Hi, I had gone through your question and understand your concerns. Nebulizer and inhaler are different methods of inhalation therapy , purpose of both is same , for long term and home use inhaler is preferred and for in hospital or severe illness nebulizer is used. But in case of a 22 months baby you need to use inhaler with spacer and mask for it to be effective as baby can not coordinate breaths . Hope this answers your question. If you have additional questions then please do not hesitate in writing to us. Take care. •     DISCLAIMER: - All the information provided here is for information purpose only , it is not a substitute for the advice of a physician after physical examination , it is not intended to replace your relationship with your doctor. This information in no way establishes a doctor-patient relationship. Before acting anything based on this information do consult your doctor. I recommend that online users seek the advice of a physician who can perform an in-person physical examination