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  • Select from over 100 symptoms to read more about managing your child's illness.

    Is Your Child Sick? TM


    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

    • 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

    Call 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

    • 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

    Call 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

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. Don't Give In After the Spell:
      • Some breath-holding spells start with a temper tantrum (Such as your child wanted something and you said "No"). Don't give in to her before or after the attack.
      • After spells, give your child a brief hug and go about your normal routine.
    7. 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.
    8. 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.

    Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.