A nebulizer is an electric- or battery-powered machine that turns liquid asthma medicine into a fine mist that's inhaled into the lungs. Nebulizers are often used with young kids because they require little effort on the child's part. But the child does need to stay in one place and cooperate. And if you have a young child, you know how challenging that can be.

Most nebulizers come equipped with a face mask (they're also available with a mouthpiece). A child wears the mask and breathes normally for 5 to 10 minutes until the medicine is gone. A child who doesn't stay still and cooperate may not get a proper dose of the medicine. For instance, if the mask is held a half inch (1.27 centimeters) away from the face, half of the medicine won't reach the lungs. Increase that distance to an inch (2.54 centimeters) and 80% of the medicine is lost.

It might seem as though a crying child takes deeper breaths, which can lead a parent to think that the child will inhale the medication more deeply when crying. In fact, the opposite is true. Crying is a long exhalation followed by a very rapid inhalation to catch one's breath. Almost none of the medication will make it to the lungs if given while the child is crying.

For an infant, you may be able to use the nebulizer while your child is sleeping or your child might be cooperative while being held. But what about older babies and toddlers? They might be frightened by the face mask and are sure to resist sitting still.

Here are some suggestions for making nebulizer use easier and more enjoyable:

• Make it part of your daily routine. Use the nebulizer at the same time (or times) each day, so your child knows what to expect.
• If your child is afraid of the mask, you can talk about how it's a "pilot mask" or a "space mask." You might even buy a video about pilots or astronauts and use some of the lingo like "start your engines" before you turn the nebulizer on. You also can buy masks shaped like dragons and other animals.
• Allow your child to decorate the nebulizer machine with stickers.
• Try having your child sit in a highchair. If that doesn't work, your little one might prefer sitting in your lap.
• Make the time your child has to sit still as fun as possible. Read stories, sing songs, or pull out some special toys only available during nebulizer time.
• Watch a short DVD or video together.
• If your child is old enough, encourage him or her to help you put the mask on, hold the tubing, and turn the machine on.
• Praise your child for a job well done!

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: October 2010