We also shake the cup a little when sputtering and it lets out a little more, then we turn it off. Our 4 mo old takes albuterol first, then sodium chloride, then chest PT, and then finally her Pulmozyme. This was the order the doctor said to do. In the hospital we were just told to hold the little turtle mask in front of her face...didn't have to be on her face, so some escaping I do not see to be a problem at all. Hope this helps! PM me if you have any other questions. Looks as though your little one is about the same age as mine. Although, my DS does/had a lot of thick mucous found in her lungs shortly after birth. We are working on cleaning them out!