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Breath-holding Spell

Is this your child's symptom?

A spell that involves holding the breath, then turning blue and passing out
Breath-holding spells were diagnosed by your child's doctor

Symptoms of a Breath-Holding Spell

An upsetting event happens right before the spell. A common trigger is being angry about parents setting limits (temper tantrums). Another is getting scared. Some spells are triggered by a sudden injury, such as falling down.
The child gives out 1 or 2 long cries
Then holds his breath until the lips and face become bluish
Then passes out and falls to the floor
Then often becomes stiff. May also have a few muscle jerks.
Normal breathing starts again in less than 1 minute. Becomes fully alert in less than 2 minutes.
Only happens when child is awake, never when asleep

Cause

A reflex response to strong feelings. This reflex allows some children to hold their breath long enough to pass out. Spells do not happen on purpose.
This happens in 5% of healthy children. Breath-holding spells can run in families.
Starts between 6 months and 2 years of age. Goes away by age 6.
Many young children hold their breath when upset, turn blue, but don't pass out. This is common and normal.
Frequent spells can happen in children who have anemia (low red blood count). This can happen if your child doesn't eat enough foods with iron. If your child is a picky eater, your doctor may order a blood test.

When to Call for Breath-holding Spell

When to Call for Breath-holding Spell
Call 911 Now Breathing stopped for more than 1 minute and hasn't returned You think your child has a life-threatening emergency Call Doctor or Seek Care Now Age less than 6 months old Passed out more than 2 minutes by the clock and normal breathing now First breath-holding spell Your child looks or acts very sick You think your child needs to be seen, and the problem is urgent	Contact Doctor During Office Hours Never been checked by a doctor for the spells Spells happen without a reason (no triggers) Muscle jerks during spell Picky eater (especially for meats) Lots of tantrums trigger the spells Spells happen more than once a week You think your child needs to be seen, but the problem is not urgent You have other questions or concerns	Self Care at Home Normal breath-holding spell

Call 911 Now

Breathing stopped for more than 1 minute and hasn't returned
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Age less than 6 months old
Passed out more than 2 minutes by the clock and normal breathing now
First breath-holding spell
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor During Office Hours

Never been checked by a doctor for the spells
Spells happen without a reason (no triggers)
Muscle jerks during spell
Picky eater (especially for meats)
Lots of tantrums trigger the spells
Spells happen more than once a week
You think your child needs to be seen, but the problem is not urgent
You have other questions or concerns

Self Care at Home

Normal breath-holding spell

Care Advice for Breath-holding Spells

What You Should Know About Breath-Holding Spells:
- While breath-holding spells are scary for parents, they are harmless.
- Normal breathing always returns on its own.
- The spells don't lead to seizures (epilepsy).
- Here is some care advice that should help.
Lie Down:
- During the spell, have your child lie down.
- This will increase blood flow to the brain.
- Remove any food from his mouth.
- Do not hold your child upright. It decreases blood flow to the brain. This could cause some jerking of body muscles.
Cold Washcloth to Forehead:
- Put a cold, wet washcloth on your child's forehead. Keep it on until he or she starts breathing again.
- That's the only care your child needs.
Time the Length of Not Breathing:
- These spells always seem to last longer than they really do.
- Time the length of a few spells. Use a watch with a second hand.
- Breathing almost always returns by 60 seconds.
- It's hard to guess at the length of a spell and get it right.
Stay Calm:
- Don't start mouth-to-mouth breathing. Don't call 911.
- Don't put anything in your child's mouth. It could cause choking or vomiting.
- Never shake your baby. It can cause bleeding in the brain.
Don't Give In After the Spell:
- Some breath-holding spells start with a temper tantrum. Example: your child wanted something and you said "No." Don't give in to your child before or after the attack.
- After spells, give your child a brief hug and go about your normal routine.
What to Expect:
- Spells happen from 1 or 2 times a day to 1 or 2 times a month.
- Kids outgrow them by age 6.
Call Your Doctor If:
- Spells become more frequent
- Spells change
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Reviewed: 10/11/2023 Updated: 12/30/2022