Breath holding in children.

A Breath holding spell is one of the most terrifying episodes to watch in the life of a parent. It is very distressing to watch when a child gets upset, turns blue, limp and pass out. It can happen in 4% of babies and toddlers.

What exactly is a breath holding spell?
Breath holding occurs when the child is surprised,upset or physically hurt. The child cries and apparently the long phase of breath exhalation associated with such crying produces the same response as to when one holds his breath for a long time- involuntary but severe enough for the child to turn blue and pass out. Sometimes the child may have an episode sever enough to cause twitching, arching of back and have seizure like movements.
Another form of breath holding (Pallid spell or reflex anoxic seizure) where the child, following an unpleasant event goes pale and limp and may have brief seizure like movements.

Is my baby too young for such spells?
Breath holding spells usually begin from 6 months of age, reach a peak during toddler years and is usually outgrown by around 5 years of age. Sometimes babies as young as 2 months can have such spells. Sometimes the grandparents can recall similar episodes in the parents when they were young.

Should I worry about my kid's breath holding spell?
Breath holding spell will cause no permanent damage.
But first your doctor will want to differentiate it from from seizure disorder. Breath holding spells usually follows an upsetting event, the twitching that occurs with breath holding is usually brief, minimal and non rhythmic. Genuine seizures are spontaneous (without any preceding event or crying), rhythmic and more severe. In less clear cut cases, your doctor may proceed with tests like EKG, EEG to rule out other causes.

What should I do when my child has a breath holding spell?
When your child gets upset, try to distract him immediately or talk to him in a non stressed tone. If your child develops a spell, don't panic. Take him to a safe environment to avoid injury. Make him lie down on the floor or in his crib. Try to avoid injury by taking her away from risky places like stairs, non strapped high chairs or near water.
There is nothing much you can do to prevent a spell. Avoid confronting situations if possible that might provoke a spell. Enforce discipline by being consistent on the standards you set for them. Avoid fatigue and hunger which may make them cranky. Do not shower too much attention on him following an episode, deal it in a matter of fact way (so that your kid's behaviour does not get reinforced by the attention he gets).
Discuss with your doctor about starting your kid on iron as the condition is sometimes found to be associated with iron deficiency anaemia.

Rest assured that this will usually be a forgotten thing , by the time he turns 5.