Administering metered dose inhaler (“puffer”)

Asthma medication delivery devices

Administering metered dose inhaler (“puffer”)

This can be used in children who are able to co-ordinate hand movements with taking a breath in, usually not before 8 years of age.


  1. Make sure the metal canister is placed firmly into the plastic outer container.
  2. Remove the cap from the mouthpiece.
  3. Hold inhaler, “tail-up” and shake well.
  4. Ask your child to breathe out, emptying his/her lungs.
  5. Your child should hold the mouthpiece about two inches in front of his/her mouth and open his/her mouth wide.
  6. At the same time that he/she begins to breathe he/she presses the metal canister down into the plastic container, releasing a puff of medication.
  7. He/she should breathe in slowly and deeply for 5 to 10 seconds.
  8. Ask your child to hold his/her breath for 10 seconds if he/she can.
  9. If 2 puffs are prescribed wait at least 30 seconds between the first and second puff.

Helpful hints

  • To determine whether the canister is empty, place it into a glass of tap water. If it is empty, it will float to the top.
  • If your child takes a bronchodilator and an anti-inflammatory medication, use the bronchodilator first, followed in 5 minutes by the administration of the anti-inflammatory medication.
  • Since it is difficult for a child to place the puffer correctly in front of his/her mouth, some inhalers come with a spacer or synchroner that positions the inhaler at the right distance from the mouth.
  • If your child is used to placing the puffer in his/her mouth, (lips snug around it, teeth open and tongue down out of the way) and is getting good results, he/she continue to use it in the way he/she is accustomed.
  • After taking a steroid medication by any kind of inhaler device your child should rinse his/her mouth with water.

Using inhalers properly is not always easy but can help your child enjoy successful treatment at home and less frequent trips to the hospital.

If despite your best efforts with inhaled medications your child’s asthma is not well controlled or worsens, seek medical attention immediately!

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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.