Breath-holding spells
Breath-holding spells are brief periods—usually lasting no longer than a minute—when a young child stops breathing. These spells usually result from anger, fear, pain, or frustration and are not a deliberate behavior on the child's part.
The two main types of breath-holding spells are cyanotic, caused by the change in breathing pattern, or pallid, caused by a slowing of the heart rate.
Breath-holding spells are most common in children ages 1 to 3 years. Breath-holding spells are usually not serious and do not cause permanent damage or affect a child's future health. Most children gradually outgrow them.
What are the symptoms of breath-holding spells?
A breath-holding spell may cause:
- Fainting. It usually lasts for less than a minute.
- Twitching muscles, a stiff body, or a seizure.
- Changes in breathing and heartbeat.
- In a cyanotic spell: The child may breathe too fast or too hard. When the child breathes out, there may be a long pause before the child takes another breath.
- In a pallid spell: The heartbeat may slow down.
- Changes in skin color.
- In a cyanotic spell: The skin may turn red or blue-purple, especially around the lips.
- In a pallid spell: The skin may be pale and sweaty.
- Crying.
- In a cyanotic spell: There may be a short burst of intense crying.
- In a pallid spell: There may be a single cry or no cry at all.
How are breath-holding spells treated?
Most children don't need treatment for breath-holding spells. Spells will go away as your child gets older. If your doctor thinks that a medical condition is causing the spells, your child may need treatment.
To decrease the chance of more spells, make sure that your child gets plenty of rest, and try to help your child feel secure. Be sure to tell your child's doctor if your child starts to have spells more often or if they seem worse or different than before.
Breath-holding spells can be frustrating for parents. If you have trouble dealing with your child's spells or find yourself getting angry, talk with your doctor or a counselor. Try to keep in mind that your child isn't having spells on purpose.
Preventing breath-holding spells in children
Parents may be able to prevent some spells by seeing that their child gets plenty of rest and feels secure. Here are some ways to help your child.
- Have regular rest times for your child during the day.
- Ensure that your child gets adequate sleep at night.
- Have regular daily routines for your child.
- Keep your home atmosphere calm.
- Allow your child to make some simple choices.
For example, let your child choose which shirt to wear.
- Praise your child for behaving appropriately and meeting your expectations.
- Praise your child when your child learns and masters new tasks, and afterward when your child does them well.
- Encourage your child to play alone.
This will help your child develop a more positive self-image and can also reduce feelings of frustration.
As children learn to deal with frustration, fear, and anger, breath-holding spells become less frequent.
How are breath-holding spells diagnosed?
Doctors can usually diagnose breath-holding spells based on what happens during a spell. The doctor will examine your child and ask you to describe the spells. It may help for you to keep a record of what happens during each spell.
If your doctor thinks that your child has a seizure disorder or another condition, such as iron deficiency anemia, your child may need other tests.
What can you do if your child has a breath-holding spell?
To protect your child during a spell, lay your child on the floor and keep their arms, legs, and head from hitting anything hard or sharp.
Your child may stop breathing for up to 1 minute (60 seconds) during a spell. If your child doesn't wake up quickly and start breathing again, call911or other emergency services. The 911 operator may tell you to give your child rescue breaths while you wait for help to arrive.
After the spell, reassure your child. Don't punish your child for having the spell.
Helping yourself and your child cope with problem behavior that causes breath-holding spells
If you have succeeded in preventing some of your child's breath-holding spells, problem behavior may remain. Here are some tips to help your child.
- Do not overreact to your child's negative behavior.
- Do not overreact to breath-holding spells.
- Suggest an alternative way to express feelings of frustration, anger, or fear when your child begins a breath-holding spell.
For example, remind your child to "use your words."
- Acknowledge your child's behavior and feelings after the breath-holding spell.
- Avoid overprotecting or sheltering the child from the normal frustrations of childhood.
Minimize unnecessary frustrations, but do not try to remove them all.
- Remind yourself that breath-holding spells are not hurting the child and that the child will grow out of them in time.
- Be firm, fair, and consistent when establishing discipline for your child.
Set limits and follow through with consequences.
If you struggle with any of these issues, parenting classes or counseling can sometimes be helpful.
What causes breath-holding spells?
Breath-holding spells are usually caused by either a change in the child's breathing or a slowing of the heart rate. These reactions may be brought on by pain or by strong emotions.
In some children, breath-holding spells may be related to iron deficiency anemia, a condition in which the body doesn't produce a normal number of red blood cells.
What are breath-holding spells?
Breath-holding spells are brief periods when children stop breathing. It's something they can't control. This can happen when children are angry, frustrated, in pain, or scared. These spells often cause a child to pass out. They usually happen in kids 6 months to 6 years old and usually go away on their own.
How can keeping a record of your child's breath-holding spells help with diagnosis?
Before taking your child to a doctor for breath-holding spells, write down what typically happens. These descriptions will help you to give your child's doctor accurate information to make an initial diagnosis. Try to observe and record what happens before, during, and after the breath-holding spell. Keep the following questions in mind:
- What situations occur just before your child has a breath-holding spell?
- During a spell, does your child's skin color appear to become more blue-red or more pale?
- How does your child act during a spell? Do your child's muscles twitch?
- How long do the spells last?
- Does your child pass out?
- Does your child vomit or pass urine?
- How does your child act after a spell?
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