'She Was Blue and Unconscious in my Arms': Breath Holding Spells Explained

When my daughter was 10 months old she fell off the couch and landed on her head. As I scooped her up, she screamed blue murder for a brief moment and then stopped breathing.

I looked down to see her blue in the lips, her face completely white, her eyes rolled back in her head, unconscious in my arms.

I remember screaming for someone to call Triple 0, trying to wake my baby up while my other kids ran around the house searching for a phone. By the time my partner found his phone and pressed the first 0, my daughter was awake. Looking up at me. Smiling. Perfectly content. I was literally sh*tting myself.

The first (of many) breath-holding spells

The ambulance crew arrived and checked her over, reassuring me she was not concussed. She simply lost her breath.

“it’s called breath-holding,” the ambo said casually.

Now, she is our third baby and we’ve been through our fair share of accidents and emergencies. Broken teeth, bad chest infections, trampoline falls, split knees. But never in my life have I experienced something so terrifying as watching my little girl turn white and floppy in my arms.

After she was tucked into bed, I did some googling. According to The Sydney Children’s Network,

Breath-Holding or Cyanotic Breath-Holding may happen after a child becomes upset or injures themselves, for example after a minor bump or fright. The child opens their mouth as if to cry but makes no noise.

They may look very pale in the face or their lips may look dusky blue for a moment. Sometimes the child may become limp and fall to the ground. Twitchy movements of their limbs may occur for a few seconds.

The child usually recovers quickly after being unresponsive for a short period and then cries normally as if upset.”

Pale. Blue. Unconscious. Limp. Twitching.

WHY HADN’T I HEARD ABOUT THIS BEFORE??

Now, I thought this was the end of it. One bad fall off the couch. One spell. We rearranged the couch, added extra padding to the floor. No more falls. No more floppiness, unconsciousness, twitching.

But, it wasn’t. Because she’s a toddler who loves to climb, jump and dive off the lounge. Despite my best-laid plans, she still hurts herself and sometimes, it ends in a breath-holding spell.

Sometimes it’s after a fall. Sometimes it’s when she’s upset. She stepped on a DUPLO the other day and that triggered it. Part of me wanted to bin ALL the DUPLO but it’s not just the DUPLO causing it.

And she’s not the only one who has breath-holding spells.

According to The Sydney Children’s Hospital,

Breath holding spells (or ‘attacks’) occur in approximately 5% of toddlers and babies aged from 6 months to four years.”

So, if your little one does this, you’re not in this alone, mama! I’m here too, terrified any time she chucks a tantrum that she’s going to stop breathing!

What is going on exactly?

Essentially, it’s a change in the child’s usual breathing pattern and/or heart rate that causes the breath-holding spell. Breath-holding is usually caused by physical pain or by strong emotions, such fear or frustration.

There are two different types of breath-holding spells.

Cyanotic (blue) breath-holding spells – These occur when a child stops breathing and turns blue in the face, usually triggered by something that upsets the child. While crying, a child exhales and doesn’t take another breath for a while, causing the child to turn blue and lose consciousness.
Pallid (pale) breath-holding spells – These occur when a child gets a sudden fright or startle and children turn pale, almost white, before losing consciousness.

Are they doing it on purpose?

No. Breath-holding spells are completely unintentional — they’re an involuntary reflex, which means kids have no control over them.

Is breath-holding dangerous?

They are scary to witness but breath-holding spells pose no serious health risks.

They WILL grow out of them and there is no increased risk of developmental delay or developing a seizure disorder later in life. Phew!

How often do breath-holding spells happen?

My daughter is two and she’s had about five spells. However, I’ve talked to some parents whose very strong-willed toddlers have breath-holding spells nearly every day.

Every single spell is scary but they do get easier because you can predict when they are coming. As soon as I see my daughter do that no-sound cry, I’m at her side, ready to sweep her up and hold her in case she does lose consciousness.

The Sydney Children’s Hospital recommends parents try these tactics:

Don’t panic.
Lie the child on their side and observe them.
Don’t shake the child, put anything into their mouth or splash water onto them.
Keep their head, arms and legs away from hitting anything hard or sharp.
Allow the episode to stop by itself.
Treat the child normally after the event.
Do not punish or reward the behaviour.

When to call a doctor

I swear anytime my daughter has an episode I want to pick up the phone and ring Triple 0, especially if she has had a fall before the spell. It’s a good idea to get your child checked if she has hurt herself. You should also contact a doctor if:

Your child loses consciousness or becomes very pale without provoking factors
Your bub is under six months of age
The spells are frequent (several times a day)
Your child experiences prolonged stiffening or shaking which goes on for more than one minute
Your child remains confused or sleepy afterwards

If in doubt, contact a doctor! I know firsthand how distressing breath-holding can be and it only makes sense to get reassurance. In time, these spells will pass and we’ll be onto the next tricky parenting stage, whatever that may be.