Cyanotic and Pallid Breath Holding Spells

Brenna - posted on 08/01/2009 ( 12 moms have responded )

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Breath-holding spells are brief periods when young children stop breathing for up to 1 minute. These spells often cause a child to pass out (lose consciousness). Breath-holding spells usually occur when a young child is angry, frustrated, in pain, or afraid. But the spell is a reflex. It's usually not a deliberate behavior on the child's part.



Breath-holding spells are categorized as either cyanotic or pallid.



Cyanotic breath-holding spells, the most common type, usually occur in response to anger or frustration. A child's skin typically turns red or blue-purple.

Pallid breath-holding spells produce a pale appearance to a child's skin. These spells usually occur in response to fear, pain, or injury, especially after an unexpected blow to the head.

Some children have both cyanotic and pallid spells at one time or another in their lives.



Breath-holding spells can occur in children between 6 months and 6 years of age. They are most common from 1 to 3 years of age. And their frequency varies. Some children have a spell once a year, while others have spells several times a day.



Breath-holding spells are usually not serious, do not cause permanent damage or affect a child's future health, and gradually go away on their own.



What causes breath-holding spells?

Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. These reactions may be brought on by pain or by strong emotions, such as fear or frustration.



In some children, breath-holding spells may be related to iron deficiency anemia, a condition in which the body does not produce a normal number of red blood cells.



What are the symptoms?

In general, breath-holding spells cause a child to faint and may sometimes cause the muscles to twitch or the body to stiffen.



Specific symptoms of cyanotic spells include:



A short burst of rigorous crying lasting less than 30 seconds.

Hyperventilating (overbreathing).

A pause in breathing after exhaling.

Red or blue-purple skin color, especially around the lips.

Specific symptoms of pallid spells include:



A single cry or no cry at all.

Slowing of the heart.

Pale skin color.

Sweating.

Sleepiness or fatigue after the episode.

Some children also have seizures during breath-holding spells, which does not mean they have a seizure disorder. Seizures are different from mild twitching. They are more likely to occur in children who have long periods of breath-holding.



How are breath-holding spells diagnosed?

Breath-holding spells usually are diagnosed by a report of the symptoms observed during a spell. The doctor will examine your child and ask you to describe the spells. Recording the symptoms will help you describe them more accurately.



If your doctor thinks your child has a seizure disorder or another condition, such as iron deficiency anemia, certain tests may be done.

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Gloria - posted on 03/16/2010

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My son has BHS and he just turned 2 on March 8th. His started when he was about 6-8 months old and it was so scary... is kind of funny now how we noticed he was doing it but wasn't at all funny at the time! My husband had him in the bedroom and I was in the other room and he was crying really hard then not crying at all when I came in and he was nearly blue. I was like "WTF HAPPENED!!" and then sure enough, later I saw him do it on his own.

His seem to be triggered by being tired or hungry then getting frustrated, scared or hurt and they only last a minute from start to finish but boy, are they all out. He draws in all his breath, holds it in, then it seems almost like he forgets to exhale and keeps trying to breathe in again. I've found that picking him up and soothing him a moment with a calm tone of voice helps snap him out of it before he actually gets to the turning-blue-and-passing-out part of it. If he isn't caught quick enough, he'll turn purple-blue and pass out for a few seconds, start breathing again and then wake up like nothing happened.

It is really scary, even if you do know what's going on... just seeing the little scared look in their face :( Luckily he seems to do it less and less as he gets older. It started off at a few times a day to where now he will go days without doing it at all so for everyone out there going through the same thing, there is hope.

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Vickie - posted on 10/16/2012

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My daughter had those spells as a young child. As a teenager she has been diagnosed with POTS see dinet.org. On the bright side, if you're worried about brain damage, she had all 20 of the 20 signs of a gifted child

Vickie - posted on 10/16/2012

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My daughter had "breath holding spells" as a toddler. She seemed to grow out of it, but began having problems as a teenager. She was dx with POTS or dysautonomia. Very few doctors understand this illness. dinet.org has good info. I wish I had known when she was little, what I know now. Some problems can be prevented if caught at an early age.

Gloria - posted on 02/06/2012

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Sorry to hear your son is still experiencing this! Mine is nearly 4 (as of March 8th) and he hasn't had a passing-out spell in probably close to a year. He gets close, but never passes that 'point of no return'. Hope yours is improving with the new treatments.

