Tips for using a spacer
BMJ Group Medical Reference
Encourage your child to start breathing in as soon as possible after he or she has pressed the inhaler. Otherwise less of the medicine will reach his or her lungs. Taking and holding several long, deep breaths for each puff works best. If this is not possible, then slow, deep breathing is better than fast, shallow breathing.
If your child cannot breathe in through a mouthpiece, you may need to attach a face mask to the spacer.
Make sure you shake the inhaler between puffs.
Only put one puff of medicine into the spacer at a time. If you put in more than one puff, the droplets of the spray stick together and coat the sides, so your child might get less medicine.
Wash the spacer with washing-up liquid and leave it to dry without rinsing or wiping it. This stops the inside from becoming too static, which makes the medicine stick to the sides. But the spacer only needs to be washed occasionally.
Many parents find it difficult to get their child to use a spacer properly. Try to turn it into an activity that is fun. Decorate it, show them how to use it, or practise counting while they breathe in.
For references related to Asthma in children click here.