The "Spacers, Puffers and Play" One

So, you’ve got to give your child a puffer or spacer. Here are some tips to make it more fun, less stressful and give control back to your child AKA work together to get the job done without any unnecessary fear, pressure or trauma.

1. Use play

Through play, we want them to become familiar with the medical equipment so it feels safe and non-threatening, rather than strange and scary. The play should be fun and low pressure.

Putting an unfamiliar mask over your toddler’s face and asking them to breathe in medicine can be confronting for a child that hasn’t experienced this before, or has potentially had negative experiences with medical masks in the past.

> Before asking your child to use the mask + spacer to take their Ventolin, let them explore it. Help them notice what it looks, feels, and smells like. Maybe it smells like a beach ball, and looks like a funny microphone they can sing into. Then see if they CAN sing into it or make silly voices/sounds with it.

> Model yourself how you breathe into it so they learn how to use it and see that it’s safe to put near their face; make if fun and relaxed.

> You can give the mask/spacer a fun name to make it feel even more normal and familiar. Let your child help choose what to call it.

> You can also pretend to give a doll or stuffed animal the medicine through the mask/spacer to familiarise your child with the steps expected of them and what they may feel, hear, smell and taste. You can demonstrate first if helpful, then let your child lead the play and give the doll the medicine if they’re keen. As you play, name the steps involved - eg “mask on, count 1-2-3-4” and describe what the doll is experiencing, eg “The mask feels soft on doll’s face. Little puff sound for medicine. Doll is taking deep breaths. Doll can smell the medicine - what do you think it smells like?"

> Allow your child to bring the mask to their face at their own pace. If they still seem hesitant, try the play activities below.

Other ways to play include:
> Blowing bubbles through the mask. Check it out here

> Painting with the mask (put paint on a plate, dip the mask into the paint, then stamp it onto paper. Make fun designs or draw fun faces in the shapes once dry). Be sure to use washable water-based paint so that it washes off easy.

2. EXPLAIN WHAT THE MEDICINE IS FOR USING SIMPLE CONCRETE TERMS

It is always important to help children understand why they are taking medicine. This helps them to know that it’s safe, there to help their body, and can help motivate them to take it.

For toddlers, use short, simple explanations:

> Explain that this is medicine they breathe (not drink like usual).

> Explain how the medicine will "help your body" and refer any symptoms they’re experiencing in the words you normally use. Eg “Medicine to stop cough” (notice short phrases/simple words).

> It may help to explain what breathing is. Show your child how you take a big breath and practice this without the spacer + Ventolin first. Make this playful - pretend to breathe in the smell of pizza or hot cocoa or whatever smells your child enjoys.

3. Create a consistent routine

Toddlers thrive in predicable environments. Help them create a routine so they know what to expect and what is expected of them when taking their medicine.

For example:
> Give a 1-2 minute heads up it’s almost time for medicine (you can use the name they chose to call it) to help them transition out of their current activity. If they protest, you can say “First medicine, then [chosen activity]” so they know they can go back to their play time.

> Get into position for doing the medicine, offering relevant choices as you go (see below). Note: It may help to do it in the same place/area of the house as often as possible. Clear the area of any major distractions before trying to give the medicine.

> Use a cue to giving the Ventolin - eg “Ready, steady, go” or “1-2-3”

> If your child is bothered by the smell/taste of the Ventolin, have something ready for them to sniff or eat right after.

> Praise your child for what they did well (making a choice, taking deep breath, etc.), and transition to a happy activity to do together to end on a positive note.

4. offer choices

Choices give children a sense of control - they don’t get to choose IF they take their medicine, but they can help choose HOW.

Offer a choice between two options, eg:

“Sit on mum’s lap or chair?”
“You put on face or I do?”

You can let them choose if they want to hold a special comfort object or toy while they do their treatment.

You can let them choose a special activity or a prize like a sticker after.

The goal is for them to feel empowered by being able to make a choice in the process.

If they’re having a hard time deciding, you can say, “Mum help you choose - let’s do XXX.” You can offer as many choices as you feel works for your child, just avoid giving so many choices that they get overwhelmed. A couple choices is usually enough.

5. Validate feelings and set boundaries

If your child is having a hard time with taking their medicine, help them name and validate their feelings. Eg “You don’t want to take your medicine, you want to play. You’re feeling mad. It’s okay to feel mad. It’s time to take your medicine - I’ll help you then we will go play together.”

You can shorten the phrases if your child is a young toddler - the idea is to show them you hear and see them, you understand how they’re feeling, and it’s still time to take medicine.

By being consistent with setting boundaries and following through with medicine time, they will learn that taking their medicine isn't negotiable, but they can make other choices with taking their medicine and will get to return to play after.

ABOUT THE AUTHOR

Amanda is a Certified Child Life Specialist. She is educated and clinically trained to support children and families in coping with medical experiences. Amanda started Prepared for Care to empower parents with practical, evidence-based information and resources to help reduce children’s fear, anxiety and pain in medical settings. For more information, follow Amanda on instagram at Prepared for Care or check out her website for information and freebies.