How to use a spacer with a mask for a baby or child

Hi I'm Caroline. I'm a specialist respiratory nurse. Using a spacer and face mask when you're giving a baby or child medicine from an inhaler means more of the medicine gets down into their lungs and is a great way to help manage their symptoms. Getting the technique right is very important. It may take a few tries to feel comfortable giving medicine this way, but it does get easier with practice. I'm going to show you how to use a spacer with a face mask for a baby or child. If you're an adult using a spacer with a face mask, watch our video for adults. When using an inhaler and spacer with a face mask for a baby or child, how you hold or sit with your child will depend on their age. If you have a baby or young toddler, sit them on your lap facing you so you can keep eye contact. With very young babies, some parents find it works best to tilt them back slightly. If your child is older, you can sit them on your lap either sideways or facing away from you, as it's easier to handle the inhaler and spacer. If they prefer to sit or stand by themselves, it works best to face them. First, hold the inhaler upright and take the cap off. Check there's nothing inside the mouthpiece. Shake the inhaler well. Put the inhaler into the hole at the back of the spacer with the indent for the nose on the mask facing upwards. Ask them to sit or stand up straight and slightly tilt their chin up as it helps the medicine reach their lungs. Put the mask on their face to make a seal over their nose and mouth. The next steps all happen smoothly in one action. Encourage your child to breathe in and out. Press the canister on the inhaler once and get them to breathe in and out slowly and steadily five times. Remove the mask from their face. If your child is using a small volume spacer with a mask, some of them make a whistling sound if they are breathing in too fast. If your baby is using a large volume spacer with the mask, you need to tilt the end of the inhaler up to open the valve. The device should make a clicking sound as the valve opens and closes. If your child needs to take another dose, remove the mask from their face. Wait 30 seconds to a minute and shake the inhaler again, then repeat the steps. When you've finished, take the inhaler out of the spacer and replace the cap. If your child has used an inhaler that contains steroids wipe your child's face with a damp cloth and rinse their mouth out with water or brush their teeth to avoid side effects. Remember, you can get more top tips on helping your child use their inhaler by watching our other videos.