Help your child use their inhaler

Using the right inhaler technique means your child gets the best from their asthma medicines.

Most asthma medicines come inside inhalers designed so the medicine can be taken into the lungs and go straight to the airways, where it’s needed. Most children with asthma are prescribed the two main types of asthma inhaler – a daily preventer inhaler to help protect their airways and reduce the chance of triggers causing asthma symptoms and a reliever inhaler (usually blue) for on-the-spot relief if symptoms do come on.

Helping your child use an inhaler might feel a bit daunting at first, especially if you don’t already know anyone close to you with asthma. And when you’re first given your child’s facemask or spacer, getting your head around how they work with the inhaler might seem impossible!

If you do feel overwhelmed, you might find it helpful to recall something new that daunted before – using a new mobile phone or starting a new job, for example. You can then remind yourself that things that feel strange at first can soon feel like second nature with enough practice.

And remember that your child’s GP or asthma nurse is there to support you and your child – so ask as many questions as you need to. And our Helpline asthma nurse specialists are here to support you too on 0300 222 5800 (9am – 5pm; Mon – Fri).

Inhalers are a great invention! Using one:

  • helps get the medicine straight into your child’s airways where it’s needed
  • means your child is likely to get fewer side effects because not much of the medicine is absorbed into the rest of their body
  • means medicine can get to your child’s lungs quickly – this is especially useful when they’re using their reliever inhaler (usually blue) because it can stop asthma symptoms in their tracks.

More information

Top tips to help your child get the best from their inhaler

Helping babies

Helping toddlers

Helping older children

Top tips to help your child get the best from their inhaler

1. Make sure you know the correct technique

Some parents have told us that helping their child use their inhaler, usually with a facemask or spacer, can be tricky. And even if you think your child's inhaler technique is correct, it might not be! A survey we carried out found that up to a third of people with asthma aren't using their inhaler in the right way.

If your child isn’t using their inhaler correctly, they might not be getting the full dose of medicine their GP or asthma nurse prescribed because some of the medicine might be hitting the back of their throat, sitting on their tongue or staying in their mouth where it’s no help at all. It may also mean your child is more likely to get side effects from their preventer inhaler, such as oral thrush or a sore throat. Your child needs to use the correct inhaler technique so the medicine can get down into their lungs where it’s needed.

Checking you know the correct technique is one of the most important things you can do to help manage your child’s asthma well.

Why not:

  • ask your GP or asthma nurse to check your inhaler technique each time your child has an asthma review
  • ask a pharmacist to check your inhaler technique when you next pick up your child’s medicines
  • watch these videos for some useful tips.

Once you’re sure you understand the correct inhaler technique, you can feel confident about using it and teaching it to your child. You can also feel reassured that you’re doing everything you can do help prevent asthma symptoms and cut their risk of an asthma attack.

2. Understand the type of inhaler and spacer your child’s using

There are lots of different types of inhalers and spacers that work in different ways. Most children are prescribed what’s called a metered dose inhaler (also known as an MDI) with a spacer. Some older children may be prescribed what’s called a ‘breath actuated’ inhaler. Your child’s GP or asthma nurse will explain which type(s) of inhaler they need and why.

If your child is going through a trial of treatment because they have suspected asthma, is newly diagnosed with asthma or has recently been given a new type of inhaler, it’s important that you, and your child if they’re old enough, understand how their inhaler works. Why not:

  • read the Patient Information Leaflet (PIL) that comes inside the box
  • ask your child’s GP, asthma nurse or consultant to explain how it works
  • ask a pharmacist to run through the information with you
  • call our Helpline on 0300 222 5800 (9am – 5pm; Mon – Fri) to speak to one of our friendly nurse advisers.

3. Check your child’s inhalers and spacers are the right ones for the stage they’re at

As your child gets bigger, the asthma inhalers and spacer they use might need to change so they’re still using the right ones. If they’re not, each dose of asthma medicine won’t be able to get to their lungs to help prevent symptoms and cut their risk of an asthma attack.

If you take your child for an asthma review every six months, your child’s GP or asthma nurse will check they’re using the right inhalers and spacer. If you haven’t taken your child to a review or appointment about their asthma for a while, book in now to check they’re using the right inhalers.

