Inhaler refusal is one of the most common practical challenges I help families with. The most important first step is ensuring the right device is being used for the child's age - young children need a valved spacer with an appropriately sized face mask, not a metered dose inhaler used directly. Technique matters enormously: the spacer allows the child to breathe normally rather than coordinating a precise inhalation. Making the process part of a calm, consistent routine rather than a confrontation helps significantly. I demonstrate technique at every consultation and encourage parents to practice with the child at home when symptoms are absent, so that the inhaler feels familiar rather than threatening.
Written by Dr. Animesh Debbarma, MBBS, MD (Pediatrics), DAACI (Diploma in Allergy, Asthma and Clinical Immunology), Consultant Paediatrician and Pediatric Allergy Specialist, Bangalore. Phone: 8415036816.
