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ASK THE CPCMG PEDIATRICIAN:
Breath-holding spells

When my toddler gets very upset, she stops breathing and passes out. Our pediatrician says these are breath-holding spells and they’re nothing to worry about. These episodes don’t last long but they’re very upsetting. Why is this happening to her?

Breath-holding spells can be scary. They occur in five percent of healthy children, most commonly between six months to two years of age. They typically resolve before a child hits his or her sixth birthday. Most importantly, breath-holding spells are not dangerous do not cause brain damage or epilepsy.

Breath-holding spells are involuntary, which means your child is not purposely holding his or her breath. Breath-holding spells are triggered by unexpected or unwanted events like a sudden loud sound or pain caused by injury. If the right situation occurs for breath-holding spells, a reflex is triggered and your child will hold his or her breath. It’s a physical response to strong emotions.

Doctors can diagnose breath-holding spells based on the history of the event. They follow a typical pattern. Usually the child will give out one or two long cries, and then they will hold their breath until their lips and face look blue. Your child may briefly pass out.  If you are holding your child, they may feel stiff. Normal breathing will start again in less than one minute.  After a brief time (less than 2 minutes), your child will become fully alert and will be back to their normal neurological state.

Many families want to understand what causes breath-holding spells. They tend to run in families and there is some evidence that anemia worsens them. Your doctor may want to test your child for anemia.

If you think your child is experiencing breath-holding spells, speak with your CPCMG pediatrician to confirm the diagnosis. If your child has spells that are lasting more than one minute, jerking movements lasting more than one minute or if your child seems really sleepy after the episode, there may be a different diagnosis that needs to be explored. And of course, if you have any concerns about your child, you should discuss this with your CPCMG pediatrician.