About Breath Holding Spells in Children:
Breath holding spells are the paroxysmal non-epileptic episodes in which when a child cries when he is hurt, gets frightened and upset, turns pale, blue and loses consciousness. They mostly occur in children of 6 to 48 months of age and are involuntary episodes and cannot be controlled by the child.(1)
These episodes of holding breath are triggered by pain, fear, and the child becoming upset and lasts for less than a minute. Though scary to watch they do not harm the child and also do not require any treatment.(2)
Breath holding spells are different in different children. Their occurrence also varies, in some, it may occur very frequently i.e. several times in a day and in some only once in every few weeks.
Depending on the color change exhibited by the child during the episode it has two clinical types,(3)
- Cyanotic type
- Pallid type
Cyanotic type: Also known as the blue spells, cyanotic breath holding is the most common type.
The child when cries or screams loudly breathes forcefully and holds the breath. This leads to lips turning blue due to the lack of oxygen and leads to loss of consciousness.
Pallid Type: Pallid types are also known as pale spells are seen occurring rarely. They occur when the child is either injured or upset. They occur due to slow heart rate and are often mistaken for a seizure.
It occurs when the child opens the mouth to cry and no sound comes out. There is a faint and very pale look on the face. There is a brief period when the arms and leg become stiff or the child loses control over the bladder or bowel.
What Causes Breath Holding Spells in Children?
Research to understand the mechanism involved in breath holding spells has implicated an autonomic system deregulation,(4) In severe forms of breath holding spells in children, cerebral anoxia is seen as an ultimate factor.
Breath holding spells in children are caused due to change in the usual breathing pattern or slowing of the heart rate or the combination of both. One in every three children suffering from breath holding spells has a family history of similar episodes. In some, it is also related to iron deficiency anemia (a condition in which the body does not produce sufficient red blood cells).
How Are The Breath-Holding Episodes in Children Managed?
When the episode occurs, the following tips help manage it well.
- Do not panic during the situation
- Make the child lie comfortably on their side
- Do not put anything inside the mouth of the child and also do not shake him
- Keep the child away from any hard or sharp thing
- The spell would resolve by itself
- Never punish or reward the child after the event
The condition does not lead to any long-term damage to health, as it occurs due to just a brief period with a low oxygen level.
Consult a doctor if in case,
- The episode occurs without the child being angry or frustrated or hurt
- The breath holding spell occurs with stiffening and shaking and extends for more than a minute
- The child takes a long time to recover and is lost or confused for a long period of time
- The child sleeps for several hours after the episode
- If the child is less than 6 months as breath holding spells are less common in this age group
What Can Be Done To Treat Breath Holding Spells in Children?
The condition otherwise does not requires any special treatment. Make sure that the child gets enough rest and help him feel secure to minimize the occurrence.
Also, speak to your doctor regarding the problem. The child might require a physical check-up, to make sure that there is no other condition for this problem.
Children suffering from breath holding spells are usually healthy. Never treat them differently from other siblings as it may lead to behavior problems.
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