Helping your child use their inhaler correctly is an important part of caring for your child. A metered-dose inhaler can help you get the right amount of medicine *right* into your child's lungs. Metered dose means that the inhaler gives a measured amount of medicine each time your child uses it. This type of inhaler delivers medicine in the form of a liquid mist. Doctors recommend using a spacer with most metered-dose inhalers. A spacer is a chamber that attaches to the inhaler. The spacer holds the dose of medicine while your child inhales it. The spacer makes it easier for your child to get medicine into their lungs. But if you don't have a spacer, you can still use the inhaler without it. You can also ask your doctor for a spacer. Before you get started, here are a few things to remember. Inhalers come in different shapes, sizes, and doses. Each kind is used differently. Read the instructions that come with the inhaler. Make sure you use the right inhaler at the right time. Label each inhaler if you have more than one. Check the instructions to see if you need to prime the inhaler before use. Prime means to get it ready. If your inhaler needs priming, follow the inhaler's instructions. Before you begin, be sure you've worked with a nurse, doctor, pharmacist, or respiratory therapist to make sure you're using your inhaler correctly. But here's how someone would generally use a metered-dose inhaler without a spacer. Begin by shaking the inhaler for 5 seconds. Remove the cap. Next, hold the inhaler upright with the mouthpiece at the bottom. Now, have your child stand or sit up straight. With the inhaler a short distance from their mouth, they should breathe out slowly and completely. Next, have your child put the inhaler's mouthpiece in their mouth and close their lips tightly around it. They should keep their tongue away from the opening. Now have your child take a slow, deep breath while pressing the canister 1 time to release a puff of medicine. They should hold their breath for 5 to 10 seconds. If your child needs another puff of medicine, wait 1 minute between puffs. Replace the cap on the inhaler. Have your child rinse their mouth with water if the inhaler has corticosteroids, such as fluticasone. Controller inhalers usually have corticosteroids. Do not let your child swallow the water. So that's how to use a metered-dose inhaler without a spacer. Now here are a few other reminders. Use the inhaler's dose counter to see how many doses are left, and get inhaler refills before you run out. Follow the instructions for cleaning the inhaler. This will help you do it the right way for each inhaler. At first, learning how to use an inhaler can be stressful. But with practice, using a metered-dose inhaler can help your child feel better and breathe easier. And if you have questions, you can always call your child's doctor.