Jane - posted on 12/08/2010

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Hi Gloria. So, the appointment today was interesting, as we haven't been to a paediatrician since the routine check at birth. He was a nice guy (and Jett told him so as we were leaving), and asked tonnes of background questions and made copious notes. I had brought about 6 movie clips of Jett having seizures. He examined Jett thoroughly and did lots of tests (eg. height, weight, can you stand on one leg, can you count your fingers, etc. etc) to check whether everything was developmentally normal, and it was. He said that what Jett does is not called breath holding, but rather Reflex Anoxic Seizures, and directed me to a website www.stars.org.uk for more info. He has also requested an ECG for heart rhythm analysis to confirm this diagnosis. He has given me a prescription for an iron supplement to try, and also wants us to see a clinical psychologist for counselling, for Jett and me as well, because of the behavioural component of his seizures. He was sure that it was something Jett would grow out of, but also agreed that this was a severe case.
So... I'd heard about the iron thing before and didn't notice any effect except it made him constipated, but I'll give it another go with this prescription. Also, I am going to start noting in my diary every single seizure because the doctor wanted me to be more precise than "about 3". Then we'll definitely know if the iron makes a difference.

Gloria - posted on 12/07/2010

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Jane, it is good that you've got an appointment with your son's doctor as this seems a bit more severe from other cases of BHS I've seen, including my son's.

An update on my son, he is nearly 3 now and has almost grown out of his BHS. He rarely holds his breath to the point of passing out now and it seems like he has the spells way less frequently than before, so there is hope for the future! :)

Jane - posted on 11/10/2010

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My son Jett is still having these breath holding spells at least 3 times a day. He will turn 4 in Feb, 2011. The most unfortunate thing about these spells is he becomes incontinent when he does it now. Also, it has now become a behavioural problem, in that he will bring it on himself if something is happening that he doesn't like, for eg. its time to take a shower or i want to change the TV channel. He also does it sometimes if he hurts himself, but once it starts he can't seem stop it. I thought he was out of nappies, but now I have gone back to keeping him in pull-up nappies, because it is just too annoying when he wets himself. But this is making him too lazy to go to the toilet! So the other day, I saw him start to do a poo into his nappy and I said, all upbeat, "oh you are going to do a poo? Come on lets go to the toilet!" and walked him to the toilet and put him on there and kept talking to him the whole time, promising him a little toy car or anything he wanted if he would just poo on the toilet again. He started the soundless cry, and after a few seconds he stood up and i could see he was going to fall, and I reached forward to catch him and he slipped down backwards through my hands and lay on his back on the floor, kicking and flailing his arms and legs, then going rigid, then arching his back as he peed all over the floor. I just had to crouch over him and put my hand under his face so he didn't bash his face on the floor. This is just so awful, and everything else in my child's life is so healthy and normal, and it seems so weird to be told by GPs, he's fine, he will grow out of it.
I recently made an appointment with a paediatrician, but its not until December. I am trying to film a couple of spells on my camera to show him.

Brenna - posted on 10/29/2009

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Thank you Christina for your post. I made this page because you never hear about this. And let moms know you are not the only mom going through it.- Brenna

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my daughter will be one on November 9th and has been having bhs for about 5 months and while I know that she will be okay...it's so hard especially as tonight felt like an escalation. Her one-year is on the 11th...so hopefully we can make sure there's on underlying reason....I don't know if anyone will read this, but I needed to know there were other moms dealing...

Yael - posted on 08/17/2009

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my doctor said that it can often run in the family - but as neither I or my husband had done anything like this we were not sure - then I heard my cousin used to do it regularly (almost daily) but she grew out of it when she reach 3 or 4 - and everything I have read say they will grow out of it, until then we manage :)

Brenna - posted on 08/17/2009

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I had never heard of this before and my son does have them quite often. I wanted to see if there was other moms who children have the sae problem. Because you never hear of them. thank you

Yael - posted on 08/08/2009

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My daughter has just has one of these this evening - not had one for a while (over six months ago), forgot how frightening it is, she tripped and fell and bumped herself, it was just before bedtime so very tired which I have found to be a trigger. All over after a couple of mins, but thoses few mins seem like forever - especially as she goes so pale (almost grey) and has a wierd contorting seizure - but we splashed some water on her face and she came to, just upset but 5mins later hse was splashing around in the bath as though nothing ever happened!

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