4. Learn how to clean and store your child’s inhalers and spacer properly

Cleaning and storing your child’s inhalers and spacer properly will make sure they can work in the best way possible.

  • You can find some top tips for cleaning your child’s inhalers here.
  • Wash your child’s spacer at least once a month. Use washing-up liquid and leave to air-dry.
  • Make sure your child’s spacer is replaced at least once a year – or sooner if it’s damaged in any way.
  • Always store your child’s inhalers with the cap on so nothing can get stuck in the mouthpiece.
  • Don’t leave your child’s inhaler where it might get too hot or too cold (in the car or conservatory, for example) because extreme temperatures can affect the way it works.

5. Get into a good routine with your child’s preventer inhaler

The protective effect of your child’s preventer inhaler builds up over time so they need to take their preventer inhaler every day (usually morning and evening) even when they’re feeling well. Try these top tips:

  • Research shows you’re more likely to remember to give your child their medicine every day if you link it to a habit, such as brushing their teeth. If your child rinses their mouth out and brushes their teeth afterwards, it helps to prevent potential side effects such as a sore throat. Keep the inhaler and spacer out on a bathroom shelf so you’ll see them and be reminded.
  • Set a reminder app on your phone or write yourself a note in your diary or in your calendar.
  • Ask family or friends to remind you, especially if your child’s only recently started using an asthma inhaler or when you’re out of your usual routine – on holiday, for example.
  • Make it fun so that your child links taking their inhaler with something positive. Some parents have told us they’ve found it helpful to decorate their child’s inhaler or spacer with stickers, do a special handshake or fist bump after each time they take it or make a silly dance together part of the routine. 

6. Always make sure your child can get to their reliever inhaler

Your child’s reliever inhaler (usually blue) gives them on-the-spot relief from asthma symptoms and asthma attacks, relaxing their airways very quickly. They need to keep their reliever inhaler with them all the time so they can use it as soon as you or they notice asthma symptoms. They should feel a difference to their breathing within a few minutes. Try these top tips to make sure they always have it handy:

  • Get your child a special bag or rucksack to carry their reliever inhaler and spacer around, or a special box they can keep in their school bag.
  • Keep a reliever inhaler in their bedroom and somewhere downstairs – and make sure your child knows where they are.
  • Make sure your child keeps a spare reliever inhaler at nursery or school and anywhere they go often – at a grandparent’s house, for example.

Helping babies

Spacers with facemasks can be used with babies or with younger children who find it hard to use an ordinary spacer with a mouthpiece. If your child’s younger than one they’ll probably use an orange spacer and mask. Around their first birthday they’ll probably be given a slightly bigger yellow spacer and mask.

Try these tips:

  • Wash your hands.
  • Cradle your baby in your arms.
  • Remove the cover from the mouthpiece of the inhaler.
  • Holding the inhaler upright, shake it before each puff so that the medicine will work well.
  • Insert the inhaler into the end of the spacer.
  • Place the end of the spacer with the facemask over your child’s nose and mouth.
  • If the baby is in lying back in your arms you will need to hold the spacer at a 45 degree angle.
  • Make sure that the mask is creating a really good seal over your baby’s mouth and nose so that no medicine can escape.
  • Press the top of the inhaler to give a dose of medicine.
  • Count to ten at a slow pace (“one and two and three….”)
  • Wait at least a minute before giving another dose.
  • When you have finished, remove the inhaler from the spacer.
  • Put the cover back over the mouthpiece and store the inhaler and spacer somewhere safe.
  • Use a damp cloth to wipe your baby’s skin under the mask after every use.

“When Emelia was first given an inhaler the asthma nurse at the doctor’s surgery showed me how to use it with a spacer which has a baby mask. She's always been a placid child, so I'd cuddle her on my lap and we got used to it pretty quickly.” - Maria Brain, mum to Emelia, 7.

“When the boys were really little and didn’t like putting the mask over their nose and mouth, we’d make it fun to stop them fussing. In between each puff of the inhaler, we’d count ‘one motorbike, two motorbike’, and we’d do the noises and actions in between – brum brum.” - Anna Bonnett, mum to Gabriel, 10, and Beau, 5.

