how to get 15mo to take inhalers?

[ALovelyBunchOfCoconuts]

we have been prescribed a salbutamol inhaler for ds who is 15mo. i have to use it with a chamber but he just screams and pushes it away. how do i do it? were wasting puffs because i can't keep him still enough to actually breathe them in. at a loss here really...

Wrap him in a towel and pin him down.

It was the only way that I could get ds2 to take his inhaler at that age - the nurses reassured me that his screaming just made the medicine more effective!

He's 4.6 now and takes his inhaler with no fuss at all.

Yep been there too. And then there was trying to get disgusting tasting soluble prednisolone down him...
I think we had to employ the strong arm tactics at first and then after a while it involved a lot of singing followed by much bribery while he had the chamber on his face.
DS is 13 and off school with asthma today but at least he can swallow the tabs and administer his own ventolin these days...You'll get there.

when he screams though, the mouthpiece thingy just ends up on the inside of his mouth. he has a massive mouth. would we benefit from the next size chamber do you think?

What Iwish said. Ds was a nightmare with his and I literally had to sit on him sometimes. The nurse said to me that the crying and screaming were helping too. It seems brutal but he needs his medicine, sometimes you have to be cruel to be kind.

at my baby being stronger than me!

Is it just a spacer you have or the aerochamber one with the mask (like this )? It is much easier with the mask than a mouthpiece. They come in different sizes - my ds3 has had the orange one since he was 3 months and ds1 has had the yellow one since he was about 2 and still uses it sometimes although he now has the big spacer too. Even with the mask though we still had to hold the little one very tight sometimes, especially when he needed 10 puffs! Ds1 is now 5 and takes it no bother now.

Don't worry at 8 weeks old DS was stronger than 3 nurses and 2 doctors!!

I found letting DS play with the spacer really helped, pretend to give inhaler to yourself and let him do it to. DS regularly has to give his toy dinosaur inhaler.

Is there someone else who can help you so one person can hold him and the other do the inhaler?

You can give it while he is sleeping which may help although obviously that doesn't work all the time!

Playing trains helped with ours. They would make puff puff noises into the spacer. Dd2 used to call the spacer her "choo choo" and loved doing it.

yes it is the one with the mask as above. im finding it o difficult to hold him still

Put the mask in his toys and make it a game, you breathing and making silly noises etc and saying for him to do it. Then when it comes to the inhaler he's used to the mask. Worked with my ds

Do it while they are asleep. We had the face-mask adapter and we were able to put it gently over DD2's mouth and nose while she slept and gave it her that way. Yes, they weren't the deepest breaths she was taking, so we left it there for longer so she'd had lots of breaths.

We did it after she'd fallen asleep at night and before we woke her in the morning.

The inhaler for teddy is a good long-term strategy, I also used to do 'inhaler for mummy' where I would do comedy giant puffs like blowing up a balloon.

But short-term ,wrapping in a towel is a bloody good idea, I missed a trick there.

I used to put DS in the crook of my left arm, tuck his right arm behind me through my armpit, and hold onto his left arm with my left hand. Then use my right elbow to stop him kicking me in the face, while manoeuvring the inhaler into position with that hand. Simple!

Luckily he takes it better now (he's 2.3).

But the problem with his mouth - maybe worth asking the pharmacist about a larger mask?

I think strong arm tactics are probably a mistake long-term.

DD was prescribed her inhaler at around this age and we started off forcing her to take it until she was actually frightened to even see the spacer. She wouldn't even let me hold it to my own mouth and would bat it away because she thought it was something to be frightened of.

We had to slowly reintroduce it, by arranging for it to appear around the house e.g. in her nappy box, on her dressing table. We would always make sure we ignored it at first. Then I would let her see me pretending to use it, demonstrating some nice deep breaths. Gradually I would just let her play with it, examine it and if she brought it up to her face that was great. Teddy and dolly always had their inhaler.

It took a few months but she would then happily take it. If she didn't one day, we didn't make a big deal about it we just said 'ok, we'll try again later'. Many many times we've done it whilst she slept.

A GP recently told me that when children have a nebuliser they have an entire blue inhaler in one go. When they are having one/two puffs the amount is tiny, particularly with very young children as the amount inhaled is minimal.

Its worth the long term approach imo. DD at 2.3 now has brown and blue inhalers morning and night and blue on demand. Generally she's pretty good at taking them (much better than she is at teeth brushing for example). We are more strict on the brown one because the dosage builds up over around 10 days so needs regular doses to be effective.

p.s. There was an episode of Get Well Soon on cBeebies where Dr Ranj prescribes an inhaler, might be worth a watch if you can track it down

For an asthmatic child the "never Mind try later" approach doesn't work. You have to get it into them immediatly. If a child can wait for ventolin they don't need it.

I have always been told that 10 puffs on ventolin is the equivalent of a nebuliser

I appreciate that in the middle of an attack.

However I'm talking about the routine morning and evening puffs that they usually start you off with. If they won't tollerate it you have the choice of pin them down kicking and screaming, or try again in a few mins/after they're asleep.

Fear of the spacer is dangerous, as in an emergency the upset caused increases the sererity of symptoms

Ventolin shouldn't be given routinely though.

Not giving inhaler is infinitely more dangerous than a fear of the spacer

DD was prescribed her ventolin to take regularly morning and night as a young toddler.

She still takes it routinely morning and night before her brown inhaler (on drs orders).

Nowhere did I suggest skipping doses

I have always been told that needing ventolin daily means asthma isn't controlled. Your post very much read like suggesting missing doses that may not have been your intention but it's how it read

I think you are correct with older children and adults (I'm an asthma sufferer myself), however these are young children who have not actually been diagnosed with asthma (too young). Prescribing an inhaler is the very first thing they do, almost as an experiment. You can't even get a diagnosis until years later, let alone be confident that the condition is properly controlled.

The rationale behind the routine ventolin for my own DD is that it opens up her airways for us to administer the steroid inhaler and hopefully ensures more gets in. With the little ones it's variable what actually goes in. But thats not relevant to the OP.

DD doesn't miss ANY regular doses, but I don't see the harm in waiting then trying again a bit later, or doing it while they're asleep which was also suggested by someone else on this thread. This is for routine doses of course.

Clearly you will not always have that option. But you're going to make those more urgent situations worse if your DC gets distressed as soon as they see the inhaler.

they can diagnose young and I have been told that they shouldn't need daily ventolin by respiratory consultants since DS was 12 months old and was diagnosed.

Maybe I need to go back to GP again then.

That's interesting, TripleRock, I was just saying on another thread that every GP seems to take a different approach to asthma.

My DCs (when under 3ish) only ever took a blue inhaler, in a struggling-to-breathe type situation, so yes, when I actually had to use it it was strong-arm tactics; backed up with daytime play type things of pretending to use it as above.

Neither of them ever ended up scared of the spacer, but I appreciate that could be more luck than judgement.

I do "Row Row the Boat' With 16mo DD. Sit her on my lap, and sing 4 different verses of Row Row your boat for 4 puffs, encouraging her to take a bit gasp for 'If you see a crocodile, don't forget to SCREAM!' etc She likes the sitting and singing, and most of the time she likes her inhaler now - she'll try and press the button herself, hold the spacer up to my mouth etc. Sometimes she'll refuse and push it away.

Incidentally did you know you're supposed to take the spacer away from the child and shake the dispenser vigorously between doses? Only I wasn't told this by the first 2 people to prescribe it, was only on when our Consultant checked how we were getting on with it she mentioned that. It does mean you have to take it away from their face and put it back on, which is a pain if they're just settling with it.