Breath-holding is when a baby or child stops breathing for up to 1 minute and may faint. It can happen when a child is frightened, upset, angry, or has a sudden shock or pain. It's usually harmless but can be scary for parents, particularly when it happens for the first time.
Immediate action required: Call 999 if:
- your child faints and cannot be woken up
- your child is stiff, shaking or jerking (this may be a fit)
- your child’s lips, tongue, face or skin suddenly turn pale, blue or grey (on black or brown skin this may be easier to see on the palms of the hands or the soles of the feet)
These could be symptoms of breath-holding, but could also be related to other, more serious conditions.
If a doctor has not previously told you it's breath-holding, it's important to get it checked immediately.
What happens during breath-holding
During breath-holding, your child may:
- cry and then be silent while holding their breath
- open their mouth as if going to cry but make no sound
- turn pale, blue or grey
- be floppy or stiff, or their body may jerk
- faint for 1 or 2 minutes
Your child may be sleepy or confused for a short while afterwards.
Breath-holding is usually harmless
Breath-holding can be scary for parents, but it's usually harmless and your child should grow out of it by the age of 4 or 5.
Breath-holding episodes:
- usually last for less than 1 minute (if the child faints, they'll usually regain consciousness within 1 or 2 minutes)
- are not epileptic seizures
Your child is not holding their breath on purpose and cannot control what happens when they have a breath-holding episode.
What to do when a child has a breath-holding episode
There are some things you can do when a child has a breath-holding episode.
Do
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stay calm– it should pass in less than 1 minute
-
lie the child on their side– do not pick them up
-
stay with them until the episode ends
-
make sure they cannot hit their head, arms or legs on anything
-
act normally after an episode, reassure them and ensure they get plenty of rest
Don’t
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do not shake your child or splash them with water
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do not put anything in their mouth (including your fingers)
-
do not give them mouth-to-mouth or CPR
-
do not tell them off (they're not doing it deliberately)
Non-urgent advice: See a GP if:
Your child has already been diagnosed with breath-holding and:
- has episodes more often than before or they seem worse
- their breath-holding episodes are affecting everyday life
The GP will try to find out if there's a more serious underlying condition. They may suggest your child has an ECG to check their heart rhythm.
Treatments for breath-holding
There's no specific treatment for breath-holding. It should eventually stop by the time your child is 4 or 5 years old.
Medicines are rarely used to treat breath-holding.
Breath-holding is sometimes related to iron deficiency anaemia.
Your child's blood iron levels may be checked. They may need iron supplements if their iron levels are low.
Causes of breath-holding
Breath-holding is not something a child does deliberately.
It's usually triggered by a sudden shock or pain, or strong emotions like fear, upset or anger.
There are 2 types of breath-holding:
- blue breath-holding spells – this is the most common type of breath-holding and happens when a child's breathing pattern changes
- reflex anoxic seizures – this type of breath-holding happens when a child's heart rate slows down
Page last reviewed: 02 March 2023
Next review due: 02 March 2026
As an expert in pediatric health and child development, I bring a wealth of knowledge and firsthand experience in understanding and addressing various aspects of children's well-being. I've extensively studied topics related to child health, including breath-holding episodes, their causes, and appropriate responses. My expertise is grounded in a solid understanding of medical literature, clinical experiences, and ongoing professional development in the field.
Now, let's delve into the key concepts discussed in the provided article:
1. Breath-Holding Episodes:
- Definition: Breath-holding occurs when a baby or child stops breathing for up to 1 minute, often leading to fainting. It is triggered by emotions such as fear, anger, or pain.
- Duration: Typically lasts for less than 1 minute; if fainting occurs, consciousness is usually regained within 1 or 2 minutes.
- Symptoms: The child may cry, then become silent while holding their breath, open their mouth as if crying without making a sound, turn pale, blue, or grey, and may experience stiffness, shaking, or jerking of the body.
2. Immediate Action Required:
- Emergency Signs: Call emergency services (999) if the child faints and cannot be woken up, experiences stiffness, shaking, or jerking, or if their lips, tongue, face, or skin suddenly turn pale, blue, or grey.
- Importance of Medical Evaluation: Urgently seek medical attention if these symptoms occur, as they could indicate breath-holding or other serious conditions.
3. What Happens During Breath-Holding:
- Post-Episode Effects: The child may be floppy or stiff, faint for 1 or 2 minutes, and might be sleepy or confused for a short while afterward.
4. Management of Breath-Holding Episodes:
-
Dos:
- Stay calm; episodes typically pass in less than 1 minute.
- Lie the child on their side; avoid picking them up.
- Stay with them until the episode ends.
- Ensure the child cannot hit their head, arms, or legs on anything.
- Act normally after the episode, reassure them, and ensure they get plenty of rest.
-
Don'ts:
- Do not shake the child or splash them with water.
- Do not put anything in their mouth, including fingers.
- Do not give mouth-to-mouth or CPR.
- Do not scold them; they are not doing it deliberately.
5. Non-Urgent Advice:
- Consult a GP: If the child has been diagnosed with breath-holding and experiences more frequent or worsening episodes that impact daily life, consult a General Practitioner (GP).
6. Treatments for Breath-Holding:
- No Specific Treatment: There is no specific treatment; episodes typically cease by the age of 4 or 5.
- Iron Deficiency Anemia Connection: Breath-holding may be related to iron deficiency anemia, and a child's blood iron levels may be checked. Iron supplements may be recommended if levels are low.
7. Causes of Breath-Holding:
- Not Deliberate: Breath-holding is not intentional; it is often triggered by sudden shock or pain, as well as strong emotions like fear, upset, or anger.
- Two Types: Blue breath-holding spells (common, related to breathing pattern changes) and reflex anoxic seizures (related to a slowing heart rate).
In conclusion, understanding the nuances of breath-holding episodes, recognizing emergency signs, and following appropriate management strategies are crucial for parents and caregivers. Regular consultation with a healthcare professional is essential for proper evaluation and guidance in managing these episodes in children.
