By Dr. Suzanne Brixey, General Booth Pediatrics

Asthma affects millions of children each year in the United States, and poorly controlled or undiagnosed asthma can lead to hospital visits, missed work and school days, and suffering that many young children can’t express. Most children with asthma are prescribed some sort of inhaler. Incorrect use of an inhaler is common and unfortunately may lead to serious complications, and even death. We have effective medicines that help control asthma symptoms to allow your child to run, play and learn without any limitations.

Let’s review the two main types of asthma medication and how to properly use those medications.

Relievers

Relievers help relieve symptoms such as cough or wheeze once they have started. These medicines work quickly to help your child feel better by relaxing tight airway muscles and allowing your child to breathe easier.

The most common reliever medicine is albuterol, often given in an inhaler or nebulizer. Albuterol can have side effects including an increased heart rate, headache, trouble sleeping, or a jittery feeling. These side effects should not last long.

Controllers

Controller medicines are taken every day to control asthma. These medicines fight inflammation in your child’s airways and prevent asthma attacks. Depending on the severity of your child’s asthma, they may need to take these medicines one or two times a day, everyday, to keep symptoms under control.

Asthma medicine comes in a variety of forms. Your doctor will work with you to decide which is best for your child. Inhaling medications helps to get as much medicine as possible into your child’s lungs.

Using a Nebulizer – For Younger Children

A nebulizer is a machine that turns liquid asthma medicine into a mist that your child can inhale. The machine consists of a small air compressor with a tube running out of it. The tube attaches a medicine cup to either a mouthpiece or face mask, depending on which works best for your child. The asthma medicine is poured into the cup, and once the machine is turned on, the child inhales the medication through the mouthpiece or face mask. The child or parent must hold the mask so there is a firm seal between the mask and the face to ensure the child gets the right amount of medicine.

Using Dry Powder Inhalers (DPI) – Older Children and Teenagers

A dry powder inhaler (DPI) is a small plastic device that dispenses asthma medicine as a fine powder that the child inhales through the mouth. Your doctor will tell you how to use the DPI, and it’s important to follow these directions carefully. When used correctly, each inhalation delivers a specific amount of medicine. DPIs are usually for older children and teenagers.

Metered Dose Inhalers (MDI) - For all ages

A metered dose inhaler is a small device that releases a fine spray of medicine that can be inhaled. The inhaler releases a set amount of medicine with each puff. Your provider will tell you how many puffs your child should take.

It can be tricky to get the timing just right when using this kind of inhaler. Simple tools called “spacers” help make sure the medication is delivered into the lungs rather than sprayed to the back of the mouth or on the tongue. Spacers also help reduce the side effects of medication. We recommend that patients of all ages always use spacers with metered dose inhalers. Younger children often find it easier to use an MDI with a spacer with an attached mask. 

See videos below for how to use a spacer correctly with or without a mask.

Other Tips When Using a Spacer with your MDI

• If your child uses a spacer with a mask, make sure you or your child hold the mask firmly against the face so there is a tight seal.
• Always wait one minute between puffs of medicine. Do not spray two puffs at once.
• When taking controllers and relievers at the same time, take the reliever medicine first.

Your CHKD pediatrician is your main partner in helping to manage your child’s asthma. We recommend routine asthma checkups at least quarterly with the change of the seasons, more frequently for patients with severe asthma. Call your pediatrician if you suspect your child’s asthma is not controlled. Your pediatrician can help get your child on track for long-term control by helping create an asthma action plan so you understand what medications to administer and how to keep your child healthy. With the proper treatment, your child can live a healthy and active life.

To learn more about successfully managing your child’s asthma, read our Guide to Asthma here.

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About CHKD Medical Group

Children’s Hospital of The King’s Daughters has been the region’s most trusted name in pediatric care for more than 50 years. As members of CHKD Health System, our pediatricians work closely with CHKD’s full range of pediatric specialists and surgeons. They also share a commitment to quality, excellence and child-centered care. With 18 practices in 29 locations throughout the region, a CHKD pediatrician is never far.