Breath-holding spells are a common, albeit alarming, occurrence primarily in young children. While witnessing a child experience a breath-holding spell can be frightening for parents and caregivers, these episodes are generally harmless and do not cause long-term damage. They represent a temporary, involuntary reflex rather than a deliberate act. Understanding these spells can help parents respond effectively and reduce anxiety.
Understanding Breath-Holding Spells
Breath-holding spells are involuntary physiological responses where a child temporarily stops breathing, often leading to a brief loss of consciousness. There are two main types: cyanotic (blue) and pallid (pale) spells.
Cyanotic spells are the more common type, typically triggered by strong emotions like anger, frustration, or pain. During such a spell, the child usually cries vigorously, exhales forcefully, and then holds their breath, causing their skin, especially around the lips, to turn bluish due to a temporary lack of oxygen. This is often followed by a brief loss of consciousness, lasting less than a minute, with rapid recovery.
Pallid spells, which are less common, are usually triggered by a sudden fright or minor injury. In these instances, the child may gasp or cry briefly before turning pale and losing consciousness, often accompanied by a temporary slowing of the heart rate. Recovery is typically quick, within a minute.
Causes and Triggers
Breath-holding spells are primarily triggered by intense emotional states or physical stimuli. Common triggers include pain from a fall or bump, strong feelings of anger or frustration, sudden fear, or a shocking event.
These spells are not indicative of a serious underlying medical condition, such as lung problems or epilepsy, even if some children exhibit stiffening or twitching movements during an episode. While the exact cause is not fully understood, a family history of breath-holding spells is common, suggesting a genetic component. Iron deficiency anemia has also been observed more frequently in children who experience these spells, and addressing this deficiency can sometimes reduce their frequency.
Responding During a Spell
When a child experiences a breath-holding spell, remaining calm is important for parents. The first step is to gently lay the child down on their side, ideally on a soft surface, to prevent any injury from falling or jerky movements. It is also advisable to clear the area around the child of any hard or sharp objects that could cause harm.
Parents should avoid placing anything in the child’s mouth, shaking the child, or splashing water on their face, as these actions are generally ineffective and could be harmful. Attempting CPR is usually unnecessary unless the child remains unresponsive and stops breathing for an extended duration, which is a rare occurrence. After the spell, treat the child normally without excessive fuss, as this reinforces the understanding that the spell is a temporary event.
When to Seek Medical Advice
There are specific situations where medical consultation is advisable. Parents should seek professional medical advice if the spells begin before six months of age or continue beyond five to six years. It is also important to consult a healthcare provider if the spells become more frequent, increase in severity, or if the child does not recover quickly and fully after an episode.
Any additional concerning symptoms during a spell warrant medical attention, such as unusually prolonged loss of consciousness, significant jerking movements that last longer than a minute, or if the child appears confused or unwell for an extended period afterward. A doctor can rule out other conditions that might mimic breath-holding spells, such as certain heart conditions or seizure disorders, and provide reassurance regarding the child’s overall health.