Breath-Holding Spells

Breath-holding spells are episodes during intense crying when a child will seemingly stop breathing, become pale or even blue and go limp. Although this is quite scary for parents, fortunately there are no serious consequences.

What is the cause of breath-holding spells?

It is not known why certain children have breath-holding spells, but it is known that they are all preceded by an intense period of crying usually out of frustration. They occur with equal frequency in males and females and there is a family history of breath-holding spells in about 25% of cases. In these children, prolonged or intense crying leads to the involuntary holding of breath resulting in the child appearing to stop breathing. These episodes are not seizures nor do they cause a lack of oxygen to the brain.

What to do?

The first thing is not to panic. Here are some other helpful tips:

  • Quickly apply a cold cloth to the face or gently tap the child’s cheeks. If this is done in the first 15 seconds of the breath-holding this may end the spell
  • Put the child on the floor or in the crib to prevent injury from falling during unconsciousness. Do not lift the child upwards(vertically), this may actually make things worse. When picking up the child do so while the child is lying horizontal.
  • Discuss this with your doctor.

Confirming the diagnosis

Although in most cases the diagnosis is simple to make, sometimes the doctor may perform specific tests to make sure that the spells were not epilepsy or seizures. In most situations, the child is well otherwise and the pattern of the spells and the fact that crying sets them off is enough to confirm the diagnosis of breath-holding spells.

Breath-holding spells usually begin after 6 months of age and peak at about age two. Fortunately, most children outgrow breath-holding spells by the age of 5 years. Also, more rarely in young children, breath-holding spells can be brought on by a painful injury such as a fall on the head, or a severe fright(without intense crying). This is similar to adult fainting spells due to the so-called “vaso-vagal” reflex which causes the heart to slow causing paleness, limpness, and even loss of consciousness. Interestingly many adults who suffer from easy fainting when seeing blood or with minor injury had breath-holding spells as young children.

Can breath-holding spells be prevented?

As breath-holding spells are usually due to a frustrated child, trying to limit, foresee or even prevent frustrating experiences may help. Also, try to avoid situations like fatigue and hunger which make things worse. Finally, setting firm and consistent limits will also help a child better deal with frustration.

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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above is designed to be an educational aid only. It is not intended to replace the advice and care of your child’s physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition always consult a physician.