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Breath-holding spells are brief periods when young children stop breathing for up to 1 minute. These spells often cause a child to pass out (lose consciousness). Breath-holding spells usually occur when a young child is angry, frustrated, in pain, or afraid. But the spell is a reflex. Children don't have breath-holding spells on purpose.
There are two types of breath-holding spells:
Some children may have both types of spells at one time or another.
Breath-holding spells can occur in children 6 months through 6 years of age. They are most common from 1 to 3 years of age. Some children have them every day, and some have them only once in a while.
Breath-holding spells are usually not serious and don't cause lasting damage. With time, they go away on their own.
Breath-holding spells are usually caused by either a change in the child's breathing or a slowing of the heart rate. These reactions may be brought on by pain or by strong emotions.
In some children, breath-holding spells may be related to iron deficiency anemia, a condition in which the body doesn't produce a normal number of red blood cells.
A breath-holding spell may cause:
Doctors can usually diagnose breath-holding spells based on what happens during a spell. The doctor will examine your child and ask you to describe the spells. It may help for you to keep a record of what happens during each spell.
If your doctor thinks that your child has a seizure disorder or another condition, such as iron deficiency anemia, your child may need other tests.
Most children don't need treatment for breath-holding spells. Spells will go away as your child gets older. If your doctor thinks that a medical condition is causing the spells, your child may need treatment.
To decrease the chance of more spells, make sure that your child gets plenty of rest, and try to help your child feel secure. Be sure to tell your child's doctor if your child starts to have spells more often or if they seem worse or different than before.
Breath-holding spells can be frustrating for parents. If you have trouble dealing with your child's spells or find yourself getting angry, talk with your doctor or a counselor. Try to keep in mind that your child isn't having spells on purpose.
To protect your child during a spell, lay your child on the floor and keep his or her arms, legs, and head from hitting anything hard or sharp.
Your child may stop breathing for up to 1 minute (60 seconds) during a spell. If your child doesn't wake up quickly and start breathing again, call 911 or other emergency services. The 911 operator may tell you to give your child rescue breaths while you wait for help to arrive.
After the spell, reassure your child. Don't punish him or her for having the spell.
Other Works Consulted
Blum NJ (2009). Repetitive behaviors and tics. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 629–641. Philadelphia: Saunders.
Brazelton TB (2006). Two years. In Touchpoints, Birth to Three: Your Child's Emotional and Behavioral Development, 2nd ed., chap. 12, pp. 179–196. Cambridge, MA: Da Capo Press.
Mikati MA, Obeid M (2011). Conditions that mimic seizures. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., online chapter 587. Philadelphia: Elsevier Saunders. Available online: http://www.expertconsult.com.
Valente JH (2008). Breath-holding spells section of Minor infant problems. In JM Baren et al., eds., Pediatric Emergency Medicine, pp. 335–336. Philadelphia: Saunders Elsevier.
Walter HJ, DeMaso DR (2011). Disruptive behavior disorders. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 96–100. Philadelphia: Saunders.
Current as of:
May 27, 2020
Author: Healthwise StaffMedical Review: John Pope MD - PediatricsKathleen Romito MD - Family MedicineLouis Pellegrino MD - Developmental Pediatrics
Current as of: May 27, 2020
John Pope MD - Pediatrics & Kathleen Romito MD - Family Medicine & Louis Pellegrino MD - Developmental Pediatrics
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