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Bubble PEP

PEP stands for positive expiratory pressure. Bubble PEP is a treatment to help children who have a build-up of mucus in their lungs.

Who should complete bubble PEP?

Bubble PEP can be used by any child who has difficulty clearing mucus, most commonly those with cystic fibrosis or those who have just had surgery.

During treatment, your child will be encouraged to blow big bubbles through water.

What is bubble PEP?

Drawing of diagram of milk jug and straw being used to blow into water and create bubbles

You can use an empty bottle or plastic jug. Please do not do it directly into bath.

Blowing bubbles is a simple but effective way of practicing blowing bubbles with your child. They can help them take deep breaths and occasionally stimulate a cough to help clear their lungs.

Your child will be encouraged to blow down the tubing into the water and make bubbles. This creates positive pressure back up the tubing and into your child’s airway and lungs

As the pressure holds open your child’s airways, it helps more air to move in and out of the lungs. The airflow helps to move the mucus out of the lungs into the airways. From here, it can be coughed up (cleared), which is the aim of the treatment.

How to do a treatment with bubble PEP?

  1. Ask your child to take a deep breath in and then blow out through the tubing, into the water to create bubbles. The breath out should be as long as possible. Aim to get the bubbles out of the top of the bottle each time. It may be messy and should be fun.
  2. Repeat step 1 again.
  3. Ask your child to huff and cough to clear the mucus, as taught by your respiratory therapist. Encourage your child to cough the mucus out rather than swallow it.
  4. Repeat this cycle a few times.

After you are done playing, the bottle and tray should be washed out and left to dry with a disposable towel. Store it in a clean place until next used. Only wipe the outside of the tubing, do not wash the inside as water may get stuck inside.

This information resource is a guide only and should be used with specific individual information given to you at your clinic appointments by a physiotherapist.

Contact us

If you have any questions or concerns, please call 0114 271 7273.

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Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: CF27

Resource Type: Article

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