I just signed up for this site, because a friend of mine saw your 'passing out' request. First I want to say how sorry I am that your niece is going through this. It is extremely scary for the people around her when it happens.
My daughter is 15 months old and she does the same thing. She usually does it when she is mad, stressed or in an environment that is unusual to her. She has only done it a few times, My doctor did mention epilepsy, but feels that this type of diagnosis usually includes one or more of the following symptoms (but not excluded to): body stiffening up, shakes, blocked airway with the tongue, convulsions, and not breathing after passing out. On the other hand he told me that some children do this because when they are mad they tend to take deep breaths in and out causing them to hyperventilate in turn their body thinks that they do not need any more oxygen. This makes them hold their breath. Sometimes a swat on the bottom will cause the child to release the air and start breathing. It kind of brings the body back into reality. In most cases this works and she will start breathing, however there has been times that it does not work and her lips will turn blue, her eyes will cross and she will pass out. Once she passes out she begins breathing normal immediately. My doctor said that he was not concerned about it at this time, because she only does it when she is mad and she starts breathing as soon as she passes out. He feels that she will grow out of it. He also mentioned that ear infections, and colds can cause a child to hold his/her breath when they are very upset because of the congestion that could be going on. His suggestion was to watch her close when it is happening. Do not hover over her and try to stay as calm as possible (what ever that is...because if your like me this totally scares you when it happens). You don't want her to feel that her actions of holding her breath is getting her attention. This can be extremely hard, because it is scary. However if holding her breath is a reaction to get what she wants then avoiding the normal motherly reaction, which is to pick her up and hold her close and love all over her is only going to enforce her thought that this is how she gets this type of attention. Of course you don’t want to ignore her but you have to show her that this isn’t an expectable way to communicate, because at this age she doesn’t know any other way until you show her.
My daughter use to do this a lot when she was between 9 months and 11 months. My doctor suggested that we swat her on the diaper to make her body react, in turn make her release her breath and start breathing. So I would do that, and for the most part it did work. If that didn’t work I would lay her on the floor or hold her (so that she wouldn’t hurt herself) while stroking her hair (so that she knew I was there) I would then watch her to make sure she did start breathing. As soon as she would pass out, I would let her lie there, because she must be dizzy from the lack of oxygen. When she would start crying again I would hug her and tell her everything was ok. I would then down and touch her on the end of the nose and look directly in her eyes and tell her (in a serious voice with some authority)” When your upset you do not need to hold your breath. Holding your breath scares momma. You need to learn to use your words” I would then set her next to any wall as if she were in time out and I would let her cry it out. **Trust me I know this sounds harsh, and OMG was it hard. I would have to go in the other room and cry it out myself** However, after doing that two times, she stopped doing it for several months. She is now 15 months old and she just had another episode.
This last episode does have me concerned. About a month ago, she did it again. It started when we had her in time out because she was hitting at us, when we wouldn’t let her in a cabinet. She cried and cried and because we didn’t allow her to take our attention with her crying she held her breath. I saw that she was holding her breath. I picked her up and swatted her several times on the diaper and she didn’t start breathing, so I set her back down, and set in front of her. She then passed out, but she didn’t start breathing again. So I picked her up and was talking to her (all while remaining calm.. I still don’t know how I did it) She then took one breath and then held it again. Her body stiffened up and she was turning very pale. I started yelling for my husband. (Thank God he is a nurse and he was there). I laid her on the floor and she had this stare in her eyes, which I will never forget. Her arm then went above her head straight out and my husband began giving her small taps on her chest. She then started breathing again. He then blew in her mouth one time, just to make sure that she was ok. My husband said that the arm going above the head is a normal reaction because she wasn’t getting any oxygen to the brain. Although, the vision in my head will remain forever. After that I held her cried and rocked her for a few minutes. I then set her down and touch her on the nose and told her in a serious voice, “You do not act like that, it scares mommy, we love you and don’t want you to hurt yourself.” I then told her to stay in time out, so that she learns that she cannot act that way. Of course I was still crying, and when I set her in time out, I stayed very close to her to make sure she was ok. She then continued her fit, by crying and kicking on the floor, until she finally gave up and became quite. I then picked her up and loved on her, and told her how proud I was that she was so good and how much we loved her. She hasn’t had another episode since then. Although I will be seeing her doctor on the 20th of this month and I plan to let him know what happened.
To end this.. I’m not telling you that your niece is simply having fits. However, if she is holding her breath only when she is mad then this could be the cause. I would recommend that you find your own way to make sure she knows that this is an unacceptable form of communication for her. If your efforts do not work, and she continues to hold her breath or develops other symptoms then I would look into other possible causes. My little girl scared me so bad with her last episode that I will be asking her doctor about it, just to make sure that there isn’t another cause. I will post another response to your questions once I see the doctor. I also suggest that you do a web search on epilepsy and seizures so that you are fully informed about the causes and symptoms. I always say you can never have enough information.
Here are some websites that I have looked at. If clicking on them doesn't work, then copy and paste the link in your address bar.
http://www.drgreene.com/21_557.html
http://www.epilepsy.com/