Some children have breath holding spells. This is an involuntary stop in breathing that is not in the child's control.
Babies as young as 2 months old and up to 2 years old can start having breath holding spells. Some children have severe spells.
Children can have breath holding spells when they are responding to:
Breath holding spells are more common in children with:
Breath holding spells most often occur when a child becomes suddenly upset or surprised. The child makes a short gasp, exhales, and stops breathing. The child's nervous system slows the heart rate or breathing for a short amount of time. Breath holding spells are not thought to be a willful act of defiance, even though they often occur with temper tantrums. Symptoms can include:
Normal breathing starts again after a brief period of unconsciousness. The child's color improves with the first breath. This may occur several times per day, or only on rare occasions.
The health care provider will perform a physical exam and ask questions about the child's medical history and symptoms.
Blood tests may be done to check for an iron deficiency.
Other tests that may be done include:
No treatment is usually needed. But iron drops or pills may be given if the child has an iron deficiency.
Breath holding can be a frightening experience for parents. If your child has been diagnosed with breath holding spells, take the following steps:
Most children outgrow breath holding spells by the time they are 4 to 8 years old.
Children who have a seizure during a breath holding spell are not at higher risk of having seizures otherwise.
Call your child's provider if:
Call 911 or your local emergency number if:
Mikati MA, Obeid MM. Conditions that mimic seizures. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 594.