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Kids Health Info

Asthma spacers

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    Key points

    • An asthma spacer is a tube-shaped container that attaches to an asthma device called a metered-dose inhaler or ‘puffer.’
    • Spacers are the best way to get asthma medicine deep into the lungs where it is needed.
    • Without a spacer, a lot of the medicine stays in the mouth and throat and is less effective.
    • If your child has asthma, they should always carry their reliever medicine and spacer with them, along with their Asthma Action Plan.
    • Make sure you and your child know how to use the puffer and spacer correctly.
    • Try not to share your child’s spacer with other children, as they can pass on germs.

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    What is an asthma spacer?

    An asthma spacer is a tube-shaped container that attaches to an asthma device called a metered-dose inhaler – more commonly known as a ‘puffer.’ It helps asthma medicine get deep into the lungs where it is needed.

    If your child uses a puffer without a spacer, a lot of the medicine will stay in their mouth and throat instead of reaching the lungs. This means it will not work as well. It can also cause irritation.

    There are two ways to use a spacer:

    • With a mask for children under age four (or anyone who struggles to coordinate pressing the puffer and breathing)
    • Without a mask for children over age four and adults.

    Benefits of asthma spacers

    There are many benefits to using asthma spacers. They:

    • allow people to inhale at their own pace, as the medicine stays inside the spacer
    • help to get the correct dose of medicine to the lungs
    • make it easier to coordinate pressing the puffer and breathing in
    • ensure less medicine stays in the mouth and throat
    • work with both reliever and preventer medicines.

    How to use an asthma spacer

    Using a puffer with a spacer and mask – four years and under

    Using a puffer with a spacer – four years and older


    For asthma medicine to work, you and your child need to know how to use the puffer and spacer properly. Ask your child’s doctor or a pharmacist to show you both and practise using it together.

    Steps to using a puffer with a spacer

    When your child is young, you will need to help them take their asthma medicine. However, you should encourage your child to use their puffer and spacer themselves when they are old enough.

    Preparing the puffer and spacer

      1. Before using the puffer, always check the expiry date. Never use the medicine after this date.

      2. Put the spacer together, following the instructions. It should look like the picture above (figure one). A pharmacist can help if required.

      3. Remove the cover from the mouthpiece of the puffer. Hold the puffer upright and shake it well.

      Note: Please read the instructions for your child's device. Some puffers do not need to be shaken.

      4. If you have used the puffer recently, press the button once to check it is working. If it is a new puffer or it has not been used for a while, you will need to prime it. To do this, press the button a few times until a fine mist comes out.

      5. Insert the puffer firmly into the end of the spacer.

    Using the puffer and spacer

      6. With a mask: Place the mask over your child's face, making sure it covers their mouth and nose. Try to make a seal on the skin so no air can get in.

      Without a mask: Put the spacer's mouthpiece in your child's mouth or ask them to do it themselves. They should hold the mouthpiece between their teeth, then close their lips around it to make a seal.

      7. Ask your child to sit upright and breathe out gently. Hold the spacer and puffer level so they do not tilt up or down.

      8. Press the puffer button once to release a dose of the medicine into the spacer. Keep the puffer attached to the spacer.

      9. Ask your child to breathe in and out normally four times. You may see the spacer valve move or hear a click with each breath. Keep the spacer in position for about 15 to 20 seconds. If your child is using a mask, do not remove it between breaths.

      10. If your child needs more puffs, shake the puffer again and repeat steps six to nine. You can shake the puffer while it is still attached to the spacer, or remove it from the spacer, shake, then re-attach it.

      11. If using a puffer that contains a steroid medicine, make sure your child rinses their mouth or brushes their teeth and tongue after use. Your pharmacist will tell you if your child needs to do this.

    Cleaning and caring for an asthma spacer

    Your child’s spacer needs to be cleaned once a month if they have used it. The best way to do this is to take the spacer apart and wash it in clean, warm water with a small amount of dishwashing liquid or mild soap.

    Allow each part to air dry – do not rinse the soap from the spacer or wipe it dry. This can create static electricity, which traps medicine inside the spacer and stops it from going into the lungs. When all the parts have dried, put the spacer back together so it is ready to use.

    Try not to share your child’s spacer with other children, as they can pass on germs.

    A pharmacist can answer any questions you may have about caring for the spacer, including how to put it back together.

    Common questions about asthma spacers

    When should I replace my child’s spacer?

    You should replace your child's spacer every year. If the spacer breaks or cracks, replace it straight away. If your child is having an asthma flare-up and there is no other spacer available, it is better to use an old or broken one than no spacer.

    When can my child stop using a spacer?

    There is no age where your child should stop using a spacer. In fact, spacers help both children and adults take asthma medicine more effectively.

    What should I do if my child needs to use the spacer again when it is still wet after washing?

    If the spacer is wet and your child needs asthma medicine, they should use their puffer alone. A spacer will not work correctly if it is wet.

    Never wipe a spacer dry – this can create static electricity, which traps medicine inside and stops it from going into the lungs. It is a good idea to keep a spare spacer and avoid washing them both at the same time. Do not wash the spacer during an asthma attack; it should be ready to use again if required.

    My child uses a different sort of asthma medicine. Can they use it with a spacer?

    There are many types of spacers available to buy at pharmacies. It is important to get a spacer that fits correctly with your child’s puffer. Speak with a pharmacist to see which spacer works best with your child’s asthma medicine. Some asthma devices cannot be used with spacers, such as dry-powder inhalers.

    My child does not like taking their spacer with them. Is there another option?

    If your child does not want to take their spacer with them, using their puffer alone is better than nothing. However, it is much better for them to use it with a spacer. Try explaining to your child that it will help their symptoms a lot more than just a puffer.

    Some older children and adolescents can use another type of medicine that does not need a spacer. You can speak to your child’s doctor about other options.

    Is an asthma puffer with a spacer as good as a nebuliser?

    A nebuliser is a machine that turns liquid medicines into mist. Research continues to show that an asthma puffer with a spacer works just as well as a nebuliser. Spacers are also portable, cheaper, and much easier to use than nebulisers.

    For more information

    Developed by The Royal Children’s Hospital Emergency department, with input from the General Medicine, Respiratory and Complex Care departments. We acknowledge the input of RCH consumers and carers.

    Reviewed November 2025

    Please always seek the most recent advice from a registered and practising clinician.

  • Asthma – use of spacers


Disclaimer

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.

Updated July 2025

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