What causes breath-holding spells?

The exact cause of breath-holding spells isn't known. They may run in families. These spells are involuntary. This means that your child isn't holding their breath on purpose. They are often set off by an upsetting event. Common triggers include:

• Shots (injections).

• Head injuries, scrapes, or falls.

• Strong emotions, such as stress, fear, anger, pain, or a scary experience. It can occur as part of a temper tantrum, in response to scolding, or because of another upsetting event.

• Iron deficiency anemia. This occurs if your child doesn't eat enough foods containing iron.

What are the symptoms of breath-holding spells?

Common symptoms include:

• Not breathing (holding breath).

• Turning blue or pale.

• Stiffness or limpness throughout your child’s body during the spell.

• Jerky movements of the arms or legs.

• Loss of consciousness.

Breath-holding spells only happen when the child is awake.

How are breath-holding spells diagnosed?

Breath-holding spells are usually easy to diagnose. To do this, the doctor will examine your child and ask about your child’s medical history, health, and symptoms. Certain tests may be done to rule out other problems if the diagnosis is uncertain.

How are breath-holding spells treated?

Even though breath-holding spells can be scary, they are rarely dangerous. To prevent them, you might be tempted to shield your child from too much excitement or strong emotion. But it’s important to treat your child normally and set appropriate boundaries. During a breath-holding spell:

• Comfort your child by cradling them in your arms or on your lap.

• If the spell lasts, lay your child down on their back. This helps blood flow to the head more easily.

• Don’t do CPR (including mouth-to-mouth breathing).

• If your child was eating before a spell, don’t try to use your finger to sweep food out of the mouth. But you can pat your child on the back, tip your child forward, or lay your child on their side to prevent choking.

• 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.

Sometimes a temper tantrum leads to a breath-holding spell. To prevent future behavior problems, don't give in to your child's demands before or after the attack.

• When the spell is over, hug your child briefly and carry on with your normal routine.

• If you can't cope with the stress, get help from a professional counselor.

These episodes can be reduced by distracting the child and staying away from the triggers. Iron supplements can also reduce the number of breath-holding spells.

What are the long-term concerns?

The good news is that breath-holding spells usually go away after age 5. They won’t cause brain damage or other problems. And they don’t make your child more likely to have health problems later in life.

When to call the doctor

Contact your child's doctor right away if your child:

• Passes out (faints) during a breath-holding spell, if fainting has not happened before.

• Has a seizure (shaking or jerking) during a breath-holding spell.

• Has a breath-holding spell and is younger than 6 months old.

• Has trouble breathing after the spell ends.