Children up to 3 years of age cannot use a mouthpiece, so treatment with a spacer should be given with a face mask1. Leaks around the face mask can result in decrease medication being inhaled3. To prevent leaks, you may need to hold the face mask on your child's face tightly. This causes the child to cry and fuss during the treatment. Crying causes more of their medication to be inhaled into the stomach and less in the lungs where it is needed. Philips LiteTouch ensure you select a mask with a good seal. Masks with soft silicone cushions tend to be more comfortable than conventional VHC masks(2) also select a low volume chamber (less than 350ml). The larger chambers require more breaths and more time to get all the medication from a single dose(4). This combination of soft, comfortable mask, and small volume chamber may hel you deliver the medication quickly and comfortably to your child.
References:
[1] Global Initiative for Asthma(GINA). Global strategy for asthma management and prevention. ginasthma.org updated Dec 2010. Accessed 13 January 2016.
[2] Tong, K. et al. An Instrumented Valved Holding Chamber with facemask to measure application forces and flow in young asthmatic children. Journal of Aerosol Med and Pulm Drug Del. 2014; 27 (Suppl 1): S55-62.
[3] Erzinger, S. et al. Facemasks and aerosol delivery in vivo. Journal Aerosol Medicine 2007; 20 (Suppl 1):S78-S84
[4] Nikander, K. The evolution of spacers and Valved Holding Chambers. Journal of Aerosol Med and Pulm Drug Del. 2014; 27 (Suppl 1): S4-24.