Breath-holding spells, while often alarming for parents to witness, are common and generally harmless events in young children. These episodes involve a child involuntarily stopping their breathing, sometimes leading to a brief loss of consciousness. They do not cause long-term health problems or brain damage, and children typically outgrow them. This article provides a clear understanding of breath-holding spells and guidance for caregivers.
What Are Breath-Holding Spells?
A breath-holding spell is an involuntary reflex where a young child temporarily stops breathing, typically after an upsetting event, fright, or pain. These spells often begin with crying or screaming, followed by the child exhaling forcefully and then not inhaling. During the spell, children may turn blue or pale, become limp, or experience brief unconsciousness. The episode usually lasts less than a minute, though it can feel longer to observers.
There are two main types: cyanotic and pallid. Cyanotic spells are the most common, occurring after intense crying due to anger, frustration, or pain. During a cyanotic spell, the child’s skin, especially around the lips, may turn blue or purplish from a temporary lack of oxygen. Pallid spells are less common, triggered by sudden pain or fright, such as a fall. In these instances, the child’s face becomes very pale, and their heart rate may slow significantly.
Understanding the Risks
Breath-holding spells are benign and do not cause brain damage, epilepsy, or long-term health issues. The child’s brain is protected because breathing resumes spontaneously, and consciousness returns quickly. While frightening to witness, these episodes are a reflex, not a deliberate action by the child.
These spells affect approximately 5% of healthy children, most frequently between 6 months and 2 years of age. Most children outgrow them by 5 or 6 years old. It is important to distinguish breath-holding spells from seizures; while some children may have brief stiffening or jerking movements during a spell, this is part of the spell itself and does not indicate an underlying seizure disorder. The only rare risk is potential injury from falling if the child loses consciousness while standing.
Responding to a Spell
When a child has a breath-holding spell, caregivers should remain calm. Gently lay the child down on their side or back on a safe surface to prevent injury from falling. Ensure no objects nearby could harm the child.
Intervention during the spell is not necessary, as the episode resolves on its own within a minute. Avoid actions such as shaking the child, splashing water on their face, or attempting mouth-to-mouth resuscitation, as these are unhelpful and could cause distress or harm. After the spell, when the child regains consciousness, offer comfort and reassurance. Do not punish the child for the spell, as it is an involuntary reaction they cannot control.
When to Consult a Doctor
While breath-holding spells are harmless, medical consultation is advisable in specific situations to rule out other conditions. Consult a doctor if a child’s first spell occurs before 6 months of age or if spells continue past 5 to 6 years. A medical evaluation is also warranted if spells become more frequent or severe.
Seek medical advice if the child does not recover quickly or exhibits unusual symptoms during or after a spell. These might include prolonged stiffness, jerking movements not typical of a breath-holding spell, or unusual behavior after the episode. If there is any doubt about whether the event was a breath-holding spell or something else, such as a seizure or cardiac issue, a doctor can provide a proper diagnosis.