[Inhalation therapy in children younger than 2 years. II. The practice]

Given its pros and cons the indication for nebulisation therapy is limited. Nebulisation is cumbersome, expensive, time-consuming and often unnecessary even during severe bronchial obstruction. Inhalation is simple with metered dose inhalers and small inhalation chambers with low or no static charge and a mask over mouth and nose. Inhalation therapy in young children can fail on many points, with the risk that treatment is considered ineffective. Good instruction and control of correct use are mandatory. Inhalation therapy for small children has to focus on effective drug delivery, particularly during conditions like dyspnoea, tachypnoea and bronchial obstruction, because otherwise the therapy will fail when most needed. Of the three inhalation chambers available for small children, viz. the Babyhaler, the Aerochamber and the metal Nebuhaler, the last two are to be preferred. Since in the near future hydrofluoroalkane (HFA) aerosols will replace chlorofluorocarbon (CFC) aerosols an increased bronchial deposition has to be taken into account.