Help Your Child Use a Nebulizer

Medically Reviewed by Hansa D. Bhargava, MD on January 02, 2020
4 min read

Debbie Taback knows all about allergies: Her 11-year-old daughter and 7-year-old twin sons have food allergies and asthma. The kids were just infants when their symptoms started. But even before doctors diagnosed them, Taback got a nebulizer, a device designed to deliver asthma medicine right to the lungs.

“We started to call it nebbing -- we turned it into a verb,” she says. “By the time they were about 3 years old, every time they became sick, they needed to be nebbed.”

Taback’s kids no longer rely on the nebulizer, but she credits the device for getting them through the early years of asthma symptoms. But it took time to get to know the machine and its advantages and drawbacks.

“When you’re learning something fresh and it’s new to you, you feel like you have to reinvent the wheel,” she says. “And then you come to find that other families are going through the exact same thing.”

The nebulizer is designed to deliver liquid medications to the body through the lungs. Powered by electricity, the device turns the liquid into fine droplets, creating an aerosol spray or mist. That makes them easy to breathe into the lungs through a mouthpiece or mask attached to the machine.

That means the medicine can act where it’s needed most: your child’s airways, says Chunrong Lin, MD, a pulmonologist at the Sean N. Parker Center for Allergy & Asthma Research at Stanford University.

Besides asthma, nebulizers can be helpful for other conditions, like emphysema, sinusitis, bronchitis, and more. Taback says she used to fill the machine’s cup with saline to help her children feel better when they came down with croup.

Both nebulizers and inhalers can deliver different asthma medications, including quick-relief (or rescue) medicines for emergencies and long-term control (or maintenance) medicines. But there are some key differences.

Inhalers are handheld and portable. The most common kind, metered dose inhalers (MDIs), let out a measured amount of medicine as a spray when you squeeze them. Many people who use them also use a tube called a spacer, which makes it easier to get the right amount of the medication. It usually takes a few minutes or less to get the medication through an MDI with a spacer.

It takes some coordination to use an inhaler, so doctors often tell parents to use a nebulizer for very young kids and babies. The machine does all the work -- all your child has to do is breathe through the mask.

“When a child might be too young to follow directions to use an MDI with a spacer, a nebulizer might be the only option,” says Sayantani Sindher, MD, an allergist and pediatrician at the Sean N. Parker Center.

“I like to try and get kids switched over as soon as possible because there’s a little more flexibility with an MDI with a spacer,” says Michael Cabana, MD, director of pediatrics at the University of California, San Francisco. “But bottom line is that clinically, they’re equally effective -- one isn’t better than the other.”

The trickiest part of a nebulizer can be persuading young kids to use it. Taback says it helped to turn her kids’ treatment time into a relaxing, fun routine.

“Then they knew if they had to get nebbed -- even if it was in the middle of the night -- they also got to climb into Mommy and Daddy’s bed and watch TV for 15 minutes,” she says.

Experts agree that kids tend to feel a lot less anxious about using a nebulizer if they can do something fun while they use it. Let your child watch a favorite TV show or read a book during their treatment. Or try calling it their Superman mask or any other name that makes it something special. Eventually, Lin says, kids will get more cooperative when they realize that the nebulizer makes them feel better.

Other kids get scared by the thought of breathing through a machine. Taback says decorated masks can make the process a little less intimidating for young ones. “We used a mask that had a duck on it, and my kids loved that,” she says. “We would say, ‘It’s time to put the ducky on.’ ”

Finally, follow the manufacturer’s instructions to keep the nebulizer working right. “You do have to replace the cups periodically,” Taback says. If you don’t, they can stop working, “and then you might wonder why your child isn’t getting better, and it’s because they’re not getting any medication.”