A family history of breat holding spells (parents may have had similar spells when they were kids)
Involuntary breathing spells most often occur when a child becomes suddenly upset or surprised. After being startled or becoming upset, the child may make a short gasp and then exhale and stop breathing.
Symptoms can include:
Blue or pale skin
Crying then no breathing
Fainting or loss of alertness (consciousness)
Jerky movements (short, seizure-like movements)
Normal breathing starts again after a brief period of unconsciousness. The child's color improves with the first breath and the event ends. This may occur several times per day, or only on rare occasions.
Signs and tests
The doctor or nurse will perform a physical exam and ask questions about the child's medical history and symptoms.
Blood tests may be done to check for an iron deficiency.
No treatment is usually needed, unless there is an iron deficiency or other medical condition causing the spells. Children with an iron deficiency will be given iron supplements.
Breath holding can be a frightening experience for parents. But once the doctor has diagnosed your child with breath holding spells, you can take the following steps:
During a spell, make sure your child is in a safe place where he or she will not fall or be hurt.
Place a cold cloth on your child's forehead during a spell to help shorten the episode.
After the spell, try to be calm. Avoid giving too much attention to the child, as this can reinforce the behaviors that led to the event.
Avoid situations that cause a child's temper tantrums. This can help reduce the number of spells.
Breath holding spells that do not cause the child to become faint are best ignored, in the same way temper tantrums are ignored. See also: Temper tantrums
Most children outgrow breath holding spells by ages 4 - 8.
Cildren who have a seizure after losing consciousness during a breath holding spell do not appear to be more likely to get a seizure disorder.
Calling your health care provider
Call your doctor or nurse if your child seems to be having breath holding spells.
If your child has already been diagnosed with breath holding spells, call they seem to occur more often breath holding spells.
Call 911 or your local emergency number if:
Your child stops breathing or has trouble breathing
Your child has seizures for more than 1 minute
Walter HJ, DeMaso DR. Age-specific behavioral disturbances. In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 27.1.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.