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Key points about spacers

  • your child needs to use a spacer with a metered dose inhaler (MDI)
  • spacers help make sure asthma inhaler medicine gets into the lungs
  • a spacer helps prevent the medicine from hitting the mouth and throat where it can cause side effects

What is a spacer?

A spacer is a clear plastic tube. The asthma inhaler fits in one end of the spacer, and at the other end is a mouthpiece. It's easier for tamariki 4 years and under to use a mask attached to their spacer. The medicine that is released into the spacer goes directly into your child's lungs when they breathe in through the spacer. Spacers help make sure the medicine gets to the right place.

How spacers work

Using a spacer helps direct the medicine into your child's lungs, where it can work best. If your child uses an inhaler without a spacer, very little medicine may actually get into the lungs.

Without a spacer, the medicine from the inhaler may just hit the back of your child's mouth and throat. A spacer helps prevent the medicine from sitting in the mouth and throat. This can cause side effects such as:

  • sore throat
  • hoarse voice
  • fungal throat and mouth infections

Your child should still always rinse their mouth out after using preventer medicine to avoid these side effects.

How to use an inhaler with a spacer

The photographs below show 6 steps for using an MDI with a spacer. Younger tamariki will need help to follow the steps. As tamariki get older, they will be able to use the spacer themselves.

These photos and instructions are taken from the New Zealand Asthma and Respiratory Foundation's 'Managing your child's asthma' guide (PDF, 2.9MB).

Step 1

If using a mask, attach it to the spacer.

A mask attached to a spacer

Step 2

Give the inhaler a good shake.

Child shaking an inhaler

Step 3

Fit the inhaler into the opening at the end of the spacer.

Child fitting the inhaler into the opening at the end of the spacer

Step 4

Have your child seal their lips around the mouthpiece.

Or place the mask so it seals around their nose and mouth.

Child sealing their lips around the mouthpiece

Step 5

Press the inhaler once only.

Child pressing  the inhaler once

Step 6

Take 6 slow breaths through the mouth while holding the spacer in place.

Child taking 6 slow breaths through the mouth while holding the spacer in place

If your child needs more than one dose of medicine, wait one minute and then repeat steps 2 to 6 for further doses. Make sure that you shake the inhaler between doses.

You could also watch a video - Lachlan shows how to use an MDI inhaler with a spacer (Asthma Waikato video)

Caption and credit

Watch Lachlan showing how to use an MDI inhaler with a spacer

Source: Asthma Waikato video

When to use a mask with a spacer

A spacer with a mask can help young tamariki who have difficulty breathing properly with a regular spacer. If you use a mask and spacer for your child, make sure the mask covers their mouth and nose completely, without any openings. Masks are often used for babies and infants who can't close their lips around the spacer's mouthpiece. Most tamariki should be able to use a spacer without a mask by the time they are 4 years old. If you use a mask with preventor medicine, wash your child's face after each use.

Caring for spacers

It is important to look after your child's spacer and inhaler. Wash the spacer once a week with a mild dishwashing detergent. Then leave it to air dry. This will stop the medicine from sticking to the spacer and blocking the valve at the mouthpiece. Your child needs a new spacer every year. You can get this at the same time as you see your doctor about your child's asthma action plan.

Where to get a spacer from

You can get a spacer for free from your health professional or asthma educator. Your child needs a new spacer every year.

Find out about asthma medicines for children

See the KidsHealth page on asthma to learn more about the condition

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