Understanding Your Child’s Asthma and Proper Inhaler Technique

Asthma is a condition where inflammation causes swelling and narrowing of the airways, making it more difficult to breath. Common symptoms are wheezing, coughing and difficulty breathing. There are some factors that can make asthma worse, known as triggers.

Avoiding or limiting triggers may help prevent asthma symptoms. Some common asthma triggers are humidity, wind, pollen, perfumes, air pollution, physical activity, pets, paint or gas fumes. Cigarette smoke is also a trigger, therefore for parents who are active smokers avoiding smoking in the car or anywhere around your child is encouraged.

Common asthma medications 

Two common medications for the treatment of asthma are inhaled corticosteroids (ex. Flovent) and short acting beta agonists (ex. albuterol). These medications are commonly prescribed in the form of an inhaler. An inhaler is a device that gets medicine directly into a person's lungs. The medicine is a mist or spray that the person breathes in. Inhalers can be divided into maintenance or rescue-inhalers.

Maintenance inhalers (ex. Flovent) are taken daily to reduce inflammation and maintain asthma control. When using this type of medication, it may take 2 weeks or longer to see an improvement in asthma symptoms. Flovent belongs to a class of medications called inhaled corticosteroids. When using an inhaled corticosteroid is important to teach your child to rinse their mouth with water and spit out after each use to prevent throat irritation and/or mouth infection.

Rescue inhalers (ex. albuterol) are used as needed for acute asthma symptoms. They rapidly open airways within minutes of inhalation to make breathing easier.  Frequent use of a recue inhaler (>2 days per week) indicate poor asthma control. If your child is needing the rescue inhaler very frequently you should contact their health care provider.

Proper inhaler technique

Proper inhaler technique is essential for the medication to reach the lungs. With either inhaler type, if the inhaler is not used correctly your child will not receive enough medication and it will not have the desired effect.

Your child’s doctor may have prescribed a spacer to be used with the inhaler. A spacer device is an attachment that connects to the mouthpiece of the inhaler. A spacer facilitates medication delivery and helps prevent waste. Spacers also reduce the risk of thrush from steroid inhalers.

How to use a metered-dose inhaler with a spacer

1. Put the MDI upright into the rubber hole of the spacer. Make sure it is in place.
2. Hold the MDI and pacer together and shake it 5 times.
3. Put the mask firmly onto your child’s face making sure to cover the mouth and nose.
4. Hold the mask over your child’s face with one hand and with the other press the MDI down firmly with your thumb. That will release one puff of medication into the spacer. Instruct your child to take deep breaths for 10-15 seconds.
5. Repeat step 3 if more puffs are needed.
6. If using a steroid inhaler have your child rinse their mouth with water. This will help prevent throat irritation and mouth infection.

For more information on proper inhaler technique you can visit https://www.aboutkidshealth.ca/asthmaspacer or refer to the package insert that comes with the inhaler.

Can my child engage in normal physical activity?

Sometimes exercise may trigger or worsen asthma symptoms. However, the good news is that physical activities need not be restricted. With proper asthma treatment, children can participate in all kind of physical activities, including sports.

References:

1. (2009, January 29). https://www.aboutkidshealth.ca/asthmaspacer Retrieved November 04, 2020, from
2. MDI with Spacer and Mask | Use Inhalers. (2013). Use-Inhalers.Com. https://use-inhalers.com/mdi-spacer-and-mask. Retrieved November 04, 2020
3. Sawicki, G., Haver, K. “Asthma in Children Younger than 12 years; Initial evaluation and Diagnosis.” UpToDate. November 16,2018. Accessed on November 4, 2020. https://www-uptodate-com.ezproxy1.library.arizona.edu/contents/asthma-in-children-younger-than-12-years-initial-evaluation-and-diagnosis?search=asthma%20in%20kids&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2