As your child grows, his or her role in taking medicine slowly changes from passive to active. Eventually, your child will “graduate” from you giving the medication, to taking medication on his or her own. In real terms, that means moving from a nebulizer to a metered dose inhaler, or MDI.

An MDI delivers a premixed dose of aerosol medication through a mouthpiece or face mask. It doesn’t need electricity, so you can use it anywhere. It requires no major maintenance or medicine mixing. On the other hand, the success of delivery depends largely on technique — from the angle of the MDI to the way the child breathes in the medicine.

Children should use a spacing device with an MDI, according to the National Asthma Education and Prevention Program (NAEPP, a project of the National Institutes of Health). Spacers (or holding chambers) hold aerosol medication between breaths. When MDI technique is less than perfect (as is often the case), a spacer can help by increasing the amount of medication absorbed by the lungs.

When will your child be ready for an MDI and spacer? That depends on his or her health and abilities. Sometimes an MDI and spacer are introduced during the “I can do it myself” stage of child development (3 to 5 years old). Some doctors, on the other hand, prefer waiting until age 6 or older.

When it’s time to try an MDI and spacer, have your child’s health care provider show both of you the proper technique. You and your child should each try it while someone from the doctor’s staff watches and helps. The NAEPP recommends that children demonstrate their MDI and spacer technique for the doctor during every office visit.

The National Heart, Lung & Blood Institute offers the following suggestions for helping your child graduate from a nebulizer to an MDI and spacer:

• Teach one new device at a time. Allow 1-2 months of practice with one device before teaching your child how to master another.
• Let the child pretend to give an MDI and spacer treatment to a favorite doll or stuffed animal. Offer just the face mask or mouthpiece. Be sure to wash it before using again.
• Change treatment methods gradually. At first, continue with the nebulizer for one (or two) daily treatments and use the MDI and spacer only once a day. After about two weeks (as long as symptoms are controlled), use the MDI and spacer for all treatments. When the time comes, follow the same gradual transition from parent-delivered medication to self-delivered medication.

How do I know the MDI is working?

The frequency and severity of asthma symptoms may be your best clue as to how well the MDI and spacer are working, especially if your child is not yet using a peak flow meter. Evaluating the MDI and spacer’s effectiveness is part of the ongoing process of managing your child’s asthma. If using the device turns out to be a problem for your child, his or her health care provider may review the child’s technique, offer suggestions to make delivery more effective, or have you try another delivery method.

The important thing is that your child enjoys the greatest possible benefit from his or her medication. Even if you move between the nebulizer and MDI and spacer for a while, take heart. Most children are eventually able to use an inhaler on their own.

This entry was posted on Friday, April 6th, 2007 at 1:49 am and is filed under Kids. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.