Key takeaways: Breath-holding spells are reflexes, not on purpose. They often start between 6 and 18 months, triggered by crying, frustration, pain, or fright. A child may turn blue or pale, go limp, and briefly pass out, then recover quickly. They’re frightening but usually harmless and outgrown. Iron deficiency has been linked to them, so your doctor may check iron levels.
Watching your baby stop breathing and turn blue is terrifying. Breath-holding spells are usually harmless, but they deserve a doctor’s evaluation.
Types
- Cyanotic (blue): the most common. Usually triggered by crying or anger. The child cries, breathes out, then stops breathing and turns blue.
- Pallid (pale): usually triggered by sudden pain or fright, such as a minor bump. The child turns pale and may go limp.
What Happens
- The spell often lasts less than a minute.
- The child may pass out briefly and sometimes jerk a few times.
- Breathing starts again on its own, and the child recovers quickly, sometimes tired afterward.
Who Gets Them
- Usually starts between 6 and 18 months.
- Often runs in families.
- Most children outgrow them by about 4 to 5 years.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. My book covers common first-year illnesses and the warning signs that mean it’s time to call the doctor, explained the way I’d explain them at the bedside.
The Iron Connection
Research, including a study by DiMario, has linked breath-holding spells to iron deficiency anemia. Iron treatment has reduced spells in some children with low iron. Your doctor may check iron levels.
What to Do During a Spell
- Stay calm.
- Lay your child on their side on a safe surface.
- Don’t put anything in the mouth.
- Don’t shake or splash water on your child.
- Time the spell.
After the Spell
Comfort your child calmly. Keep routines consistent. Giving in to every demand to avoid spells isn’t necessary.
When to See a Doctor
See your doctor after the first spell to rule out other causes, such as seizures or heart rhythm problems.
Call 911 if: your child doesn’t start breathing within a minute, stays blue, has jerking that lasts more than a minute, or doesn’t return to normal soon after.
The Bottom Line
Breath-holding spells are frightening but usually harmless. See your doctor after the first one, and ask about checking iron levels.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
Sources
- DiMario FJ Jr. Prospective study of children with cyanotic and pallid breath-holding spells. Pediatrics. 2001;107(2):265-269.
- American Academy of Pediatrics. Breath-holding spells. HealthyChildren.org. https://www.healthychildren.org
- National Library of Medicine. Breath holding spell. MedlinePlus. https://medlineplus.gov
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
