A number of diseases in infants require respiratory treatment using a nebulizer. Nebulizers deliver medications that help open the bronchial tubes in a fine mist spray that easily enters the lungs. Premature infants, infants with chronic diseases like asthma and cystic fibrosis, or those with acute illnesses like pneumonia, bronchitis or bronchiolitis may need nebulizer treatments. Since infants can't hold a mouthpiece in their mouth, they require a nebulizer that allows use of a mask. Nebulizer treatments normally take 10 to 15 minutes to complete. Treatments can be administered in several different ways.
Much of the medication in the nebulizer never reaches the lungs. About 10 to 20 percent of the dose is inhaled and only around 50 percent of that reaches the lungs, lead author Jennifer Pryor, PhD reports in the textbook "Physiotherapy for Respiratory & Cardiac Problems: Adults and Pediatrics". A face mask provides the most effective way to administer a nebulizer treatment to an infant and ensure absorption. The face mask fits securely around the baby's face, held in place by elastic straps over the ears. Some infants fight having something put over their face, and the ensuing struggle may worsen their respiratory problems. Respiratory treatment can be done while the infant is sleeping; it may be easier to place the mask and keep the child calm to do the treatment during a nap. Attach the mask and do the treatment on a sleeping infant placed in an infant seat rather than lying down. Face masks painted with cute characters may make treatments more acceptable to a slightly older infant. Nebulizer compressors disguised as toys may also make treatments easier with older babies.
Blow-by nebulizer treatments can be done if an infant fights having the mask placed and needs a treatment done immediately because he's having trouble breathing. The mask can be placed a few inches away from the child's face, so that the medication is still directed at the nose. The downside of using blow-by is that the mask fitting isn't tight, so the infant receives less medication. Alternatively, the mask can be removed and just the tubing is directed at the child's nose. This may be the easiest way to administer nebulizer treatments to an infant who really hates having something near his face.
Once an infant reaches the age of year or sometimes less, he may be able to hold a mouthpiece attached to the nebulizer in his mouth. Much more medication reaches the lungs with use of a mouthpiece. An infant with chronic respiratory problems may learn to do this at a fairly young age because he's learned that the treatment makes him breathe easier, pediatrician and columnist Warren Silberstein, M.D. explains on his website, Ask Dr. Warren.