Breath holding is a typical kind of tantrum. Your toddler will make a request that you refuse to comply with, and before you know it, you have an angry child on your hands who’s slowly turning shades of red and blue and maybe even passing out. This usually occurs in children 1-6 years old. The best reaction to this kind of breath holding is to simply ignore it and don’t give in.
However, there are breath holding spells that can signal an underlying medical condition. This very rare condition results when a toddler has no control over breath holding and it should trigger a visit to your pediatrician.
Breath holding spells often occur when your child is frightened. Some children breath-hold if they are in pain or a child may begin breath holding when upset, such as after a trauma, the death of a loved one, a car accident, etc. Some children will breath-hold if they are startled. Knowing your child’s triggers can help you redirect the behavior. Most of the time, regardless of the cause, these spells will last a short time, less than one minute.
If you’re concerned that your child is involuntarily breath holding, begin to pay close attention to your child’s appearance during the episodes. Look for your child’s skin tone and color. Is the skin pale? Red? Blue? These will be valuable details for your doctor.
Occasionally, breath holding spells can include a seizure-like episode in which your child’s arms and legs exhibit jerky motions. Your doctor will likely do certain test to be sure nothing serious is wrong. Besides asking about appearance and fainting, as well as jerky movements, testing may include an electroencephalogram (EEG). This painless test will look at your child’s brain activity to see if a seizure disorder is present. Even during a breath holding spell, this test will probably be perfectly normal. Your child’s doctor may also order an EKG, or electrocardiogram. This will look for an extremely rare condition in which your child’s heart rhythm is amiss (an arrhythmia). Blood tests will also likely be taken as iron deficiency is sometimes linked to breath holding spells.
After the tests are taken, it’s your job is to redirect your toddler’s behavior and to not overreact, which can reinforce the breath holding behavior. It is natural for you to be frightened or panic. However, be reassured that the human body’s natural instincts will take over if your toddler actually passes out. As soon as your child loses consciousness, breathing will start again. Knowing this can help you control your own panic. Rest assured your child will eventually grow out of the breath holding spells.
Reviewed by Dr. Sara Connolly, January 2019
- Typical breath holding tantrums occur in children 1-6 years old.
- Pay close attention to your child’s skin color as they are breath holding.
- Occasionally, a child will look like he or she is having a seizure, with jerky limb movements.
- Your doctor may order specialized tests to ensure nothing is serious.