breath-holding spells in children
Breath-holding spells can be alarming, but they are fairly common and usually harmless

When a young child is scared, angry, shocked, or upset they may hold their breath to the point where they turn blue or pass out. This is called a breath-holding spell and something your child doesn’t necessarily have control over. 

A breath-holding episode can be alarming for any parent, especially when they see it for the first time. However, these spells are fairly common and harmless, and a child will not die from holding their breath for a minute or so. 

Most children grow out of breath-holding by the age of 5. If your child’s episodes are very frequent, talk to your pediatrician to make sure there are not other underlying causes.

How to identify a breath-holding spell

You may see your child having a breath-holding spell after you’ve scolded them, or when they are angry or sad. During breath-holding, your child may:

  • Cry and then hold their breath
  • Open their mouth to cry but make no sound
  • Turn blue or gray
  • Faint for 1-2 minute and regain consciousness

What are the two types of breath-holding spells?

Breath-holding spells are categorized into two types based on causes and characteristics:

Cyanotic breath-holding spells

  • More common
  • Often triggered by situations that upset the child
  • The child’s face turns blue (sometimes blue to purple)
  • You can predict the start of a breath-holding spell by observing the child’s face

Pallid breath-holding spells

  • Less common
  • Happens when the child gets frightened
  • Kids turn very pale, almost white
  • More unpredictable

What should you do during a breath-holding spell?

During a breath-holding spell, try to stay calm. Lay your child on their side and don’t pick them up.

Stay with your child until they wake up. Then comfort them by hugging them and soothing them with reassuring words. Make them go to their bed afterward so that they get plenty of rest.

When to seek medical help

Call your child’s pediatrician right away if a breath-holding spell:

  • Causes the child to faint but not wake up
  • Causes the child to tremble or shake, resembling a seizure
  • Makes the child turn blue or gray

While these signs point to a breath-holding spell, they can also be caused by more serious conditions. If you are unsure, seek medical attention.

Schedule an appointment with your child’s pediatrician if your child:

  • Has increased breath-holding episodes
  • Takes more time to recover than before

How are breath-holding spells treated?

Breath-holding spells are not serious and there is no specific treatment for them. 

However, some cases have been associated with iron deficiency. So you may want to get your child’s iron levels checked to see if they are too low.

Breath-holding episodes usually go away on their own once the child reaches 4 or 5, when they have matured enough to know how to handle their emotions better. It’s important for parents to avoid pampering or giving in to their children’s stubborn tantrums. This can help your child come to terms with different situations and learn how to cope with them.

If you are concerned about your child’s breath-holding spells, seek the help of a pediatrician who may be able to suggest different coping strategies.

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Medically Reviewed on 6/17/2021
References
National Health Service. Breath-Holding in Babies and Children. https://www.nhs.uk/conditions/breath-holding-in-babies-and-children/#

Kids Health. Breath-Holding Spells. https://kidshealth.org/en/parents/spells.html