Asthma Mom’s Rules for Nebulizers and Little Kids

(Excuse the photo quality. This was pre-digital days.)

My daughter started using a nebulizer right after she turned 2, when the doctor diagnosed her asthma. As a 25 year-old mom with no breathing problems myself, I had no idea what I was doing back then.


The nurse at the pediatrician’s office showed me how to administer nebulizer treatments to my frightened, struggling toddler by holding her against my lap and trapping her left arm behind my back. Simultaneously, I had to hold her head, her other arm, and the nebulizer mask on her face still while she screamed. Can you picture it, the way I’ve described? No? I’m not surprised; it felt like a gymnastics routine or a yoga position at the advanced level, and it made AG miserable.

But I thought, well okay. This is the procedure. This is how you do things, clearly.

We were always flying blind with the asthma stuff in those early days, but eventually my kid and I slowly, eventually felt our way through a better system. Because the method necessary for a nurse in a busy doctor’s office did not make as much sense at home, where I had plenty of time and space to help her through it. (Have I mentioned before, ever, what I total amateur I was as a mom in general and an Asthma Mom in particular?)

These became my rules. They transformed the nebulizer from a scary, smoky machine into a regular, normal routine when my daughter was young.

1. Flip the nebulizer switch before you put the mask on. The sound of the motor, the misty medicine, the bizarre feeling of a face mask; all at once, these make for a terrifying experience for little kids.

2. In fact, let your kid put the mask on herself if she wants to. This gives her some control over the process.

3. Use the TV for distraction. Toddlers never stay still, anyway, and nebulizer treatments are boring. My daughter’s serious Elmo obsession always helped.

4. Use an extra mask to give your child’s favorite doll or stuffed animal a “treatment” at the same time. Then it feels like a game.

5. When I bought new masks, I let my kids use the old ones for dress-up, but only under my supervision or when they were old enough for the masks not to pose a safety risk. You know, so they could play Fire Rescue with pink boots and plastic hats. Obviously.

Got any tips that worked for your kids? Share ‘em below.

Thanks, Sarah, for inspiring this post with your comment about children, medical issues, and a sense of control.

62 responses to “Asthma Mom’s Rules for Nebulizers and Little Kids”

  1. Samantha says:

    We taught miss monkey that she was “being a dragon” ( a tip stolen from a more experienced asthma family) and had her “blow smoke like a dragon” which made it (almost) like a game for her…. we have always done her treatments either at the computer, or in front of tv/movie and i tried to give her as much involvement as possible.. ie she got to out on her mask, she got to flip the switch, etc

  2. kerri says:

    Okay, so I can’t identify with any of this, but you are freaking awesome if you didn’t already know. Your use of the word “obviously” was cracking me up.
    “You know, so they could play Fire Rescue with pink boots and plastic hats. Obviously.”
    LOVE it. And that picture. :-D

    This, however, has me thinking back to your sick day tips post, Amy. Could a lot of the quiet, flare-y day activities not be used while you’ve got a kid stuck behind a neb?

  3. Sarah says:

    If your kid doesn’t like straps (I hated straps – still do! Something about holding the mask to my face is just reassuring, plus it gives me a feeling of control, which definitely helps when your breathing is out of control), let the kid hold it. Eventually, your kid might get bored or tired and consent to the strap out of boredom/exhaustion, but don’t force the issue.

    Put the mask on yourself first to show the kid that it doesn’t hurt (maybe with just saline running through).

    Definitely agree with the TV thing. Books are a good idea, too (I was a huge bookworm), and so are small, portable games like Pass the Pigs or magnetic checkers.

  4. Sara C. says:

    I tend to give Mariella the choice of “wearing the mask” or “holding the mask”

    Also, it seems silly…but if the mask doesn’t really fit their little head right, and the elastic slides around, it will make it even more frustrating and more of a fight. Mariella uses her pony tail to hold the strap on…but if she isn’t wearing a ponytail, the thing slips over her ears and is uncomfortable, etc. If it’s not fitting well, just letting your child hold the mask might make all the difference.

  5. Amy says:

    Samantha–Oh, that dragon tip is perfect for little kids, thanks.

    Kerri–Thanks! I can’t remember whose idea that was, but I’m betting it was Kyra’s. Do you not love the boots and shorts? It was probably about 100 degrees outside that day. You’re right about that other post–I should incorporate it with this one, huh?

    Sarah–My nephew hated the straps, too, but Kyra was okay with them–I guess b/c they left her hands free.

    Sara C–Whatever works, right? Kyra used to put the mask on VERY loose & then tighten the straps herself. I was NOT to touch them-totally understandable, of course.

  6. Allison says:

    My son was four I think when he first used a nebulizer. I would have him help me get it out and set it up and do as much of it as possible. Hooking the tubes up and squeezing in the albuterol in the cup really helped calm him down (and as a result calm me down too!) while we tried to hook it all together for a middle of the night flare.

  7. Steve says:

    No tips, but I sure do remember those fireman hats as a child:-)

  8. Elisheva says:

    Ooh! Childhood neb memories!

    My mom used to tell us to blow “smoke signals”. She’d ask us questions. One deep puff out was a yes. Two were no. We also got to sit in the special “breathing treatment chair”. I was less amused by this since I was older at diagnosis and understood what was going on – I mostly just spaced out in front of the TV. But my brother who was asthmatic since birth tended to be pretty good with these tactics.

  9. MC says:

    I hate the straps on the masks often. But usually when I need/use a mask, I’m to worn out to even hold it myself, so I just manage and keep sliding the strap back on my head where it’ll slide the least.

