Q. My 3-year-old son has asthma and has to use a nebulizer, a tabletop unit with tubing that involves securing a mask over his mouth and nose. It takes about 15 minutes to administer a dose of medicine. Why can't his doctor prescribe a hand-held inhaler with a spacer and mask, which is a much quicker process?
A. A nebulizer and an inhaler offer two different ways to deliver the same medicine to relieve asthma symptoms, says Dr. Susan Schuval, chief of allergy and immunology at Stony Brook Children's Hospital. A child may have to take the medicine intermittently when experiencing symptoms, or daily as a preventive measure. While parents may prefer the inhaler because it takes less time, Schuval agrees with your doctor and usually also recommends a nebulizer rather than an inhaler for children younger than 5.
When using an inhaler with a spacer -- also called a chamber -- parents need to hold a mask over the child's mouth and nose, and they have to depend on the child taking six to eight deep breaths to get the maximum benefit from the medication, Schuval says. Often very young kids don't really understand the concept of inhaling deeply and consistently. "The problem with young kids is it's variable how much of the dose they get," she says.
With a nebulizer, kids are breathing regularly over a longer time period. "I know they're getting all the medicine," Schuval says. "It doesn't depend on their effort at all."