Asthma Inhalers for Kids

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

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 full effect.

Preventive Asthma Inhalers

Inhaled corticosteroid inhalers are a mainstay of asthma preventive therapy. These medications are not the same as the anabolic steroids associated with harmful effects and abuse.

These inhalers cannot offer quick relief for asthma symptoms, but are used regularly to help prevent your child from developing asthma symptoms in the first place.

Some preventive (long-acting) asthma inhalers only contain a corticosteroid. Others are combination inhalers that combine a steroid with a long-acting beta-agonist.

These medications are typically taken several times per day, on a schedule.

Long-Acting Inhaler Steroid Only Combination  Age for Use
Advair Diskus   Ages 4 and up
Advair HFA (flovent + serevent)   Ages 12 and up
Alvesco (ciclesonide)   Ages 12 and up
Asmanex Twisthaler (mometasone)   Ages 4 and up
Dulera (asmanex/foradil)    Ages 5 and up
Flovent Diskus (fluticasone)   Ages 4 and up
Flovent HFA (fluticasone)   Ages 4 and up
Pulmicort Flexhaler (budesonide)    Ages 6 and up
Qvar (beclomethasone)   Ages 5 and up
Symbicort (pulmicort/foradil)    Ages 6 and up

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

Rescue Asthma Inhalers

Because preventative asthma inhalers don't work quickly, they won't help relieve the effects of an acute asthma exacerbation. It's important that you also have a rescue inhaler for your child in the event of an asthma attack.

Rescue inhalers are typically only used as-needed when your child feels that an asthma attack is happening or that an asthma attack may start. They are not meant to be used every day.

Symptoms of an asthma attack that should prompt the use of a rescue inhaler include:

  • Chest tightness
  • Wheezing
  • Anxiety
  • Shortness of breath

Atrovent (ipratropium) and albuterol (a.k.a. salbutamol) are rescue inhalers commonly used for children.

  • Ipratropium is an anticholinergic medication that works by quickly widening the airways.
  • 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

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.

Types of Devices

Aside from the two different types of inhaled asthma medications for kids, there are two main types of inhaler devices: metered-dose inhalers (MDIs) and dry powdered inhalers (DPIs).

While it's ideal to use the medication that controls asthma best, any medication is only as good as how well it is used. MDIs and DPIs each deliver medication a little differently, and your child might feel that one device is easier to use than the other.

DPIs

DPIs are breath-actuated, which means that medicine comes out as you take a breath.

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

MDIs release medication automatically and require the user to coordinate a deep breath with manipulation of the inhaler. They contain hydrofluoroalkanes (HFAs), a substance that propels the medication with pressure.

You might have heard about another type of MDI, which uses chlorofluorocarbons (CFCs) to pressurize the medication. No longer in use, CFCs have been phased out by the U.S. Food and Drug Administration (FDA) because of environmental concerns. 

Kids who use MDIs commonly make the mistake of breathing too fast instead of taking a slow, deep inhalation when using the medication.

MDIs
  • Advair HFA (flovent/serevent)

  • Alvesco (ciclesonide)

  • Dulera (asmanex + foradil)

  • Flovent HFA (fluticasone)

  • Qvar (beclomethasone)

  • Symbicort (pulmicort/foradil)

DPIs
  • Advair Diskus

  • Asmanex Twisthaler (mometasone)

  • Flovent Diskus (fluticasone)

  • Pulmicort Flexhaler (budesonide)

Tips for Inhaler Use

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

A spacer is a small device that can be attached to an MDI inhaler. It has a holding chamber that keeps the medicine inside it until your child takes a breath so that breathing doesn't have to be coordinated with activating the inhaler. This can include a mask for infants, toddlers, and children up to 4 years of age.

A spacer may be a good solution for your child if they are having trouble using an MDI.

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. Consult with your child's pediatrician if you need help explaining the importance of asthma management to your child in an age-appropriate way, and help evolve that understanding as they age.

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