Ask the Pediatrician: Breath holding spells

Q: I have been told that children can hold their breaths until they go unconscious, but does this really happen?

A: Yes, it does sometimes, to some children. It’s not something that a child does on purpose, but out of fear or extreme emotion.  A typical example is a two year old who falls down or hurts himself in some minor way. The child cries and gets pretty worked up, and just when you think he should be taking a breath, he turns blue and falls to the ground. He stiffens and then begins to breath again and wakes up in less than a minute. Occasionally a child will jerk a bit before the breathing begins again. This is not a seizure, but can be very frightening.

Q:  That must be about the scariest minute a parent could have. Does it cause the child any harm?

A: None whatsoever. The precise mechanism for these events is still somewhat controversial, but essentially happens to perfectly healthy children.  The children may be a little groggy for a short time but soon are entirely back to their usual selves. The episode, called a breath holding spell, does not cause brain injury and has no relation to convulsions.  Sometimes a child has one if frustrated, but mostly it is a painful event that sets one off.  The spell stops on its own and is not an emergency, although I can fully understand why a parent seeing one for the first time might think so.  Most doctors suggest that a child be evaluated by his or her pediatrician after the first episode to make sure all is well. If the story is typical, then during that check the doctor would educate and reassure the parents, and explain what to do the next time.

Q: Can they be prevented?

A:  Not unless you can keep a child from banging himself up! The major point is not to overreact and not to worry too much.  My goal for today is to make more parents and child care workers aware of the condition so they won't be so frightened if they should see a spell happen.
Once they do occur, they may happen again, after a minor injury, but they usually stop by the age of five.

Helpful Link: http://kidshealth.org/parent/growth/growing/spells.html