What concentration of normal saline is recommended for nebulization in an 8-month-old infant?

Normal Saline Nebulization Concentration for an 8-Month-Old

Normal saline (0.9% NaCl) is the standard concentration used for nebulization in infants, including 8-month-olds—neither 3% nor 9% saline is "normal saline."

Clarifying the Terminology

• Normal saline = 0.9% sodium chloride solution 1
• This is the isotonic concentration used as the diluent for nebulized medications in pediatric patients 1
• The question appears to confuse normal saline with hypertonic saline concentrations

Standard Nebulization Practice for Infants

For bronchodilator nebulization in an 8-month-old:

• Albuterol should be diluted in a minimum of 2-3 mL of normal saline (0.9% NaCl) for adequate nebulization 1
• The minimum dose for infants is 2.5 mg (0.5 mL of 0.5% albuterol solution) diluted in saline 1
• Oxygen is the preferred gas source for nebulization at 6-8 L/min flow rate 1, 2

For anticholinergic therapy (if indicated as adjunct):

• Ipratropium bromide 250 mcg can be mixed with albuterol in the same nebulizer chamber using normal saline as the diluent 2
• Total volume should be at least 3 mL in the nebulizer chamber 2

When Hypertonic Saline Might Be Considered

Hypertonic saline (3% or 7%) is a completely different indication:

• Used specifically for bronchiolitis (typically viral lower respiratory tract infection in infants) 3
• Not used as a routine diluent for bronchodilators
• Research shows 7% hypertonic saline may reduce hospital stay in bronchiolitis, but this is distinct from normal saline nebulization 3

Critical Administration Details for This Age Group

For an 8-month-old infant:

• Use a tight-fitting face mask over nose and mouth—infants cannot coordinate breathing through a mouthpiece 2
• The infant should breathe with an open mouth during treatment 2
• Monitor heart rate, respiratory rate, and oxygen saturation (target SpO2 >92%) 2
• Watch for adverse effects including tachycardia and tremor 2

Common Pitfall to Avoid

The most critical error would be confusing normal saline (0.9%) with hypertonic saline (3% or 7%):

• Normal saline is the standard diluent for bronchodilator medications
• Hypertonic saline is a therapeutic agent for specific conditions like bronchiolitis
• 9% saline is not a standard concentration used in pediatric nebulization