Types of breath holding

Breath holding episodes usually last from a few seconds to a couple of minutes and there are two main types:

1. Blue spells (cyanotic breath holding) are the most commonYour child may have hurt themselves or become very upset or frustrated and may:

  • cry or scream 
  • breathe out forcefully 
  • breath hold and turn blue, especially around the lips - this blueness is caused by a lack of oxygen and only lasts a few seconds 
  • faint.

2. Pale spells (pallid breath holding) are less common and can happen in young children after a minor injury or if a child is upset. Pale spells are caused by a slow heart rate and are often mistaken for a seizure. Your child may: 

  • open their mouth as if to cry but no sound comes out 
  • faint  
  • look very pale 
  • have a brief period where their arms and legs become stiff or lose control of their bladder/bowel.

What to do during a spell

Although breath holding spells can be upsetting to watch, your child usually doesn't need any treatment and will recover. 

They aren’t holding their breath on purpose and can't control this behaviour. If your child is having a breath holding spell:

  • stay calm (even though it may be hard) 
  • make sure your child is in a safe place to avoid falls or getting hurt 
  • watch your child 
  • allow the spell to stop by itself 
  • don’t shake your child or put anything in their mouth 
  • your child may need to see a doctor to make sure there are not any other causes. 

It can help to try to work out what the common triggers are for your child and if there are ways to minimise them. 

When to call 111

Call an ambulance if your child:

  • stops breathing  
  • loses consciousness 
  • has trouble breathing 
  • has jerky movements or a seizure for more than one minute.
Breath holding spells


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