All Children's Hospital Logo

Health Information Library

Parents > Growth & Development > Growing Up > Breath-Holding Spells
Breath-Holding Spells

About Breath-Holding Spells

Many of us have heard stories about stubborn or willful toddlers who hold their breath until they turn blue in the face. These might sound like amusing "terrible twos" tales, but they're not funny to the parents of these toddlers. Breath-holding spells can be terrifying for parents because kids hold their breath until they pass out.

But these spells aren't intentional — they're an involuntary reflex, which means kids have no control over them. Although very disturbing to those who witness them, breath-holding spells aren't harmful and pose no serious health risks. A spell typically lasts less than a minute before a child regains consciousness and resumes breathing normally.

Breath-holding spells can happen in healthy children between 6 months and 6 years old, but are most common during the second year of life. They can be more common in kids with a family history of them.

In most cases, breath-holding spells can be predicted and even prevented once triggers are identified. Kids usually outgrow them by age 5 or 6.

Types of Breath-Holding Spells

Breath-holding spells differ by cause and characteristics:

Cyanotic breath-holding spells happen when a child stops breathing and turns blue in the face. These spells are often triggered by something that upsets the child, like being disciplined. Parents who have witnessed prior cyanotic spells know exactly when another one is about to occur because the child's face slowly turns a shade of blue, ranging from light blue to almost purple.

Pallid breath-holding spells are less common and more unpredictable because they happen after a child has gotten a sudden fright or startle (like being surprised from behind). Unlike with cyanotic spells, kids turn very pale, almost white, during the spell.

Both types of spells cause kids to stop breathing and lose consciousness for up to a minute. In the most extreme cases, kids have seizures. Having a seizure does not cause any long-term harm or put a child at risk of developing a seizure disorder.

If Breathing Stops During a Spell

If your child has a breath-holding spell (stops breathing; turns blue, purple, or white in the face; and passes out for brief time), stay calm and:

When to See the Doctor

If this is your child's first breath-holding spell, seek medical care. Although breath-holding spells are not harmful, they can sometimes be a sign of an underlying medical condition and should be checked out.

Most spells are an involuntary response to strong emotions (like being angry, scared, or frustrated), but some are caused by medical conditions, like a seizure disorder, heart arrhythmia, or iron deficiency anemia. Treating these conditions may help reduce the frequency of breath-holding spells.

Once underlying conditions are ruled out, a doctor can help parents determine what triggers a spell in their child, how to prevent future spells, and how to deal with them if they do happen.

Preventing Future Spells

Once kids develop better coping skills they usually outgrow breath-holding spells. But in the meantime, parents can face a challenge greater than witnessing the episodes themselves: finding a way to discipline the child that won't provoke another spell.

Your doctor can work with you to achieve this delicate balance by helping you find better coping strategies for you and your child. Try not to give in to tantrums and obstinate behavior; young kids need limits and guidelines to help them stay safe and become well-adjusted emotionally.

With experience, courage, and your doctor's help, you can learn to cope with breath-holding spells while providing a safe and structured environment until your child outgrows them.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: November 2013
Originally reviewed by: Rosemary Casey, MD

Related Articles
P    How Can I Help My Toddler With Separation Anxiety?
P    Is It Normal for Children to Hold Their Breath?
P    Separation Anxiety
P    Taming Tempers
P    Temper Tantrums
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2014 KidsHealth® All rights reserved. Images provided by iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart.com

Additional Info

Pocket Doc Mobile App
Maps and Locations (Mobile)
Programs & Services
Employment
For Health Professionals
For Patients & Families
Contact Us
Find a Doctor
News
CME

All Children's Hospital
501 6th Ave South
St. Petersburg, FL 33701
(727) 898-7451
(800) 456-4543

Use Normal Template
© 2014 All Children's Hospital - All Rights Reserved