Asthma Inhalers for Kids

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Children who have asthma often need to use inhalers for treatment, including long-acting maintenance inhalers and short-acting rescue inhalers. Asthma inhalers prevent asthma attacks and make it easier to breathe on a day-to-day basis by reducing lung inflammation and/or widening the airways.

The two main types of inhalers used in the treatment of asthma are metered-dose inhalers (MDIs) and dry powdered inhalers (DPIs). Children who take inhalers need to be familiar with the signs of an asthma attack and learn how to properly use their own inhalers so the treatment can have its effect.

Types of Devices

MDIs and DPIs each deliver medication a little differently. And your child might feel that one type easier to use than the other. DPIs are breath-actuated, which means that medicine comes out as you take a breath. MDIs release medication automatically and require the user to coordinate a deep breath with the inhaler.

DPIs

While some children prefer the level of control offered by DPIs, these inhalers typically aren't used until kids are at least 5 to 6 years old. Generally, kids are not strong enough to take a deep, forceful inhalation until this age.

MDIs

Breath actuated MDIs contain hydrofluoroalkanes (HFAs), a substance that propels the medication with pressure. You might have heard about another type of MDI, which uses chlorofluorocarbons (CFC) to pressurize the medication. No longer in use, CFCs have been phased out by the US Food and Drug Administration (FDA) because of environmental concerns. 

A common mistake with MDIs/HFAs is for kids to breathe too fast instead of taking a slow, deep inhalation when using the medication.

MDIs With Spacers

A spacer is a small device that can be attached to an MDI inhaler. It can include a mask for infants, toddlers, and preschoolers who are 4 years old or younger. Spacers have a holding chamber that keeps the medicine in the spacer until your child takes a breath so that breathing doesn't have to be coordinated with activating the inhaler.

Children may have some trouble learning to use an inhaler, so it's important to get help from your child's medical team when teaching your child the proper technique.

Mistakes to watch out for include:

  • Blowing out into the inhaler instead of breathing in
  • Positioning the inhaler incorrectly
  • Forgetting to exhale fully before using the inhaler
  • Not holding their breath for about 10 seconds after inhaling the medicine
  • Forgetting to breathe out slowly afterward

Rescue Asthma Inhalers

Rescue inhalers are meant to be used when your child feels that an asthma attack is happening or that an asthma attack may start. Symptoms of an asthma attack include chest tightness, wheezing, anxiety, and shortness of breath.

Atrovent (ipratropium) and albuterol (which is also referred to as salbutamol) are rescue inhalers commonly used for children.

  • Ipratropium is an anticholinergic medication that works by quickly widening the airways. It comes as an MDI with a spacer.
  • Albuterol is a short-acting beta-agonist that provides quick relief for asthma symptoms by relaxing the airways to widen them.

There are a number of brands of albuterol including:

  • ProAir HFA
  • Proventil HFA
  • Ventolin HFA
  • Ventolin HFA 60
  • Xopenex HFA
  • ProAir RespicClick inhalation powder

These rescue inhalers are typically only used on an as-needed basis and not every day.

If your child seems to need to use quick-relief asthma medication more than two times a week, be sure to talk to your child's pediatrician. This could be a sign that your child needs to avoid triggers or that the preventative medication needs to be adjusted.

Preventative Asthma Inhalers

Inhaled corticosteroid inhalers are a mainstay of asthma preventative therapy. Unlike rescue inhalers, which can give quick relief for asthma symptoms, steroid inhalers are typically used on a daily basis to help prevent your child from developing asthma symptoms. These medications are typically taken several times per day, on a schedule.

If your child needs to use a steroid inhaler, don't be alarmed. These medications are not the same as the anabolic steroids associated with harmful effects and abuse.

Steroid inhalers include:

Each inhaler may be available in multiple strengths. Generally, your child's pediatrician will prescribe the lowest that keeps your child's asthma under control and may increase it if symptoms persist.

Inhalers that combine a steroid with a long-acting beta-agonist are used for control of childhood asthma as well.

Combination inhalers include:

Because preventative asthma inhalers don't work quickly, they won't help relieve the effects of an acute asthma exacerbation—so it's important that you have both types in case your child experiences an asthma attack.

A Word From Verywell

An asthma action plan can help you and your child understand when the daily inhalers should be used and when the rescue inhalers are needed.

Talk to your pediatrician or pharmacist if you can't afford your child's asthma inhalers. Prescription assistance programs can help parents get needed medications for kids.

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