    Love the fireman gear… brings back childhood memories, though they had nothing to do with asthma as I didn’t have it when I was younger, neither did anyone else in my family.

  10. Libby says:

    So we aren’t the only ones with a kid who hates the strap!

    Under “normal” circumstances, i.e., no respiratory infection in sight, my son only gets one nebulizer treatment per day. Except instead of doing it AT bedtime, we do it immediately after. So, yes, that is my tip. Do it while the child is sleeping.

    (Zombifying child with TV and allowing him to hold mask himself are also our usual strategies when number of treatments per day require doing them while child is conscious.)

  11. sarah d. says:

    my son is only a year old and gas to use the nebulizer. of course hehates it and all of these suggestions seem to be for older kids. anyone have any ideas on how to help? i have to hold him down and he screams. then he screams for a long time after it is over because he is so stressed ot from it. HELP!!!!!!

  12. Amy says:

    Hi Sarah,
    Unfortunately, I don’t. My daughter was misdiagnosed until she was 2 years-old, so when she was your son’s age, ER docs kept sending us home with oral meds rather than a neb. Even as a toddler, though, my daughter screamed for a few months until she got old enough to distract. I hope someone else out there has some ideas for you!

  13. Jennifer says:

    We started my son on a nebulizer today and he is using the mouth piece, not the mask (He is almost 3). The nurse told me that I could stuff a cotton ball in the back side of the mouth piece (where the steam comes out) and just let the mist run on his nose and mouth if I have a hard time getting him to put it in his mouth; she also said this way works well when they are sleeping. She said not to put in the cotton ball if the piece is in the mouth though.

  14. Asia says:

    Hi Sarah D.,
    I feel your pain, I too have a 1 year old who screams and wiggles her way out of my arms! Just recently I’ve let her press the button on her machine and use the accordion looking tube instead of the mask and this has helped a great deal! She puts it in her own mouth and is thrilled to see the ” smoke” come out the other end. I hope this may be of some help to you!

  15. gymnastics says:

    Heya i’m for the first time here. I found this board and I in finding It really useful & it helped me out a lot. I’m hoping to give something again and help others such as you helped me.

  16. Christina says:

    I just find sleeping time to be the only sure time to get it in them right. If necessary while they are awake, of course watching tv or laptop but they can’t really hear it over the awful hum. We’ve recently let our little one use headphones during this time to keep her occupied. And don’t think I haven’t allowed her to do anything she asked to get it done, cutting with scissors, tearing through my jewelry box or anything else that was previously on the forbidden list.

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  19. Sara A. says:

    Ok, so my 18 month old has had 2 boughts of pneumonia in the last year, and when he started down the path of a repiratory infection again, we went straight to the doctor. She noticed he was weezing and sent us home with a nebulizer and albuteral treatments (3 times daily). Like most other posts of little, little ones, we have to hold him down and he screams and fights us the entire time. He too loves Elmo, but even that didn’t seem to amuse him. If anyone who has one under 2 has found something that works, please let me know. My gut says we’re going to be in this for the long haul, so we are going to have to find something that works. Thanks

  20. Kara says:

    Just an idea for those with littler ones….
    First, you need to be calm… really, really calm!
    Yes, it’s important and must be done but there is nothing to be worried or stressed about. Both of my boys were around a year when they had their first treatments and the more stressed I was about it, the crazier they were. My husband did some of the treatments with them in the beginning and they handled it much better when they were with him. In part I think because he wasn’t scared like I was!

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  22. Autumn Wilson says:

    Dear Asthma Mom, 12 May, 2016

    Hi. My name is Autumn and I’m 15 years old. I hope you don’t mind me posting an idea here.
    My little sisters, Summer and Winter, have asthma. They have had trouble breathing since they were preemies. When the babies where 18 months old, they got to where they did not want to do their nebulizer treatments. So, I talked to their pulmonologist and Uncle Ray about an idea I had and got their okay to do it.
    I don’t have any respiratory problems but I do “breathing treatments” with them four (4) times daily. (I have my own nebulizer machine and aerosol mask.) While they were watching me, I’d set mine up with albuterol only, turn it on and put the mask over myself. I’d do my “treatment” while they watched. But while I still had my mask on I’d get their masks ready and give them their treatments.
    Now that they are three (March 11th) they help prepare the treatments for us (while I supervise of course) and give me and each other the treatments.
    They use to be fussy about the treatments. Now, when I say that’s it’s treatment time, they literally run to do them. So they don’t fuss about who gets the masks ready, we take turns. Today, I set up the treatments for us and put the masks over us. Tomorrow will be Summer’s turn and Saturday’s Winter.
    We also do like you and let them play with and wear the old masks. Winter and Summer both really, really like giving breathing treatments to their stuffed animals.
    But, they also have to be on oxygen at night. So, I got an oxygen mask and wear it while reading a bedtime story to them. One night last week, I fell asleep on Winter’s bed and Uncle Ray took a picture of us sleeping with our oxygen masks on!
    Since I’m older now, the pediatric oxygen and nebulizer masks don’t really fit me anymore. Monday, we’re going to the medical supply store so the girl’s can buy an adult size oxygen and nebulizer mask for me.
    I need to go because I have to do my homework. I hope I haven’t been a bother.

    Sincerely your,

    I think playing Fire Rescue is a wonderful idea. Your daughters look so adorable wearing the plastic oxygen masks over their faces!

  23. My sisters child needs a nebulizer and I was wondering what could help her and her child. You talked about letting the child be in control by letting her put the mask on and I know that her child would love that. Anything to help the process a bit easier goes a long way. Thanks for the tips.

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