Breath holding can happen after a child gets a fright, has a minor accident, is frustrated or becomes very upset. It is very common and affects about one in 20 children. Breath holding usually affects children up to the age of six.

Signs of breath holding include:

  • Cry and child will hold their breath (stop breathing)
  • Loss of consciousness
  • Become pale and blue in colour
  • Become unconscious
  • Become listless, faint or collapse

Causes of breath holding

The exact cause of breath holding is not known but often tends to be caused by slowing of the heart rate or changes in the child’s usual breathing patterns. Sometimes there is a family history of similar events. Breath holding is not caused by a health problem and will not harm your child.

Types of breath holding

Blue spells (cyanotic breath holding)

These are the most common. Often a fright or pain triggers a spell.  The child cries or screams out and then turns red in the face before going blue usually around the lips. The child becomes floppy and unconscious. Whilst this can be scary to watch there is no treatment needed.  Your child will start breathing and recover by themselves.  There are first aid actions (provided below) that you can take during an episode.

Pale spells (pallid breath holding)

These are less common, and can happen after a minor injury or if the child is upset. They can also occur very early on in life. The child will open their mouth as if they are going to cry but no sound will come out.  They may then faint or lose consciousness and become very pale. No treatment is needed, your child will start breathing and recover by themselves.

First Aid

When your child is breath holding:

  • Lie them on their side and watch them.
  • Keep their limbs and head from hitting anything hard or sharp.
  • Do not put anything in their mouth (including your fingers).
  • Do not splash them with water.
  • Do not shake them.
  • Your child will start breathing on their own again after the spell subsides.
  • After the incident treat your child normally.
  • Do not punish or reward them as this may lead to long-term behavioral problems.

Key points to remember

  • If your child is having frequent attacks (more than once a day or several times a week) you should have them seen by a doctor.
  • You should seek medical help if you child has a fit (seizure) that lasts more than a couple of minutes and is confused and drowsy for several hours post the spell.
  • If your child becomes pale or unconscious for no reason, seek medical help.  In an Emergency go to your nearest Emergency Department or call 000.

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