A baby is playing merrily with his rattle. You take the rattle away- for it is feeding time now. But then something goes horribly wrong. The baby starts crying loudly and while crying suddenly stops breathing and starts going blue. This is your first brush with a breath-holding spell- a seemingly scary but ultimately benign condition of early childhood! Let’s see what these spells actually are and what can be done to treat and avoid them.

Breath-holding spells are sudden involuntary temporary stoppage of breathing in an otherwise normal child. These spells typically follow violent crying as a result of baby’s anger, frustration or pain. These spells usually start by 6 months, peak by around 2 years and disappear by around 5-6 years. They are more common in girls.

There are two distinct types of breath-holding spells – the most common variety is Cyanotic or Blue Breath-holding spell when excessively passionate crying is followed by a brief breath-holding for a few seconds and the baby’s color changes to blue. Sometimes the baby then becomes limp and slowly resumes normal breathing. Occasionally the blueness is followed by a body becoming taut and going into a minor jerky seizure/ convulsion which also is self-limited. This type is more commonly associated with anger or frustration and seen in more assertive, aggressive babies.

The other rare type is Pallid or White Breath-holding spell, where the baby suddenly stops breathing, turns limp and white- usually following a painful stimulus and with practically no initial crying. This type is not really associated with any particular behavior and is thought to be as a result of physiological aberrations.

Don’t panic. These spells are not life-threatening and most of them stop within few seconds, even without any treatment. Blowing air on face or sprinkling water on face or turning upside down are some measures which have been tried but no one is particularly superior in efficacy.

Get the child evaluated from a doctor to avoid any confusion about similar conditions like a cyanotic heart disease or a seizure disorder. Once their benign nature is proved, just take it into your stride and don’t make unnecessary fuss over their occurrence.

Many parents try non-confrontational approach by not offending such child and letting him do whatever he wants to do, in order to avoid the potential crying and resultant breath-holding spells. But this is not needed and will spoil the child’s behaviour even further. Just be consistent and set the proper disciplining limits.

No medicines have proved effective and none are needed. By 6 years, almost all sufferers of this condition come out of this frightening habit.