How does my child use a spacer?

Remove mouthpiece from the pump.
Shake 4 or 5 times.
Insert pump into spacer.
Have your child breathe out normally.
Place the mouthpiece of the spacer between your child’s teeth and the top of the tongue and have your child close mouth.
Press down on inhaler 1 time.
Have your child take a slow deep breath.
Child should hold their breath for 5 to 10 seconds.
Remove the mouthpiece from your child’s mouth to breathe out.
Wait at least 1 minute before taking a second puff, which is needed by most medications.