What are breath-holding spells?
Breath-holding usually happens when babies or children:
- are crying
- are frightened or upset
- have had a minor accident and gone into shock.
Children cry, then catch their breath and ‘hold’ it without breathing. They don’t do it on purpose – even if it looks like they’re holding their breath as part of an extreme tantrum.
Breath-holding spells usually end within 30-60 seconds, when children stop holding their breath and start to cry or scream. In some cases, children hold their breath until they lose consciousness. When this happens, the body automatically kick-starts breathing again.
Breath-holding spells can happen as often as several times a day or as rarely as once a year.
Children as young as 6 months can have breath-holding spells, but breath-holding is most common in children aged 1-2 years. Most children stop doing it by the time they’re 6 years old.
Some cases of breath-holding are associated with iron-deficiency anaemia. Your GP can do a simple blood test to work out whether this is the cause in your child’s case.
It’s natural to feel scared and even to panic the first time your child has a breath-holding spell, especially if you’ve never heard of breath-holding before. It might help to know that breath-holding doesn’t cause long-term damage or have any harmful effects on the brain.
What to do during breath-holding spells
Follow these tips to help your child through a breath-holding spell:
- Stay calm. The spell is likely to pass within a minute.
- Lay your child on their side and watch them until the spell ends.
- Don’t put anything in your child’s mouth, not even your fingers to clear the airway. If your child starts having jerky movements, you can hold their head, arms or legs to prevent injury or move away items that could hurt them.
- Don’t shake your baby or child. This won’t stop the breath-holding and can cause injuries.
- If other children or adults are present, reassure them that it’s a harmless spell and will pass soon.
- Sometimes children might fall and hurt themselves during the spell. If you think this has happened, it’s best to have a doctor check your child.
- Once your child has recovered, avoid punishing or rewarding them or making a big fuss.
Seek medical attention the first time your child has a breath-holding incident. Your health professional will check to make sure that your child doesn’t have a more serious condition.
When to see a doctor about breath-holding
You should consult a doctor about breath-holding if your child:
- is younger than 6 months
- has spells more than once a week – these might be caused by anaemia
- suddenly starts breath-holding
- looks confused or drowsy after breath-holding
- becomes very pale or loses consciousness
- has shaking and stiffness that lasts for longer than a minute and takes a while to recover from.
How to prevent breath-holding
You can’t prevent breath-holding, but you might be able to prevent the events leading up to breath-holding:
- Try distracting your child in situations where they might have a breath-holding spell.
- Give your child plenty of warning if you need to make a change to a different activity or situation. This means they won’t get too much of a fright when things change.
- Learn more about tantrums, if this is what seems to trigger your child’s breath-holding spells.
- Reassure your child after they’ve had a fright or a shock.
- Try to avoid your child becoming too hungry or overtired.
- Help older children learn to recognise emotions like frustration. If your child can recognise, understand and manage emotions, it might stop the emotions turning into the anger or fear that triggers breath-holding.
If your child’s breath-holding is triggered by tantrums because you said no to something, try to avoid giving in and saying yes. It’s important to give your child clear boundaries and guide them towards positive behaviour.
Types of breath-holding
Cyanotic breath-holding
This is the most common type of breath-holding. Children who are affected:
- cry or get upset
- catch and hold their breath
- turn a bluey-purple colour, particularly around the mouth.
This type of breath-holding is also called ‘blue spells’.
Pallid or pale breath-holding
This is less common than cyanotic breath-holding. Children:
- might not cry or get upset
- catch and hold their breath – their heart rate slows down and their skin can look pale
- sweat and are tired when the spell is over
- might also faint when they’re teenagers or adults.
Some children have jerky movements or a seizure, but this is very rare.
This type of breath-holding is also called ‘pale spells’.