How to Use an MDI with Spacer and Face Mask for Children Under 4 Years

Dr Balachandra BV 18 September 2025

As an allergy specialist, I understand that giving inhaler medicine to young children can be challenging. Using a Metered Dose Inhaler (MDI) with a spacer and face mask is the best way to ensure effective delivery of medicine for children under 4 years or those who cannot use a mouthpiece.

You can watch my full video tutorial here:

How to use MDI with Spacer and Mask – Dr Balachandra BV

How to Use the MDI with Spacer and Face Mask

Shake the inhaler vigorously 5-6 times before every use.
Attach the inhaler to the spacer, making sure both are oriented correctly (facing upwards).
Place the face mask snugly over your child’s nose, mouth, and chin ensuring no air leaks.
Press the inhaler canister once to release the medication.
Encourage your child to breathe in and out slowly and steadily through the mouth for about 25-30 seconds.
After this, remove the mask gently.
If more than one puff is prescribed, wait 30 seconds to 1 minute before repeating.
If the child is uncooperative, doing this for 10-15 seconds is acceptable; additional doses can be given to compensate.

Caring for the Spacer and Mask

Wash the spacer and mask once weekly with lukewarm water and mild soap.
Air dry them completely; do not use cloth to dry.
Replace the spacer every 6 months to maintain effective medication delivery.

Conclusion:

Using the MDI with spacer and face mask correctly ensures your child gets the medication deep into the lungs while minimizing side effects. Practice the technique regularly, and consult your doctor if you have any concerns.

For detailed guidance, watch my video here:

How to use MDI with Spacer and Mask – Dr Balachandra BV

References

Dr Balachandra BV, Allergy Central (YouTube Video)
Johns Hopkins Medicine: Steps for MDI with Spacer and Mask

Children’s Hospital of Philadelphia: MDI with Spacer and Mask Instructions