Breath-Holding Spells: बच्चे का रोते-रोते साँस रोक लेना

Pre-school children of the age 2-4 years are the most notorious of all the kids that I have come across.

They dont listen to you, get angry really quickly, and cry a lot.

Sometimes during their crying episodes they hold their breath and go completely pale or blue. This causes intense fear among their caregivers.

Such episodes are known as Breath-Holding Spells in medical terms.

What happens during a Breath-Holding Spell?

The episode begins when the child is provoked by any action that causes him pain or anger. The child starts crying loudly and just when he exhales his breath completely: he stops crying, stops breathing, and turns either pale or blue.

This may be followed by the child losing consciousness or having brief seizures.

The 2 types of Breath-holding spells seen in children

There are two types of breath-holding spells: the pallid spell where the child turns pale, and the cyanotic spell where the child turns blue.

Some spells may have mixed features where the child turns both pale and blue. Cyanotic/blue spells are more common of the two.

At what age do these spells occur?

These spells are begin after 6 months of age, peak at 2 years and slowly resolve by 5 years of age.

How do we know it is a Breath-holding spell and not a seizure?

The breath-holding spells have a typical history where the parent says that the child started crying after some provocative event and later turned pale/blue.

This history helps us to differentiate such spells from more serious conditions like seizures and rythm disorders of the heart.

It must be noted that a spell may be followed by a seizure but that is not classified as a seizure disorder as the primary event was the breath-holding spell. Such seizures do not require long term anti-seizure drugs.

How do we stop or treat a spell?

• You, as a parent, should remain calm in such an event as it is not a serious condition though it might look so.

• In the rare case that the child becomes unconscious- do not pick up the child; just turn him sideways so that the saliva in the mouth does not choke him. The child gains consciousness really soon after the episode.

• Do not show undue concern if the spell was provoked by anger, as it will reinforce the behaviour.

• Angry reactions by the parents should be avoided.

• Calmly talking to the child and providing him simple choices helps in overall social and emotional development of the child.

• “Time-out” for a period which is 1 minute for each year of age (eg- 5mins for a 5 year old child), at a safe place in the house.

• You should intervene by calmly talking to the child before the child gets extremely distressed or angry.

• Your doctor may prescribe Iron syrups for the child if he feels that the child suffers from iron deficiency as some children with breath-holding spells respond to oral iron therpay.

• The seizures occurring after such an event do not require any medications.

If you have any queries regarding breath-holding spells, please feel free to comment below.

Regards,

Dr. Zeeshan

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