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Breath-Holding Spells

What Is a Breath-Holding Spell?

A breath holding spell is when a child holds their breath, usually after being angry, frustrated, startled, or in pain. Sometimes the breath holding leads to the child passing out.

It can be frightening to watch a breath-holding spell, but they aren’t harmful and usually last less than a minute. Kids outgrow the spells without any treatment.

What Are the Types of Breath-Holding Spells?

There are two types of breath-holding spells:

  • If the child’s face turns blue, it’s called a cyanotic breath-holding spell. Usually the child cries very hard and then has the spell. Cyanotic breath-holding spells are usually caused by anger or frustration.
  • If the child’s face turns white, it’s called pallid breath-holding spell. The child may cry a little bit or not at all before having the spell. Pallid breath-holding spells are usually caused by the child being startled or in pain.

Both types of spells can make kids pass out for up to a minute. In the most extreme cases, kids might have seizures. Having a seizure does not cause any long-term harm or put a child at risk for a seizure disorder.

Breath-holding spells happen in healthy children from 6 months to 6 years old. They’re most common when kids are 6–18 months old, and tend to run in families.

What Causes Breath Holding Spells?

Children do not have breath-holding spells on purpose. They can’t control when they happen.

Doctors don’t know the exact cause of breath-holding spells. Sometimes, iron-deficiency anemia might cause them. Treating the anemia may help reduce the number of spells.

What Should I Do if My Child Has a Breath-Holding Spell?

If this is your child's first breath-holding spell, get medical care. Although the spells aren't harmful, it's good to get your child checked out.

If your child has a breath-holding spell:

  • Lay your child in the crib or on the floor.
  • Keep your child away from anything hard or sharp.
  • Stay with your child.

If your child passes out:

  • Try to stay calm and reassure yourself that your child is safe.
  • Check your child's mouth for food or any object that could cause choking.
  • Call 911 if your child remains blue or is not breathing for longer than a minute.

After the breath holding spell:

  • Reassure your child that everything is OK and that the spell is not their fault.

Can Breath-Holding Spells Be Prevented?

Your doctor can work with you on ways to try to limit your child’s spells. If your child typically has a breath-holding spell after crying, you can try to prevent your child from getting upset. For example, you can:

  • Make sure your child doesn’t get too tired or hungry.
  • Try to use calm discipline methods.

It’s can be hard to watch your child have a spell, but try not to give in to tantrums or unreasonable behavior just to prevent one. Talk to your doctor if you need help finding the best way to discipline your child.

Remind yourself that the breath-holding spells are not harmful and that your child will outgrow them. If you are very worried about the spells, talking to a mental health professional can help you find ways to cope.

Reviewed by: Amy W. Anzilotti, MD
Date reviewed: January 2021