Helping toddlers

If your child is younger than five, they need to use a spacer with their inhaler, and they may need to use a spacer with a facemask until they’re ready to use a spacer with a mouthpiece. Your GP or asthma nurse talk to you about which ones are right for your child at their asthma review every six months.  

Try these tips:

  • Wash your hands.
  • Cuddle your child in a comfortable position on your lap, facing away from you.
  • Remove the cover from the inhaler mouthpiece.
  • Holding the inhaler upright, shake it before each puff so that the medicine will work well.
  • Insert the inhaler into the end of the spacer.
  • If your child’s using a spacer with a facemask, make sure that the mask is creating a really good seal over their mouth and nose so that no medicine can escape.
  • If your child’s using a spacer with a mouthpiece, ask them to close their lips around it to make a really good seal.
  • Press the top of the inhaler to give a dose of medicine.
  • Tell your child to breathe in slowly and deeply a few times as your GP or asthma nurse has shown you.
  • Wait at least a minute before giving another dose.
  • When you have finished, remove the inhaler from the spacer.
  • Put the cover back over the mouthpiece and store the inhaler and spacer somewhere safe.

“When Charlie first needed to use an inhaler, we decorated his spacer with superhero stickers to make it look more appealing and not scary. We counted his breaths slowly and gave him a big clap and cheer at the end so he thought he'd done something really amazing - which of course, he had!” - Jo Brocklehurst, mum to Charlie, 7.

“Most of the time Sami is okay taking his preventer inhaler. If he has the odd temper tantrum about taking it, it tends to be short-lived because he knows he can’t win. I’m really firm. He knows he has to take it whether he wants to or not. ‪I do get frustrated, especially when we are in a hurry, but I have to stay calm, and tend to bribe him by saying, ‘You will not get a treat if you don't take your inhaler’, and it usually works.” - Shakeela Riaz, mum to Sami, 6.

Helping older children

As your child gets older, it makes sense for them to continue to use a spacer because spacers hold the medicine inside them, so your child doesn't have to worry about pressing the inhaler and breathing in at exactly the same time. This makes inhalers easier to use and more effective. Using a spacer also helps to prevent possible side-effects, such as thrush and a sore throat.

Remind them to:

  • Wash their hands.
  • Remove the cover from the inhaler mouthpiece.
  • Holding the inhaler upright, shake it before each puff so that the medicine works well.
  • Insert the inhaler into the end of the spacer.
  • Put the mouthpiece in their mouth and close their lips around it to make a really good seal.
  • Press the top of the inhaler to give a dose of medicine.
  • Breathe in slowly and deeply a few times, as their GP or asthma nurse has shown them.
  • Wait at least a minute before having another dose.
  • Remove the inhaler from the spacer when they’ve finished.
  • Put the cover back over the mouthpiece and store the inhaler and spacer somewhere safe.

“When Emmie was younger she would take her blue reliever inhaler whenever we told her she had to have it. As she’s getting a bit older, we sometimes get into the scenario where she’s wheezing and I say, ‘I think you need your inhaler.’ If she’s busy or distracted she’ll say, ‘No I’m fine, Dad,’. It feels a bit like nagging, but I try to stay calm and remind her of past experiences. She’s a good girl so she doesn’t usually need much persuading.” - Scott Brain, dad to Emelia, 7.

“The boys both still use a spacer because they can’t grasp the proper breathing technique yet. I watch them taking their preventer inhaler every morning and evening.” - Shakeela Riaz, mum to Salis, 11, and Sami, 6.

“Taking our preventer inhalers is part of the routine of life in our house. The boys don’t make a fuss about taking them because they both remember what it’s like to get symptoms and understand that the medicine helps to prevent them feeling bad." - Anna Bonnett, mum to Gabriel, 10, and Beau, 5.

“Zak’s going to senior school later this year so I’ve given him more responsibility to look after his own medicines. For the last couple of years I’ve waited to see if he remembers to take his inhaler before I tell him, and now he ends up reminding me! I’ve also set an alarm on my phone to remind me.” - Hayley Wing, mum to Zak, 10.