Kids MD - Nebulizers vs. Inhalers

Yvette J. Brown | CWK Network

"It's the medicine that they need. The delivery system (is) secondary as long as the child is not fighting."
- Robin Hyman, asthma educator -

Three-year-old Nicholas is home from the hospital following a recent asthma attack. Doctors prescribed an inhaler for Nicholas, a pump-like device that delivers asthma medication in quick puffs. A nebulizer is different. This device is attached to an air compressor and allows asthmatics to inhale fine mists of medicine, often through a mask.

So which is better: the inhaler or the nebulizer?

According to a Harvard University study of 1552 children, those using nebulizers were 53 percent less likely to be re-hospitalized or rushed to the emergency department compared to kids using inhalers. The most dramatic results were among kids 4 and younger.

"When you have a very young child between the ages of several months and several years – a 3- or 4-year-old – they may fight the inhaler. Therefore the nebulizer might be better," explains Robin Hyman, a respiratory therapist and asthma educator with Children's Healthcare of Atlanta.

But the nebulizer may not be best for all children. Nicholas' mother, Vanessa Kirk-Brown, often struggled to get him to use it. He fought against the face mask; so much so, Mrs. Kirk-Brown worried if her son was actually inhaling the medicine he needed.

"If (children) are fighting, you're not getting a good treatment," says Hyman. The medicine "is going on their face. It's going in the air. It's not getting down inside their lungs" where it needs to be.

What's most important, says Hyman, is that the child gets the medicine they need. Which device you choose depends largely on what each individual child can tolerate. Parents should ask themselves, says Hyman, 'What does my child respond to? What has my doctor seen success with, and (which) method (is) my child not fighting?"

For Nicholas, the answer is clear. He prefers the inhaler. "He is doing wonderful," says Mrs. Kirk-Brown. "He doesn't fight with it. It's much easier and takes a lot less time."

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