Inhalation of asthma medicines directly into the lungs is by far the most efficient way to ensure your son gets the treatment he needs to either prevent or treat asthma.
It's especially important in asthma that medication is taken as prescribed, because missing doses or not getting the full dose can leave a child vulnerable to an attack.
If there's a chance your son isn't getting the full dose, go back to your doctor and talk about this. Alternatively, lots of practices these days have a specialised asthma nurse who's trained to help children learn how to use inhalers and deal with any problems that arise.
Spacer devices
The standard recommendation for children under five with chronic stable asthma is routine treatment with inhalers, which deliver two types of medicine:
Steroid treatments, which reduce inflammation of the airways, are the most effective preventers in adults and older children, and are increasingly used in small children. Relievers consist of bronchodilator medicines, which open the breathing tubes.
Both these types of medication are delivered to the lungs using a pressurised metered dose inhaler (which your son has been given) and a spacer system. If you don't have a spacer device - which looks like a large rigid plastic balloon that attaches to the inhaler - ask your doctor for one.
Inhalers need a bit of skill to use properly, as the child must activate the inhaler and inhale at the same time. The spacer device helps because it catches the medicine and allows the child to breathe it in at a less coordinated pace over several breaths.
There are various slightly different inhaler/spacer devices and it's sometimes worth trying different ones because children can work some and not others.
Some children find a face-mask attachment easier to use than a mouthpiece. If you don't have one of these, again ask your doctor.
Other options
If your son can't get to grips with this system, there are two other options: a nebuliser or a dry powder inhaler system.
Nebulisers are a more reliable way to deliver the treatment but are bulky and difficult to carry around. One option may be to use a nebuliser at home and an inhaler/spacer while out and about.
Help your son to persevere with his inhaler/spacer system. With practice and support, most small children manage surprisingly well.
This article was last medically reviewed by Dr Trisha Macnair in October 2007
