Your child may be suffering from Breath-Holding Spells (BHS), also known as Expiratory Apnea. BHS can affect healthy, otherwise normal infants and young children, and often occurs when they cry. We want you, as a parent, to know what this phenomenon is, how frequently it occurs, and how you can handle episodes when they occur.
Breath-Holding Spells are often terrifying for parents. Many believe their child is holding his or her breath on purpose, but these spells are actually involuntarily and reflexive. They occur while your child is awake and engaging in active breathing. Spells usually last from 2 to 20 seconds, but can last as long as a minute or more.
A typical BHS episode involves an event that makes your child upset or distressed, such as pain (falling or getting hurt) or discipline (taking away a toy). This event leads to the child crying, which diminishes to quietness or leads to BHS. If the child has a BHS episode, there can be a change in his or her skin color and the episode can end with the child disoriented and either conscious or unconscious.
In most cases, a doctor will give you information about BHS and reassure you how it is not harmful to your child. We also would add that a BHS diagnosis should not lead to dramatic changes in the way you treat or attend to your child, with two exceptions. First, don’t be overly anxious or concerned about your child, either prior to or following BHS. Second, don’t surrender your authority to the child in an attempt to keep him or her from ever being upset. A doctor may also tell you, if your child is anemic, physician-guided treatment with iron supplements can decrease the frequency of BHS. Although medication is rarely beneficial for children with BHS, children with severe and frequent BHS may benefit from it.
When BHS occur, you should lay your child on his or her back and protect them from head injury and aspiration until recovery occurs. If necessary, you should clear out their mouth and airway to prevent choking. Try to do these things without overreacting and while staying calm.