Introduction
A breath-holding spell is when your child catches their breath and does not continue to breathe for a period.
Breath-holding spells commonly happen when children are crying and:
- upset
- in shock
- frightened
- have hurt themselves.
Breath-holding spells can be common in children between six months and six years. They can be scary for parents and carers to see.
Babies and children do not have breath-holding spells on purpose.
Signs and symptoms
Breath-holding spells will usually happen while a child is crying.
When a breath-holding spell happens, a child will:
- start to inhale deeply
- go quiet
- appear frozen
- hold their breath.
Your child may look like they are unable to let go of their breath. They may hold their breath for between 30-60 seconds.
Physical signs of a breath-holding spell can include:
- very pale face and lips
- a dusky blue colour on the lips
- becoming limp or twitching
- losing consciousness for a few seconds.
Eventually, your child will let go of their breath and continue to cry.
Diagnosis
Breath-holding spells are common in young children. They do not usually need to be diagnosed by a doctor.
See your local doctor if you are concerned or if your child:
- is having more than one breath-holding spell a week
- loses consciousness
- becomes stiff or shaky for longer than a minute
- is younger than six months old
- takes a while to recover from the spell.
The first time your child has a breath-holding spell, mention it to your local doctor as part of a general checkup.
Treatment
There is no treatment for breath-holding spells.
Parents and carers can make sure their child is safe during a breath-holding spell by:
- staying calm and comforting your child
- laying your child on their side
- making sure nothing is blocking your child’s mouth or nose
- making sure there is nothing around your child that could hurt them if they fall or lose consciousness.
Do not shake your child during a breath-holding spell as it can cause serious injuries.
Comfort your child after the spell without focusing on or rewarding it. While children do not hold their breath on purpose, rewarding them after a spell can teach them to associate breath-holding with comfort. This can lead to future issues.
Management
Different types of breath-holding spells
There are two types of breath-holding spells.
- blue or cyanotic breath-holding spells where your child’s lips and mouth may turn a dusky blue colour
- pale or pallid breath-holding spells where your child’s face will become very pale.
Both types of spells can happen at the same time, but pale or pallid spells are more common.
Causes of breath-holding spells
Breath-holding spells are an involuntary response. This means your child is not holding their breath on purpose.
Breath-holding spells usually happen when your child is experiencing strong emotions or crying very hard.
Some children who have more frequent breath-holding spells:
- have a family history of frequent breath-holding spells
- have anaemia – a condition that causes fatigue from low iron levels.
Children who have more pale or pallid spells can be more likely to have fainting spells as teenagers.
Breath-holding spells are not related to epilepsy, even though they may appear similar. There is no risk of developmental issues due to breath-holding spells.
Preventing a breath-holding spell
Breath-holding spells cannot be prevented. However, parents and caregivers can help their child manage big feelings that may lead to a spell.
Strategies to manage breath-holding spells can include:
- distracting your child immediately after something upsetting like a fall or vaccination
- give your child comfort after frightening or upsetting events
- show your child how to breathe slowly and calmly when they are upset
- encourage your child to tell you how they are feeling through words, signs or pictures
- make sure your child is getting enough sleep, and they are eating well.
It is normal for children to have trouble managing big feelings. This skill develops as they grow and can change depending on different events in their life.
If you are concerned about your child’s ability to manage big feelings and breath-holding spells, speak to your local doctor.