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    Breath-Holding Spells - Topic Overview

    What are breath-holding spells?

    Breath-holding spells are brief periods when young children stop breathing for up to 1 minute. These spells often cause a child to pass out (lose consciousness). Breath-holding spells usually occur when a young child is angry, frustrated, in pain, or afraid. But the spell is a reflex. Children don't have breath-holding spells on purpose.

    There are two types of breath-holding spells:

    • A cyanotic spell is caused by a change in the child's usual breathing pattern, usually in response to feeling angry or frustrated. It's the most common type.
    • A pallid spell is caused by a slowing of the child's heart rate, usually in response to pain.

    Some children may have both types of spells at one time or another.

    Breath-holding spells can occur in children 6 months through 6 years of age. They are most common from 1 to 3 years of age. Some children have them every day, and some have them only once in a while.

    Breath-holding spells are usually not serious and don't cause lasting damage. With time, they go away on their own.

    What causes breath-holding spells?

    Breath-holding spells are usually caused by either a change in the child's breathing or a slowing of the heart rate. These reactions may be brought on by pain or by strong emotions.

    In some children, breath-holding spells may be related to iron deficiency anemia, a condition in which the body doesn't produce a normal number of red blood cells.

    What are the symptoms?

    A breath-holding spell may cause:

    • Fainting. It usually lasts for less than a minute.
    • Twitching muscles, a stiff body, or a seizure.
    • Changes in breathing and heartbeat.
      • In a cyanotic spell: The child may breathe too fast or too hard. When the child breathes out, there may be a long pause before the child takes another breath.
      • In a pallid spell: The heartbeat may slow down.
    • Changes in skin color.
      • In a cyanotic spell: The skin may turn red or blue-purple, especially around the lips.
      • In a pallid spell: The skin may be pale and sweaty.
    • Crying.
      • In a cyanotic spell: There may be a short burst of intense crying.
      • In a pallid spell: There may be a single cry or no cry at all.
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