A press-and-breathe pressurised metered dose inhaler used with an appropriate spacer is recommended as the first choice of inhaler for use with inhaled corticosteroid medicines for asthma (preventers). If a clinician believes that it is so unlikely that an individual child will use the press-and-breathe inhaler and spacer properly that his or her asthma control may be affected, other inhalers should be considered.

For other inhaled medicines for asthma, such as bronchodilators (relievers), a wider range of inhalers should be considered. This recommendation takes into account that the child is more likely to have to carry this inhaler around with him or her so that it is available for use when needed.

The choice of inhaler should be determined by individual needs, including the medicine the child needs, and the child’s ability and willingness to use a particular inhaler. If, after these factors have been taken into account, there is more than one inhaler to choose from, the inhaler with the lowest overall cost to the NHS should be chosen.

The health professionals who help to look after a child with asthma will support the proper use of the inhaler. From time to time, they will check that the inhaler being used remains the best one for the child.