HealthWatch: Child’s Breath-Holding May Present Real Danger

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(CBS 5) – Few things are more frightening for the parents of a toddler than a breath-holding spell.

About 5 percent of children will have at least one breath-holding spell, typically between the ages of one and three. They may start as young as two months old, and they almost always stop by the time the child reaches age 6-8. There are two kinds of such spells. A “pallid” spell usually starts with a minor injury. The heart rate slows, and the child passes out. “Cyanotic” spells are more common and happen when a child becomes angry or upset.

Although normally a benign phenomenon, it’s a good idea to speak with a pediatrician when breath holding happens. The doctor or nurse may do a physical exam and ask questions about the child’s symptoms and medical history. A blood test may be done to check for iron deficiency, and in some cases an EKG is done to check the heart or an EEG to check for seizures.

Katie Pottinger remembers every terrifying detail of the time her son, Alexander, went limp in his father’s arms. Alexander was 18 months old and had just taken a fall. He let out a huge cry, went silent and apparently passed out.

“I immediately called 911 because my husband said he’s not breathing,” said Pottinger. Even as she called, Alexander was starting to revive.

“The doctor said, ‘I know what this is,’” Pottinger recalled. “’It’s a breath-holding spell.’”

In either variety, breath holding appears to be a response to fear, pain, or even being startled. These events can cause a reaction in the child’s nervous system, which slows the heart rate or breathing for a short period of time. Breath holding spells are not thought to be willful defiance, but they can occur with temper tantrums.

“They often start crying very hard and then they’re silent,” explained pediatrician Patricia Hametz, MD, MPH. “They essentially stop breathing, can turn either purple or blue, and they may pass out.”

A breath holding spell may also cause twitching muscles, a stiff body, or a seizure.

The spells are more common in children with certain genetic conditions (Riley-Day syndrome or Rett syndrome), iron deficiency anemia, or a family history of breath holding spells.

There’s no way to prevent breath holding, but if it happens, doctors say to cushion the child’s fall and make sure the tongue isn’t blocking the airway. As frightening as it sounds, the episode typically passes in less than a minute with no damage done. If a child doesn’t wake up quickly and start breathing, call 911.

Alexander had a couple more episodes before he grew out of it. “It happened maybe three or four times, and I knew what to look for,” said Pottinger. He has no memory of it now, but his Mom says it was a scare she’s not likely to forget.

(Copyright 2012 by CBS San Francisco. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

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