The latest asthma guidelines recommend a stepwise approach for managing asthma in children up to 4 years of age. This includes the use of quick-relief medications (such as albuterol ) for intermittent asthma symptoms. A low-dose of an inhaled steroid, cromolyn , or Singulair is the next step up. Then the intensity of the asthma treatment is focused on controlling their asthma. If the child's asthma is controlled for at least three months, your child's doctor may decrease the medication or "step down" the asthma treatment. Consult with your asthma specialist for exact medications and dosages.
In order to properly use an inhaler without a spacer, one has to coordinate a certain number of actions in a set order (pressing down on the inhaler, breathing in deeply as soon as the medication is released, holding your breath, exhaling), and not all patients are able to master this sequence. Use of a spacer avoids such timing issues. Spacers slow down the speed of the aerosol coming from the inhaler, meaning that less of the asthma drug impacts on the back of the mouth and somewhat more may get into the lungs . Because of this, less medication is needed for an effective dose to reach the lungs, and there are fewer side effects from corticosteroid residue in the mouth.