Breathing Problems: Helping a Child Use a Metered-Dose Inhaler and Mask Spacer


A metered-dose inhaler (MDI) with a regular spacer has a mouthpiece that some younger children find hard to use. But a mask spacer that fits over the mouth and nose can make the inhaler easier to use.

Using an MDI with a mask spacer:

  • Helps get the right amount of medicine into your child's lungs.
  • Can help keep your child's asthma symptoms under control and allow your child to live an active life.
  • May prevent or reduce side effects of the medicine.
  • May let your child use less medicine than is found in a pill but get the same effect.
  • May result in the medicine working faster than a pill form.

How to help your child use the inhaler

Before using a metered-dose inhaler (MDI) with a mask spacer:

  • Talk with your doctor about how to use it. Be sure your child uses it just as the doctor prescribes.
  • If your child is old enough, teach them how to check to make sure it's the right medicine. If your child uses several inhalers, label each one. Then make sure your child knows what medicine to use at what time. You might try using colored stickers to teach the difference between medicines.
  • Keep track of how many puffs of medicine are in the inhaler. This may help you keep from running out of medicine. Refill the prescription before the medicine runs out. Ask your doctor or pharmacist to show you how to keep track of how much medicine is left.
  • If your child is using corticosteroids, have your child gargle and rinse their mouth with water after use.

Using a metered-dose inhaler with a mask spacer

Shake the inhaler and remove the cap: Step 1

Removing cap from mouthpiece of inhaler.
slide 1 of 5
slide 1 of 5, Shake the inhaler and remove the cap: Step 1,

Shake the inhaler, and remove the inhaler cap. Check the inhaler instructions to see if you need to prime your inhaler before you use it. If it needs priming, follow the instructions on how to do so.

Hold the inhaler upright and insert it into the spacer: Step 2

Inserting inhaler into end of mask spacer.
slide 2 of 5
slide 2 of 5, Hold the inhaler upright and insert it into the spacer: Step 2,

Hold the inhaler upright with the mouthpiece at the bottom, and insert the inhaler into the end of the mask spacer.

Place the mask spacer: Step 3

Adult placing mask of spacer over child's mouth and nose.
slide 3 of 5
slide 3 of 5, Place the mask spacer: Step 3,

Place the mask spacer securely over your child's mouth and nose, being sure to get a good seal. The mask must fit snugly, with no gaps between the mask and the skin.

Press down on the inhaler: Step 4

Adult holding mask spacer over child's nose and mouth, while pressing down on inhaler to release medicine into spacer.
slide 4 of 5
slide 4 of 5, Press down on the inhaler: Step 4,

With the mask spacer in place, press down on the inhaler to spray one puff of medicine into the spacer.

Have your child breathe in the medicine: Step 5

Adult holding mask spacer over child's nose and mouth, while child breathes in medicine from spacer.
slide 5 of 5
slide 5 of 5, Have your child breathe in the medicine: Step 5,

Keep the mask spacer in place and have your child breathe in and out normally for 5 to 6 breaths. This is how long it takes to breathe in all the medicine.

If your child needs another puff of medicine, wait 30 to 60 seconds and repeat steps 4 and 5.


Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
John Pope MD - Pediatrics
Adam Husney MD - Family Medicine
Martin J. Gabica MD - Family Medicine

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