When a baby stops breathing while crying, it can be a frightening experience. This common, usually harmless phenomenon is known as a breath-holding spell. This article provides guidance on understanding these spells and how to respond.
Understanding Infant Breath-Holding Spells
Infant breath-holding spells are involuntary reflexes. These episodes typically occur in healthy children between 6 months and 6 years of age, with peak incidence around 18 months. Children usually outgrow these spells by school age, though some may continue to experience them until around 8 years old.
There are two main types of breath-holding spells. The more common cyanotic type occurs when a child cries intensely, exhales forcefully, then stops breathing, leading to a bluish or pale appearance due to a temporary lack of oxygen. The less frequent pallid type is often triggered by sudden pain or fright, causing the child to become pale and limp due to vagal nerve stimulation, which temporarily slows the heart rate. Common triggers include pain, such as from a fall or injury, or strong emotions like anger, frustration, or fear. The body responds to these intense stimuli by temporarily interrupting the normal breathing pattern.
Immediate Action During an Episode
Remaining calm is helpful. Gently place the baby on their back on a flat, safe surface, such as the floor or a bed, ensuring no hazards nearby. Check for and remove any objects from their mouth that could pose a choking risk.
Loosen any tight clothing around the baby’s neck, such as collars, to ensure an unrestricted airway. Observe the baby closely, noting changes in color, episode duration, and recovery. Do not shake the baby, splash water on their face, or attempt to put anything in their mouth, as these actions are not beneficial and could cause harm. Once the baby begins breathing again, which usually happens within a minute, offer reassurance and comfort.
When to Seek Medical Attention
Immediate emergency medical attention is warranted in certain situations. Contact emergency services if the baby does not start breathing within approximately 60 seconds, or remains unconscious for more than a minute after the spell. Similarly, call 911 or local emergency services if the baby experiences a seizure (more than just temporary stiffening), or if it is their first-ever episode and there is any uncertainty about the cause.
A non-emergency doctor’s visit is advisable if spells become more frequent or severe. Consult a healthcare provider if there are ongoing concerns about the cause, or if the baby exhibits unusual symptoms like unexplained fever or developmental delays. A medical professional can confirm the diagnosis and help rule out other conditions, such as epilepsy or certain cardiac issues.
Managing and Supporting Your Child
Identifying and avoiding common triggers can help reduce spell frequency. For instance, if a child frequently has spells due to frustration, parents might try to soothe or redirect their attention before frustration escalates. While responding with empathy, maintaining a calm and consistent parental response can prevent reinforcing the behavior if linked to anger or demands.
Supporting the child involves understanding the emotional toll on parents and caregivers. Talking to a pediatrician can provide reassurance and guidance, offering strategies tailored to the child’s situation. These spells are typically benign, and children almost always outgrow them as their nervous systems mature. They rarely have long-term health consequences or are associated with underlying brain damage or developmental issues.