ABSTRACT
Considerations for delivering inhalant therapy to infants and children are similar to those for adults, that is, ease of use, production of therapeutic aerosol within the size range for optimal deposition in the lung, minimal oropharyngeal deposition and reliable, and reproducible device performance. However, with infants and young children, the breathing parameters are a prime influence in determining how much aerosol is inhaled into the lung. Children have lower tidal volumes, which translates into reduced delivery,1,2 and breathing patterns vary widely,3,4 with inspiratory flow rates (IFR) ranging from near 0 to approximately 40 l/min. Higher flow rates mean deposition on more proximal airways. Furthermore, a crying child will have higher IFRs, with the result that decreased amounts of drug are inhaled into the lung.5 Inhaling aerosol through the nose, or nasal breathing in addition to mouth-breathing during treatment, also reduces the dose to the lung.6
