Helping all children become happy learners
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.
Which Children breath-hold?
It is estimated that about 1 in 20 pre-school children experience episodes of breath-holding. Breath-holding usually starts before the child is 18 months old.
Many children may only have a few episodes. For others it can occur frequently. However, as children mature they are less likely to breath-hold and many will cease while toddlers. It is very rare for breath-holding episodes to continue beyond six years of age.
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.
Most children who experience breath-holding are healthy. However, it is important that parents seek medical advice when a child first experiences breath-holding. This can rule out any underlying medical conditions such as epilepsy or iron deficiency.
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.
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 the 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
It is really important to avoid giving the child positive or negative attention for breath-holding. A child should never be punished for breath-holding nor should they given any rewards or treats
It is really useful to record when breath-holding episodes occur. Writing down what the child was doing before the episode started can help identify triggers. Also record who else is with the child and what they were doing. Equally, recording when episodes occur can establish whether certain days or events are more likely to trigger this behaviour.