gently tuck your baby's arms out of the way with one hand if she/he tries to knock the mask away.
• Be positive and smile. Your baby will know if you are anxious.
• Gently stroke your baby's cheek with the mask so that she/he gets used to the feel of it.
• Use it when your baby is asleep.
• Wipe your baby's face after using a preventer.

Using a spacer and inhaler with children over two

Sometime between the ages of two and three, your child will learn to use a spacer without a mask.

• Show your child how to use their inhaler and spacer first without puffing medicine into it.
• Turn the spacer into a toy - decorate it with coloured stickers
• Turn it into a counting game. Count aloud as your child takes a deep breaths.
• Have a routine - set a time of day to give preventer medicine. It is best to do this before brushing teeth.
• Praise your child when she/he uses their spacer correctly.

Many parents find it difficult to use a spacer with very young children. Don't worry - you are not alone, but do keep trying. Getting a child to take inhaled medicine properly is the most important way to control their asthma.