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Surviving a Breath-Holding Incident

by Sue Hubbard, M.D.

I had a phone call from a young mother and she started with ” I just wanted to let you know that James stopped breathing on Friday.” Okay, it was now several days later, and I was alarmed. Why hadn’t she called sooner, what had happened? She proceeded to let me know that he was fine now, but several days prior he had been playing with a toy, and she had taken it away from him at which time he began to scream and suddenly he “stopped breathing” turned blue around his mouth, and then passed out. She frantically called 911 and told her husband to try back blows in case he was choking. Before the ambulance arrived and after a few attempts at back blows, he woke up, sat up and proceeded to reach for the toy!! This was a classic breath holding spell. Believe me, breath holding spells can be very scary as a parent, especially if you have never seen one before or even heard about them.

Breath holding spells typically occur in children between the ages of six months and four years, but they are most common in the toddler years. When your child gets angry, frustrated, or hurts themselves and they begin to cry for some reason they have an abnormal reflex, that allows them to hold their breath. Now, think about it you really cannot hold your breath yourself and die, as once you pass out your autonomic nervous system kicks into gear and you breathe. But before that happens you may see your pale, blue, child on the floor looking like they may die, they may sometimes even have a brief episode of jerking, almost like a seizure and then suddenly they are breathing, and become alert, all in less than one minute. It feels more like an hour the first time you witness this. In most cases 911 has already been dialed!!

Children may have breath-holding spells daily (of course one of mine did) or infrequently but either way they are disconcerting to parents. Your child is not developing a seizure disorder, and breath holding spells do not cause brain damage. The diagnosis is made based on a good history, and is always related to crying. There is sometimes a correlation with anemia so it is worth having your child have a blood count if they have not had one, just to make sure.

Be assured, these do not last forever. As the child gets older they outgrow breath-holding spells, and move into verbal debates when they don’t get their way! Another day, another topic!

That’s your daily dose, we’ll chat again tomorrow.

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