A spacer is a tube that attaches to an asthma inhaler (also called a metered-dose inhaler or MDI). It holds the medicine so your child can breathe the medicine in slowly and deeply either through the mouthpiece or a mask. This helps more medicine reach their lungs. Here's how to help your child use the spacer correctly.

If your child is using a mouthpiece:

If your child is using a mask:

How to Use a Spacer

1. Check the spacer for any cracks, damage, dirt, or particles in it. If it's cracked or damaged, don't use it. If it has dirt or particles in it, clean it according to the manufacturer's instructions.
2. Remove the cap from the inhaler.
3. Connect the spacer to the inhaler. 
4. Shake the inhaler before each use and in between each inhalation. It's OK to shake it when it's attached to the spacer.
5. Have your child stand or sit up straight.
6. Tell your child to breathe out slowly and fully to empty the lungs. Make sure they face away from the spacer so they don't breathe into it.
7. If using the mouthpiece:
   • Have your child close their lips around the mouthpiece. Press the inhaler to release the medicine into the spacer. Tell your child to take a slow, deep breath in through their mouth.
   • Remove the spacer from your child's mouth. 
   • Have your child hold their breath for about 10 seconds to allow the medicine to settle in their lungs, then have them breathe out through their mouth.
8. If using a mask:
   • Press the mask firmly on your child's skin, covering the nose and mouth.
   • Press the inhaler to release the medicine into the spacer.
   • Tell your child to take 5–6 slow, deep breaths in and out through their mouth before removing the mask.
9. Shake the inhaler and repeat after about 30 to 60 seconds if your healthcare provider prescribed more than one inhalation (puff) of medicine.

Reminders

• If the spacer makes a noise (such as a squeak or a honk), your child is breathing in too hard or too quickly. Tell them to breathe in a bit more slowly and softly.
• If the medicine is an inhaled steroid, help your child rinse out their mouth with water after using the spacer and inhaler. If you are unsure if your medicine is an inhaled steroid, check with your healthcare provider.
• Clean the spacer according to the manufacturer's instructions when it looks cloudy and at least once a week (when using every day). Be sure the spacer is completely dry before using it.
• Throw away the inhaler as recommended by the manufacturer or if you notice any cracks or problems.