Toddler breath-holding spells

Stories about toddlers who hold their breath until they faint during a tantrum usually have an undertone of judgement or a moral about spoiled children, but the truth is that it’s fairly common for young children under 6 to have breath-holding spells, and that children don’t have any control over these breath-holding spells.

Why do toddlers have breath-holding spells?

One of the main reasons breath-holding can be seen as willful, or as a toddler’s way of protest is that it is common for them to happen during tantrums. This is because the emotions that can trigger a breath-holding spell happen pretty commonly during tantrums, although they can happen at other times. These feelings include:

  • Fear
  • Pain
  • Surprise

Breath-holding spells can be more common in children who have a family history of childhood breath-holding, and are somewhat associated with iron-deficiency anemia. This means that if breath-holding spells start to become common, a toddler’s pediatrician might test for anemia.

What do breath-holding spells look like?

There are two types of breath-holding spells, and they’re different both in the way that they look and the triggers that cause them.

  • Cyanotic breath-holding: This type of breath-holding is more common, and happens when a child is upset. During a cyanotic breath-holding spell, a child will breathe out, and then not breathe in again for a while, and their parent or caregiver will notice their face start to turn a shade of blue.
  • Pallid breath-holding: The less common type of breath-holding spell also takes its name from the appearance of a child’s face during the spell – in this case, a child having a pallid breath-holding spell might turn very pale. Pallid breath-holding spells also have different triggers, and usually happen when children are startled or surprised, which can make them harder to predict.

Breath-holding spells usually last less than a minute, and can look like seizures, though they are not seizures, and do not put children at any higher risk for developing seizure disorders.

When do toddlers have breath-holding spells?

Breath-holding spells can start in children as young as 6 months old, but they’re most common in children between the ages of 1 and 2. Most children outgrow breath-holding by the time they’re 5 or 6 years old.

What should I do if my toddler has a breath-holding spell?

Breath-holding spells look scary, but they’re actually harmless. Still, if your child has a breath-holding spell for the first time, it’s important to seek medical help to make sure that it actually is just breath-holding that’s going on. Parents who notice the beginning of a breath-holding spell should make sure their children are somewhere safe where they won’t hurt themselves if they fall down.

  • Elana Pearl Ben-Josef. “Breath-Holding Spells.” Kids Health. The Nemours Foundation, October 2016. Web.
  • Sarah Roddy. “Breath-Holding Spells.” Child Neurology Foundation. Child Neurology Foundation. Web.
  • “Breath holding spell.” MedlinePlus. U.S. National Library of Medicine, April 4 2017. Web.
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