Toddler Breath-Holding Spells

I don’t talk about this much because it’s not exactly something easily brought up in conversation, but I’d like to discuss it now in case anyone else is going through the same situation: my daughter has breath-holding spells. I will try to explain this condition to the best of my ability, with help from some literature provided by our neurologist.

*I’m not an expert, and don’t claim to be an authority figure on this topic, please consult your pediatrician if you think your child is exhibiting any of the symptoms discussed in this post.

Breath-holding spells (BHS) are when children hold their breath in response to fear, anger, pain, or being startled. They are a common pediatric problem. I’m not talking about a toddler having a tantrum and willingly holding their breath, this seems to be involuntary. By age 5, most breath-holding spells are gone.

CAUSES: BHS seem to be due to an abnormal nervous system reflex. This causes otherwise normal children to hold their breath long enough to change color and pass out. BHS are dramatic, uncontrolled events that happen in otherwise healthy children. This condition is sometimes passed on from the parents (genetic). Low iron levels in the body may increase frequency of BHS.

SYMPTOMS: There are 2 kinds of BHS – cyanotic (turn blue) and the less common pallid (turn pale). Some children have both types. Spells often follow this pattern:

  • Something triggers (such as scolding, upsetting, or pain) the spell.
  • They may begin to cry. After a few cries or prolonged crying, the child becomes silent and stops breathing.
  • The skin becomes blue or pale
  • The child passes out and falls down
  • Sometimes there is brief twitching, jerking or stiffening of the muscles.
  • The child shortly wakes up and may be a bit drowsy for a moment

PROGNOSIS: Breath-holding spells are frightening to see. They are not harmful and children will outgrow them. There are no serious long-term effects.

My daughter was diagnosed by her pediatrician with BHS between 6 months and 1 year of age. She’s now 20 months. Her spells can range anywhere from multiple times per week, to a few weeks in between. She’s otherwise totally healthy, with no other obvious problems. I recently requested a bit more in-depth clarification regarding her BHS, so the pediatrician referred us to a neurologist. A few weeks ago they performed an EEG to measure brain waves and confirmed there was no evidence of any prior seizures (thank God!). Let me tell you, seeing your baby with wires stuck to her head is not something you want to experience if you can help it, talk about feeling helpless as a parent.

After discussing the details of our experiences and the results of the EEG with the neurologist, he ordered blood work to check the level of iron. Again, a heartbreaking experience as a mother; holding your child so a stranger can try to draw blood from her little arm. Thankfully, as with the EEG, my mother was there for moral and emotional support. The blood work came back technically “normal”, but on the low side of normal. We are currently waiting for an iron prescription to be filled, and will see what happens over the next month of treatment.

I’ve learned, by the look on my daughter’s face, when a spell is likely going to happen. The neurologist encouraged us to lay her down when we see this is happening, to allow more blood flow to her head which hopefully shortens the length of the spell. I was happy to learn this, previously I just held her so she wouldn’t fall down and get hurt. I will update this after we begin using the iron.

Thanks for taking the time to read, hopefully this post was helpful.

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