holdingchamber2National asthma guidelines say children should use a holding chamber when they are using an MDI – a metered-dose inhaler. Why? Because the aerosolized spray comes out of the inhaler faster than most kids can inhale – and requires a very quick response time.

How does a holding chamber help?

Holding chambers help coordinate breathing and deliver the medication to where it’s needed. When you attach an MDI to a holding chamber and actuate the spray, the chamber’s one-way, breath-activated valve keeps the medicine inside. As the child inhales, the valve opens to let the medicine out. It then closes again, and a special exhalation valve opens as the child breathes out, directing the breath out of the chamber and away from the face.

Is a holding chamber like a spacer?

Yes … it’s like a spacer, but different – even though many healthcare professionals refer to both devices as a spacer. A spacer is a tube that attaches to an MDI (or is built into it, as with Aerospan) to direct the spray into the back of the user’s throat and reduce the amount of medicine that hits the inside of the mouth. Users must still time their inhalation to begin a split second after activating the inhaler. A holding chamber is a spacer that has a valve that traps the spray inside the device and holds it in suspension long enough for users to inhale at their own speed.

Does my child need a mask?

Young children unable to hold a holding chamber mouthpiece firmly in their mouth should always use a mask. The holding chamber’s valves then allow the child to breathe in and out and inhale the medicine over several breaths if necessary.

There are several models of holding chambers available. When your doctor prescribes one, you’ll likely receive whatever model your local pharmacy offers. There are other options available – and you might choose to research models online and choose one that fits your needs.

Here are some kid-friendly options to consider:

  • Soft, flexible mask attachments
    • Be sure the mask is large enough to fit over the child’s mouth and nose, but not so big that it gaps at the top. Manufacturers’ websites offer easy-to-use size guides.
    • It should be flexible enough to hold a tight seal and soft enough to be comfortable on the child’s face.
    • Some holding chamber brands offer fun, animal-design masks.
    • A new feature on one holding chamber allows you to insert the child’s pacifier into the mask, offering comfort during the procedure.
  • Easy-to-see valves that open and close as the child breathes
    • Parents or caregivers can watch the valve open and time the activation of the inhaler to match the child’s breathing pattern.
    • Watching the valve open and close allows caregivers to monitor the child’s breathing – and confirm that the mask is sealed properly on the face.
  • A whistle that sounds if the child inhales too quickly
    • One of the biggest mistakes people make with their MDIs is inhaling too quickly and forcefully.
  • Antistatic, BPA-free and latex-free materials

No matter how many child-friendly features the holding chamber has, it does no good if the child struggles and fusses when it’s time to use it. Allow the child to handle the holding chamber without any medicine. Explain very simply how the holding chamber works and why it is important to use. Role play so everyone knows what to do when medication time comes.


This article is sponsored by Lupin Pharmaceuticals