Considerations in children

Drug delivery to the lungs is variable in children, which could explain fluctuations in effectiveness of inhaled drugs even in children using the device correctly.

Device choice in children should consider the child’s age, developmental stage and inspiratory flow. A pressurised metered dose inhaler (pMDI) with a spacer is usually the preferred option for all children; however, children older than 10 years can use a range of devices depending on individual ability. A pMDI with a spacer and facemask should be used in children younger than 4 years and children who are unable to form a lip seal around the spacer mouthpiece.

Device technique should be taught to the child (depending on their age) and their parent or carer.