If the child is able, tell the child to take an extra deep breath every 10 breaths or so, hold that breath for 10 seconds, and then breathe out slowly. This technique permits the medication to stay in the lungs longer for better effect. With smaller children, it may help to hold their nose closed to get more medication into their lungs. If a child is too small to use a mouthpiece, hold the nebulizer 2 to 4 inches in front of the child's mouth. Or you may use a mask, which can be secured loosely over the nose and mouth so the child does not become frightened.
Most nebulizers work best in an upright position.
If the mixture has coated the sides and isn't being nebulized, gently shake the nebulizer occasionally during the treatment. An average treatment takes 10 to 15 minutes. The treatment is over when all the medication is gone and the nebulizer makes a constant sputtering noise. Some children cough up mucus after breathing treatments. Observe the mucus color and thickness.