Is this your child's symptom?
- A spell that involves holding the breath, then turning blue and passing out
- Breath-holding spells were diagnosed by your child's doctor
Symptoms of a Breath-Holding Spell
- An upsetting event happens right before the spell. A common trigger is being angry about parents setting limits (temper tantrums). Another is getting scared. Some spells are triggered by a sudden injury, such as falling down.
- The child gives out 1 or 2 long cries
- Then holds his breath until the lips and face become bluish
- Then passes out and falls to the floor
- Then often becomes stiff. May also have a few muscle jerks.
- Normal breathing starts again in less than 1 minute. Becomes fully alert in less than 2 minutes.
- Only happens when child is awake, never when asleep
- A reflex response to strong feelings. This reflex allows some children to hold their breath long enough to pass out. Spells do not happen on purpose.
- This happens in 5% of healthy children. Breath-holding spells can run in families.
- Starts between 6 months and 2 years of age. Goes away by age 6.
- Many young children hold their breath when upset, turn blue, but don't pass out. This is common and normal.
- Frequent spells can happen in children who have anemia (low red blood count). This can happen if your child doesn't eat enough foods with iron. If your child is a picky eater, your doctor may order a blood test.
When to Call for Breath-holding Spell
Call 911 Now
- Breathing stopped for more than 1 minute and hasn't returned
- You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
- Age less than 6 months old
- Passed out more than 2 minutes by the clock and normal breathing now
- First breath-holding spell
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Contact Doctor During Office Hours
- Never been checked by a doctor for the spells
- Spells happen without a reason (no triggers)
- Muscle jerks during spell
- Picky eater (especially for meats)
- Lots of tantrums trigger the spells
- Spells happen more than once a week
- You think your child needs to be seen, but the problem is not urgent
- You have other questions or concerns
Self Care at Home
- Normal breath-holding spell
Seattle Children's Urgent Care Locations
If your child’s illness or injury is life-threatening, call 911.
Care Advice for Breath-holding Spells
- What You Should Know About Breath-Holding Spells:
- While breath-holding spells are scary for parents, they are harmless.
- Normal breathing always returns on its own.
- The spells don't lead to seizures (epilepsy).
- Here is some care advice that should help.
- Lie Down:
- During the spell, have your child lie down.
- This will increase blood flow to the brain.
- Remove any food from his mouth.
- Do not hold your child upright. It decreases blood flow to the brain. This could cause some jerking of body muscles.
- Cold Washcloth to Forehead:
- Put a cold, wet washcloth on your child's forehead. Keep it on until he or she starts breathing again.
- That's the only care your child needs.
- Time the Length of Not Breathing:
- These spells always seem to last longer than they really do.
- Time the length of a few spells. Use a watch with a second hand.
- Breathing almost always returns by 60 seconds.
- It's hard to guess at the length of a spell and get it right.
- Stay Calm:
- Don't start mouth-to-mouth breathing. Don't call 911.
- Don't put anything in your child's mouth. It could cause choking or vomiting.
- Never shake your baby. It can cause bleeding in the brain.
- Don't Give In After the Spell:
- Some breath-holding spells start with a temper tantrum. Example: your child wanted something and you said "No." Don't give in to your child before or after the attack.
- After spells, give your child a brief hug and go about your normal routine.
- What to Expect:
- Spells happen from 1 or 2 times a day to 1 or 2 times a month.
- Kids outgrow them by age 6.
- Call Your Doctor If:
- Spells become more frequent
- Spells change
- You think your child needs to be seen
- Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Last Reviewed: 04/01/2023
Last Revised: 12/30/2022
Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.