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What are breath-holding spells?

Breath-holding spells are brief periods of halted breathing and loss of consciousness that occur in about 5 percent of otherwise healthy children. The episodes typically begin before a child is age one and peak by age two. Breath-holding spells are rare after age five.

Sometimes mistaken as a sign of stubbornness or willful behavior in a child, breath-holding spells are actually an involuntary reflex that children who have them can't control. Breath-holding spells are usually triggered by a physically painful or an emotionally upsetting event. They are more common in children who have: a family history (other family members who experienced breath-holding episodes as children); iron deficiency anemia or certain genetic conditions. There are two types of breath-holding spells.
  • Cyanotic spells, the more common type, typically are triggered by an emotionally upsetting event that causes a child to stop breathing, turn blue, become unconscious and possibly even have a small seizure. After a few seconds breathing resumes on its own, skin color returns to normal and there are no lasting effects of the breath-holding spell.
  • Pallid spells typically occur in response to physical injury, such as falling and banging the head. The brain sends a signal that slows the heart rate, causing loss of consciousness, halting of breathing and making the child appear pale and limp. In some cases, a seizure and incontinence may also be symptoms of pallid spells. After the spell, the heart resumes beating normally, the child starts to breathe again and consciousness returns. Your child's doctor may recommend a thorough evaluation to rule out heart or brain disorders if your child has pallid spells.
Although most children outgrow breath-holding spells, in some cases doctors might recommend treatment with iron supplements for children who experience cyanotic spells, or medications to stop the heart from slowing down for children who experience pallid spells.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.