Inhalers and nebulizers are two different devices used to deliver rescue or controller asthma medications directly into your child's lungs. Your child's doctor will decide what type of device is best for your child.
Nebulizers are electric- or battery-powered machines that turn liquid asthma medicine into a fine mist that's inhaled into the lungs. The child breathes in the mist through a mouthpiece or facemask (a plastic cup that covers the child's mouth and nose). Nebulizers vary in size and shape, but they can be somewhat bulky and noisy and may need to be plugged in.
A child doesn't have to "do" anything to receive the medicine, except stay in one place and accept the mouthpiece or facemask. It usually takes about 5 or 10 minutes to give a child medication by nebulizer, and sometimes even longer. Nebulizers may be less effective if a child is crying while they're being used, since less medicine is inhaled when a child is crying.
Inhalers are portable, hand-held devices that are available in two types:
Metered dose inhalers (MDI) are the most commonly prescribed. Like mini-aerosol cans, these devices push out a pre-measured spray of medicine. When the child squeezes the inhaler, a measured "puff" of medicine is released.
Dry powder inhalers deliver medicine in powder form, but it doesn't spray out. The child must do more of the work, by inhaling the powdered medicine quickly and quite forcefully (which is often difficult for very young children).
If your child uses a metered dose inhaler, he or she may also use a spacer, which attaches to the inhaler and makes it easier to use. A spacer is a kind of holding chamber for the medicine, which eliminates the need to closely coordinate squeezing the inhaler and inhaling the medicine. With an inhaler and spacer, the medicine can be inhaled slowly when the child is ready. So, it's possible for very small children and even babies to receive their medications using an metered dose inhaler with a spacer.
Spacers also make inhalers more effective. When using an inhaler without a spacer, the medicine may go into the back of the throat but may not actually move down into the lower airways. A spacer helps to deliver the medicine into the lower airways, which is where it needs to go to work properly.
Babies and small children use a facemask to inhale the medication held in the spacer, whereas older children can use a mouthpiece. It usually only takes a couple of minutes or less to give medication by metered dose inhaler with a spacer.
During an office visit, your child's doctor may ask your child to demonstrate using the inhaler. Then, the doctor can offer advice, if needed.
Whichever device your child's doctor recommends, learn how to use it so that you can teach your child to use it correctly. Improper usage may result in less medicine getting into your child's lungs. Your doctor can help educate you about how to use these devices. Practice at home helps, too.
If you have any questions about the type of device your child's doctor has recommended, or if you're concerned that your child isn't getting the proper dose of his or her medication, talk to your child's doctor.