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What is breath-holding?

Breath-holding, as the name suggests, is when a child cries then holds their breath until they become unconscious. It usually occurs following an incident where the child has become upset, frightened or has hurt themselves. Fortunately, breath-holding does not have any harmful effects on the child's short or long term health. The frequency of episodes varies from child to child but can occur as often as several times in a day.

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How many children breath-hold?

Breath-holding is not uncommon with an estimated 5% of all children experiencing episodes of breath-holding.

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How old are children who breath-hold?

Breath-holding usually starts before the child is 18 months and stops by the time they are six years old.

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What causes breath-holding?

The exact cause of breath-holding is unknown. Episodes appear to be a reflex reaction to an unpleasant experience and not a deliberate behaviour by the child. There is often a family history of breath-holding in the families of children affected. The majority of children who experience breath-holding are healthy. It is however important to speak to your doctor when your child first experiences breath-holding to rule out any other causes such as epilepsy or iron deficiency.

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What happens during a breath-holding incident?

Most children have what is known as a blue spell (cyanotic breath-holding) where they cry or scream turning red in the face before going blue around the lips. At this point the child will faint and go limp. Blue spells are often triggered by a fright or pain. Rarely, a child may have a fit following a blue spell.

Less commonly are pale spells (pallid breath-holding) which occur in babies. The child tries to cry but no sound comes out and the child goes pale before fainting. These epidodes are triggered by pain or the child becoming upset.

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How do you manage an episode of breath-holding?

No emergency help with breathing is required!

As they faint try to protect them from injury through falling or hitting themselves against hard or sharp objects.

Place child in the recovery position on their side and wait for them to start breathing again.

Do not try to rouse them by shaking them or splashing them with water.

When they regain consciousness it is likely that they may be distressed and need lots of reassurance.

Avoid communicating any anxiety to the child by acting calmly as if nothing has happened.

Do not punish the child or give rewards.

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Managing an episode of breath-holding.

Managing Breath Holding

A handy printable poster resources with advice for managing an episode of breath-holding.

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You may also be interested in the following pages:

Emergency First Aid

Emotional Regulation

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