Advice on administering inhaler to a toddler please?

[JimbosJetSet]

DD is 20 months old and needs to use an inhaler on occasion. Has anyone got any tips on administering it? We have been given a spacer but she hates using it and moves her head or tears it away after a couple of seconds. She gets very distressed which obviously doesn't help her shortness of breath.
We have tried using the inhaler without the spacer - squirting it straight into mouth - but I don't know if it's effective or safe?
And she is too young to understand the concept of being bribed, unfortunately :(

Many thanks in advance.

It took a good few tries with DS to get him to accept the inhaler.

We let him play with it and we fake sprayed the inhaler so he got used to it when he didn't need it IYSWIM.

I'm afraid that perseverance was the only thing that worked and ensured he got to use it correctly when he did need it. Unfortunately we had to decide that temporary discomfort and distress did not override the need to almost force him to use it

We made all the teddys take it, then I pretended, then dh. By this point he was desperate to have a go, though this didn't always work, good luck!

Playing trains into it (puff puff) worked with my dc. Dd2 called the spacer her "choo choo" for ages.

What type of spacer are you currently using? My DS has chronic asthma and has had to use an inhalar regularly from 9 months of age. He hated the enormous contraption he was first given and it would take DH and I both pinning him down to administer it, all 3 of us would end up stressed and in floods of tears. He was eventually given a smaller spacer with a built in mask. It's called an Aero Chamber plus from GlaxoSmithKline. He had the orange one first as this had the correct mask size for babies and toddlers then he moved on to the yellow one. It has a small vent in it unlike the others, so breathing through it feels much more natural. We took him to buy some shiny sparkly stickers to decorate it and spent lots of time making Mummy and Daddy/ teddy/ Bob the Builder/ the cat better by using the magic spray (he couldn't actually press it himself so he didn't cotton on to the fact that we weren't actually using the inhalar). Obviously as he got older we explained that it was only for him to use and could make other people ill if they don't actually need it. It is really important to use the spacer because even at the age of 7 my DS still can't use the inhalar effectively on it's own.

We used to pretend the inhaler was an elephant trunk so each time dd used it she made an elephant noise and tipped her head up! Worked so well. Now she's 3 and it's not an issue for us.

Please use the spacer, it's the only way to make sure it is used effectively with children; infact it's reccomended that adults use them to.

Let him play with the spacer, like others have said give teddy or toys some, mummy have some to! Sing songs or anything else which will distract him.

It does get better over time. At 2.5 Ds holds the spacer on his own face!

Sirzy is absolutely correct, the spacer is vital at this age. DS1 who is 11 has just learnt to use the inhaler on its' own, sinve then he can slip it in a pocket if he is going out on his own (he kept 'forgetting' the bag with the spacer in). At home he still uses the spacer however, especially for his preventative, since he just doesn't get the full dose of the drug without it.

The spacers that people mentioned upthread are very good though - I remember the orange one had pictures of how a teddy took the inhaler, which we used to talk about. If it came to it though I made both DC take their inhalers however much they disliked it - better than them being hospitalised, as both have been with asthma.:(

Agree you need a spacer. I went to a training program and they insist even adults would be better with a spacer. I was told the crying actually helps it get inhaled as horrible as it is. They improve as they get older and it feels much less traumatic!

We made it a huge game with lots of giggles and clapping. Her teddies had a puff puff, mummy, daddy and then dd. As soon as we did that it stopped being a nightmare. Must give dh credit for that! Good luck!

Thanks guys, as usual I have been given some very helpful ideas. We have now got the GSK aero chamber which is a definite improvement on the old spacer and we are experimenting with the other tips - thanks again