Witnessing a child experience a breath-holding spell can be frightening for parents or caregivers. Loss of breath and consciousness often triggers fear. This article addresses their fatal risk and provides information to understand and manage them.
Understanding Breath-Holding Spells
Breath-holding spells are involuntary reflexes where a child temporarily stops breathing, leading to brief loss of consciousness. They are not intentional, but an automatic response to distress. These spells typically begin in the first year of life, with a peak incidence around age two, and generally resolve by ages four to eight years.
Common triggers include strong emotions (anger, frustration, fright) or pain/shock. There are two primary types: cyanotic and pallid. Cyanotic spells, the most common, follow intense crying or anger, turning the child’s skin bluish due to decreased oxygen. Pallid spells, triggered by pain or sudden scare, cause the child to become pale and limp, sometimes with a slowed heart rate.
Are Breath-Holding Spells Fatal?
Breath-holding spells are not fatal and cause no lasting harm. A child turning blue or pale and losing consciousness is due to a temporary physiological response, not permanent lack of oxygen or brain damage. During a spell, the body automatically restarts breathing once brain oxygen levels drop or consciousness is lost.
Brief loss of consciousness occurs due to temporary reduction in brain blood flow and oxygen. This self-limiting reflex means the body’s systems naturally correct themselves. There is no evidence breath-holding spells lead to long-term neurological damage, increased epilepsy risk, or other serious health issues. Children recover quickly, usually within a minute, returning to normal without intervention.
What to Do During a Spell
Staying calm is important during a breath-holding spell. Panicking increases anxiety for child and caregiver. Lay the child on their side to prevent injury and ensure an open airway. Remove any hard or sharp objects from the vicinity.
Avoid certain actions. Do not shake or splash water on the child; these are unhelpful and potentially harmful. Do not put anything in the child’s mouth, as this could lead to choking or vomiting. After the spell, comfort the child without reinforcing the behavior if triggered by a tantrum.
When to Consult a Doctor
Though generally harmless, some situations warrant medical evaluation. For a child’s first spell, consult a primary care provider to rule out mimicking medical conditions. A doctor can differentiate true spells from seizure disorders or heart conditions.
Seek medical attention if spells become more frequent, severe, or prolonged. Red flags include slow recovery, confusion or lethargy after the spell, or unusual symptoms like prolonged unconsciousness or atypical seizure-like movements. A doctor may also assess for iron-deficiency anemia, sometimes associated with spells.