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Breath-holding spells

Breath-holding spells

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Your child cries, and stops breathing, and almost turns blue. It is one of the scariest situations for parents. The episode seems life threatening but in reality, it is relatively benign (not serious). And it does not pose any risk to the health of the child.

It’s a very challenging situation for the caregiver, and needs to be handled with patience rather than panic. One thing which parents need to understand is that breath-holding spells are an involuntary reflex. The episodes usually last less than a minute (though it may seem like ages to the anxious parent), and after that the child regains consciousness and starts breathing normally.

Usual age of occurrence is from 6 months to 6 years but they can occur at earlier age too. Few cases have been reported in newborns also, but in such small babies, other factors need to be ruled out. Family history may be positive in some cases.

Episodes typically start after excessive crying.  Children usually outgrow this disease by the time they start going to school.

Breath holding spells are of two types

  • Cyanotic:  Child turns blue in face
  • Pallid:       Child turns pale, almost white

In both the cases the child stops breathing and loses consciousness for few seconds. In very rare cases seizures might occur, but these are benign and do not cause any long term harm.

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What to do if your child stopped breathing during a spell

  • Stay calm
  • While your child is in the brief unconscious phase, just check she is safe and has fallen flat on the ground
  • Remove any sharp object in vicinity which can cause damage to child.
  • Once she is awake, try to appear normal and unaffected by the whole thing.

When to See your Child Doctor

  • After first episode
  • These episodes are not harmful but proper check up and investigations might be needed to rule out underlying medical condition.
  • Consult your child specialist to determine triggers of spell and to know how to prevent future spells and how to deal with it if it happens again.

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How to prevent Future Spells

  • Try to prevent the trigger
  • You should try not to give in to tantrums of children
  • No special attention after spells, otherwise in a way we might reinforce the behavior.
  • Iron supplementation might help in decreasing the incidence, more so if child is anemic.
  • Reassure yourself and find a way to discipline your child in a way that does not provoke another spell
  • As the child grows old he develops better coping skills
  • With experience, courage and guidance from your child specialist you should be able to provide a safe and structured environment to your child.
  • In some cases when episodes are very frequent, some medications (like Piracetam) might be needed. But in most cases it can be avoided.

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Condition that should be ruled out

  • Heart conditions with rhythm disturbances like Arrhythmia etc via ECG or ECHO.
  • Anemia (Get Hemoglobin done)
  • Seizure like episodes and Seizure Disorder.

 

Feel free to contact Maya Clinic for any queries or discuss with your pediatrician.

Regards

Dr Rahul Varma