Is Your Child a Breath Holder?

If your toddler holds her breath until she passes out, you know how scary these episodes can be. Barton D. Schmitt, MD, FAAP, author of Your Child’s Health (Bantam Books), explains this condition in more detail.

What is a breath-holding spell?

A breath-holding spell is when your child holds his breath until he passes out. Breath-holding spells begin between the ages of six months and two years. They can be triggered by frustration, a fall or something frightening. During a breath-holding spell:

• Your child may begin crying and then hold his breath until he becomes blue around the lips and passes out.
• Your child may stiffen and even experience a few twitches or muscle jerks.
• Your child will breathe normally again and become fully alert in less than one minute.

These spells are harmless and always stop by themselves. Time the length of a few episodes — using a watch with a second hand — so you can get a better understanding of how long they actually last. Children normally have these spells a few times per month.

What causes spells?

An abnormal reflex allows five percent of children to hold their breath long enough to pass out; it is not deliberate. Holding their breath when frustrated and becoming bluish without passing out is such a common reaction in young infants that it is considered normal.

What happens to children who have breath-holding spells?

Children typically outgrow breath-holding spells by the time they are four or five years old. Breath-holding spells are not dangerous, and don’t lead to epilepsy or brain damage.

How can I take care of my child during a breath-holding spell?

During an attack, do not hold your child upright. Instead, she should lie flat. This position will increase blood flow to her brain and may prevent muscle jerking. Put a cold, wet washcloth on your child’s forehead until she starts breathing again. Also, be sure not to put anything in your child’s mouth because it could make her choke or vomit.

What can I do to ensure my child doesn’t get hurt during one of these spells?

The main injury risk during a breath-holding spell is a head injury. If your child starts to have an attack while standing near a hard surface, go to him quickly and help lower him to the floor.

What should I do after a breath-holding spell?

Give your child a hug and return to your normal routine. If you’re frightened, don’t let your child know it. Act relaxed and the two of you will be just fine.

Barton D. Schmitt, MD, FAAP, is a board-certified pediatrician at The Children’s Hospital. He has been practicing medicine for 40 years and has received two distinguished awards from the American Academy of Pediatrics, including the Child Development Award in 1994, followed by the Education Award in 2004. A father of four and grandfather of eight, he most recently completed the third edition of Your Child’s Health (Bantam Books), now available in bookstores.