“You have taken baby care courses. You have read all the parenting books. You weren’t prepared to see your baby hold their breath until they turned blue.”

If you notice your child holding their breath, you may have a lot of questions. How should you deal with it? Are there long-term health problems that should be taken care of?

“If you have questions about your child’s health, it’s best to talk to their doctor, but we have gathered some information about young children that may help you prepare for that.”

As you might guess from the name, breath holding is when a child stops breathing, possibly for up to 1 minute, and often until they faint.

The baby will breathe again once they faint. The episodes are too short to cause permanent harm.

There are two main types of breath holding in babies.

Blue or cyanotic breath holding spells

These are the most common types of breath holding episodes. They happen when a baby has a change in breathing pattern.

Your baby may cry. They may start to turn blue. They will become limp if they faint.

Pale or pallid breath holding spells

“This type is not as common. They can happen if a baby is injured. They are caused by a baby’s heart rate slowing.”

Your baby may open their mouth but no sound comes out. They may become very pale and faint. They may become rigid.

These episodes are not seizures.

Breath holding affects 0.1% to 4.6% of otherwise healthy young children. It typically starts occurring between 6 and 18 months of age.

Breath holding is often caused by shock or pain. It can be the result of strong emotions.

Researchers suggest the following reasons why some babies hold their breath and others don’t:

  • Autonomic nervous system dysregulation: This system regulates involuntary functions like heartbeat, blood pressure, and body temperature, and if it doesn’t function fully, it may lead to episodes where the heartbeat or breathing slows.
  • Vagally mediated cardiac inhibition: The vagus nerve is a large nerve in the chest that helps regulate things like heart rate and digestion. If it’s not fully developed or isn’t working correctly, it might affect the heartbeat and contribute to breath holding episodes.
  • Delayed myelination of the brain stem: Myelination happens as neurons in the brain mature. If this process is delayed, it might contribute to breath holding spells.
  • Iron deficiency anemia: A common type of anemia, iron deficiency anemia occurs when there’s not enough iron in the body to produce enough hemoglobin in red blood cells. Without hemoglobin, oxygen cannot be transported to the brain.

Your baby may cry and become silent during breath holding. They may open their mouth and cry, but no sound comes out. They may become floppy or stiff, or even faint.

“If your little one is holding their breath, you may feel scared or have a flood of suck that pushes you into action. You want to remember a few do’s and don’ts.”

Do

  • This should pass in a minute.
  • Stay with your child.
  • “Make sure your child is on their side to help blood flow to the brain and to make sure they don’t hit themselves on anything.”
  • Make sure your child gets enough rest after.

Don’t

  • Put something in their mouth.
  • Pour water on them.
  • do not give them CPR or mouth-to-mouth
    • If there is no notable breathing or heart rate, or if symptoms last longer than a minute, then you should call the emergency room.
  • “They are not doing this on purpose and can’t prevent it.”

If your child is in an emergency, it is important to call the emergency services immediately.

  • “Can’t be woken up after a fall.”
  • Is it shaking or jerking?
  • Is it blue or gray?
  • It was difficult to breathe.

“These can be symptoms of breath holding, but they can also be related to more serious conditions. If your child’s doctor has not told you before that your child is breathing heavily, you should have your child checked out by a doctor.”

“If you have a child’s doctor, talk to them.”

  • Your child has already been diagnosed with breath holding and their episodes seem to be getting more frequent, longer, or otherwise more severe.
  • Your child shakes for a long time, or takes a long time to recover from an episode.
  • They are beginning to impact their daily life with breath holding.

If your child has unusual heart rhythms or scurvy, your doctor may do further testing to see if any underlying conditions are present.

It is usually harmless when your baby holds their breath. Many children are not able to tolerate this by the time they are 4 or 5 years old.

There is no known medication that can stop a baby from breathing.

In some cases, breath holding may be related to iron deficiency anemia. In these cases, an iron supplement may help decrease the frequency of breath holding.

In fact, a 2019 study found that iron supplements should be given in all breath holding cases regardless of anemia.

Before giving your child any supplements or medications, it is advisable to have a discussion with your doctor.

If your child has trouble breathing, their doctor may refer them to a brain specialist or a heart specialist. These healthcare professionals can rule out a medical condition.

You may be breathless when you see your baby holding their breath. Chances are that they are fine.

“If your baby is holding your breath, you want to make sure that they are in a safe position, that they don’t get any medical attention, and that they don’t have anything in their mouth.”