Breath-holding spells are scary to watch, but your child does not need any treatment.
Toddlers, and sometimes babies, can have breath-holding spells (or attacks). They happen in about 1 in 20 children. A breath-holding spell may happen after a child has been upset or startled - for example, had a minor bump or a fright.
They are scary to watch, but your child does not need any treatment.
Your child may recover quickly or be unresponsive for a short period.
Breath-holding spells often happen as part of toddler tantrums. The spell is an automatic reaction to something unpleasant - it is not a deliberate behaviour on your child's part.
Breath-holding spells happen at similar rates in boys and girls. The spells usually happen in children between the ages of 18 months and 6 years. They are rare before 6 months of age.
Breath-holding spells are different for different children. They may happen fairly often, sometimes several times a day or only every few weeks or months. They usually happen more often when your child is overtired, upset and irritable (grizzly). Often parents who have seen breath-holding spells can predict when another is likely to happen.
There are 2 types of breath-holding spells. Both types may happen in the same child at different times in their lives.
Neither type has any serious consequences (unless your child hurts themselves if they fall) but they are frightening to see.
Blue spells are the most common. Your child may have hurt themselves or become very upset or frustrated, and they then:
These are less common. They can happen in young children after a minor injury or if a child is upset. Pale spells are caused by a slow heart rate and are often mistaken for a seizure. Your child will:
Breath-holding spells are caused by either a change in a child's usual breathing pattern, a slowing of the heart rate or a combination of the two. Pain or strong emotions, such as fear or frustration can bring on these reactions.
The underlying reason for breath-holding spells is not known. 1 in 3 children with breath-holding spells will have a family history of similar episodes. In some children, breath-holding spells may be related to iron deficiency anaemia. This is a condition where the body does not produce a normal number of red blood cells.
Most children with breath-holding do not have a serious underlying problem.
No. Children with breath-holding spells do not have epilepsy. As breath-holding spells may look like epileptic seizures, the 2 are often confused. Breath-holding spells happen after your child has been frustrated, startled or hurt. Children with epilepsy have seizures without any of these things happening beforehand.
Breath-holding spells can only happen when your child is awake and usually when they are standing. Epileptic seizures may happen while a child is awake or asleep.
There is no increased risk of children with breath-holding spells later developing epilepsy.
No. Your child will not have any long-term damage due to the brief period with reduced blood oxygen levels.
Some children with pale spells may be more likely to faint as they grow up.
Treat your child normally after a breath-holding spell.
Talk with your family doctor about the problem. Your child will need a physical check-up to make sure they do not have any other problems, such as an irregular heartbeat.
Your doctor may suggest a blood test to check your child is not anaemic or low in iron. If they are, your doctor may suggest iron medicine. This can reduce the frequency and severity of breath-holding spells.
Children who have breath-holding spells are usually healthy.
Take your child to your family doctor if:
No special treatment is necessary.
Make sure your child gets plenty of rest, help your child feel secure and help minimise and manage their frustration.
Don't treat your child differently from their brothers or sisters, or other children. This is because different treatment can lead to behaviour problems which continue once the spell has stopped.
This page last reviewed 07 December 2021.
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Links
[1] https://www.rch.org.au/kidsinfo/fact_sheets/Breath_holding/
[2] https://www.schn.health.nsw.gov.au/fact-sheets/breath-holding-spells
[3] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F136