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April 27, 2013

Breath-holding spells can be scary

Parents have been holding their breath waiting for me to tell them what to do for their young children who seem to be having “breath-holding spells,” especially when they get angry.

Well, I don’t want anyone to get blue in the face over this topic, so here’s some information.

Breath-holding is a fairly common behavior in most toddlers. In fact, about 5 percent of healthy, breath-holding toddlers will get so upset that they exhale forcefully and then decide not to inhale to the point that they may turn blue or pale, and literally fall to the ground limp, with some shaking of the arms and legs. This is what we call an official breath-holding spell.

Though these are extremely scary to watch, breath-holding spells resolve spontaneously, and within 30 to 60 seconds, the child will catch their breath and begin to cry. They do not indicate a serious seizure disorder or brain damage. Breath-holding spells are rare before 6 months of age, peak at the age of 2 and then disappear by age 5.

After your child recovers, usually within seconds, it is good to speak with your child’s doctor or have your child seen to reassure you that this is a typical spell and not a problem with your child’s brain or heart. Sometimes, being anemic due to low iron stores can contribute to the problem.

The most important thing a parent can do if their child has these spells is figure out what provokes them and avoid that stimulus, or at least try to distract your child, which might prevent the action from occurring.

Once you know it is a breath-holding spell and that the outcome will be fine, you should stay relaxed, give your child a hug when they come out of it, and go about your business. If you are frightened, don’t let them know it, or they’ll do this more frequently to get their way or seek your attention.

Hopefully, this tip will allow you to breathe more easily the next time your child has a breath-holding spell.

Dr. Lewis First is chief of Pediatrics at Vermont Children’s Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine.

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