Breath holding spell

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A breath holding spell is an involuntary holding of the breath accompanied by loss of consciousness in response to a confrontational situation.

Breath holding is seen in some normal children approximately 8 months to 2 years of age. It appears to be a reflexive response to fear, a confrontational situation, a traumatic event (for example: pain), or to being startled.

The child may make a short gasp and then exhale and cease breathing. Then the child rapidly becomes bluish (cyanotic) and may have several jerky movements resembling a small seizure.

The event is terminated by a momentary period of unconsciousness, at which time normal breathing resumes. The color improves with the first breath and the event is over. This behavior may be repeated several times per day or seen only on rare occasions.

Breath holding can be a frightening event for parents who may perceive it as a seizure or even cardiac arrest. Breath holding can be mistaken for a seizure, and seizures can be mistaken for breath holding.

A physician evaluation to determine that the behavior is actually breath holding is appropriate. Breath holding may also be a symptom of a rare genetic disorder, Riley-Day syndrome.

After recognizing the event as breath holding, the parent can simply await the event's natural conclusion. No undue attention should be given to the child  --  such attention might encourage a repetition of the behavior with future events.

Review Date: 12/01/2005
Reviewed By: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.