Witnessing a baby turn purple while crying can be unsettling. This alarming sight is often linked to breath-holding spells, a common and generally harmless phenomenon. These episodes, while appearing dramatic, are usually a temporary part of a child’s early development. Understanding the reasons for this color change can provide reassurance and help parents respond effectively.
Understanding Breath-Holding Spells
Breath-holding spells are involuntary reflexes where a child temporarily stops breathing, typically after an upsetting event. These spells are not deliberate actions, even if they occur during a tantrum. Common triggers include intense crying due to anger, frustration, pain from a minor injury, fear, or sudden shock. They most commonly occur in children between 6 months and 2 years, though they can begin as early as 2 months and usually resolve by age 5 or 6.
During a breath-holding spell, the baby holds their breath, often after a forceful exhalation, leading to a temporary reduction in oxygen to the brain. This can cause the lips and face to appear bluish or purplish, a condition called cyanosis. In some cases, a vagal nerve response can slow the heart rate and reduce blood flow to the brain, causing the child to become pale.
There are two main types: cyanotic spells, characterized by blue/purple discoloration and often triggered by emotional upset, and pallid spells, where the child turns pale due to pain or fright. Both types usually last between 10 to 60 seconds, and the child quickly regains consciousness.
Responding During an Episode
Remaining calm is the most helpful response during a breath-holding spell. Gently lay your baby on their back or side in a safe area to prevent injury. Avoid shaking or hitting the baby, as this will not stop the spell and could cause harm.
The baby’s breathing will automatically resume; active intervention is usually not required. Do not attempt to put anything into their mouth or offer food or drink during the episode. After the spell, offer comfort and reassurance without overreacting or punishing them. Treating the situation calmly helps both you and your child recover.
When to Seek Medical Care
While breath-holding spells are generally benign, certain signs warrant medical evaluation. Contact your pediatrician if this is your child’s first breath-holding spell, or if spells become more frequent or severe. Seek immediate medical attention if your baby does not resume breathing quickly, remains unconscious or unresponsive for longer than one minute, or exhibits prolonged seizure-like activity after the spell.
Additional red flags include color changes when the baby is not crying, unusual breathing patterns, or spells without obvious triggers. A pediatrician can confirm the diagnosis, rule out conditions like iron deficiency anemia, or other neurological or cardiac issues that might mimic these episodes. Consulting a healthcare professional provides peace of mind and ensures proper management.
Other Considerations for Color Change
While breath-holding spells are the most common reason a baby turns purple while crying, other medical conditions can also cause skin color changes. These conditions typically present with additional symptoms that distinguish them from breath-holding spells. For instance, a persistent blue tint not associated with crying, or an overall blue coloration of the body, could signal problems with the heart or lungs.
Other color changes, such as persistent paleness or yellowing of the skin (jaundice), also indicate different underlying issues, often accompanied by other specific symptoms like fever, vomiting, or lethargy. If your baby displays any persistent or unexplained color changes, or if the discoloration is not clearly linked to crying and resolves quickly, seek prompt medical evaluation. A medical professional is best equipped to differentiate between a benign breath-holding spell and a potentially more serious underlying condition through a comprehensive assessment.