Breath Holding in Babies and Children

What is breath-holding?

Breath-holding is when your child stops breathing for up to a minute and might faint. It can look very frightening, but it's usually not dangerous. Your child isn't doing this on purpose - they can't control what happens.

This mostly happens to babies and young children. Most children grow out of it by age 4 or 5.

What triggers breath-holding?

Breath-holding usually happens when your child is:

• Very upset or angry
• Frightened or shocked
• In sudden pain
• Very frustrated

The episode starts because something has upset them, not because they're trying to get attention.

What happens during an episode?

During breath-holding, you might notice your child:

• Cries, then suddenly goes quiet
• Opens their mouth like they want to cry but makes no sound
• Turns pale, blue or grey around the lips, face or skin
• Goes floppy or stiff
• Has jerky body movements
• Faints for 1-2 minutes

After the episode, your child might feel sleepy or confused for a short while. This is normal.

When to call 999 immediately

Call 999 straight away if:

• Your child faints and you can't wake them up
• Your child is stiff, shaking or jerking (this might be a fit)
• Your child's lips, tongue, face or skin suddenly turn pale, blue or grey

These symptoms could be breath-holding, but they could also mean something more serious is happening. If a doctor hasn't already told you it's breath-holding, you need to get it checked right away.

What to do during an episode

DO:

• Stay calm - the episode should pass in less than a minute
• Lie your child on their side
• Stay with them until it ends
• Make sure they can't hurt their head, arms or legs on anything nearby
• Act normally afterwards and give them plenty of rest

DON'T:

• Shake your child or splash water on them
• Put anything in their mouth (including your fingers)
• Give mouth-to-mouth or CPR
• Tell them off - they're not doing it deliberately

When to speak to your GP

You should speak to your GP if your child has already been diagnosed with breath-holding and:

• The episodes happen more often than before
• The episodes seem worse than usual
• The breath-holding is affecting everyday life

Your GP might want to check if there's another condition causing the episodes. They may suggest a heart rhythm test called an ECG.

Treatment

There's no specific treatment for breath-holding. Most children naturally grow out of it by age 4 or 5.

Sometimes breath-holding is linked to low iron levels in the blood. Your GP might check your child's iron levels and suggest iron supplements if needed.

Medicine is rarely used to treat breath-holding.

Remember

Breath-holding episodes are scary for parents, but they're usually harmless. Your child will grow out of them. The most important thing is staying calm and keeping your child safe during an episode.

If you're worried about any symptoms, always speak to your GP for advice.

---

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.