Breath holding spells is not uncommon in children.

The phenomenon is very much frightening to the parents.

It is usually seen in children after the age of 6 months.

It usually starts between the age of 6-18 months and mostly observed in the age group of 1-3 years.

It abolishes automatically after 4-6 years of age.

There is no difference between male and female.

There are two types of attacks-1.Pallid spells and 2. cyanotic spells

In pallid spells, the heart rate of the child becomes slow,the child looks pale(more white) and there is loss of consciousness for few seconds ,but definitely ,less than 60 seconds(1 minute).

The pallid spell is usually triggered by pain ,like fall from the bed ,fall on the ground while playing,or minor impact on head of child by gently slapping.

In CYANOTIC SPELLS-

The colour of child becomes blue or purple specially around the lips.It is triggered by aggression,frustation,emotional distrubances and crying in fear or frightening environment to the child.There occurs a short burst of cry or single cry in which at the end of cry the child exhales for a slightly long period and holds the breath in exhalaltion ,not followed immediately by inhalation.There is loss of consciousness for a brief period ,not more than a minute.The muscels of the body may becomes stiff and there may be arching of the body in backward direction.Sometimes,there may be abnormal body movement and rarely there may be seizure.

This phenomena is typically described by parents as the child sometimes forget to take breath.

WHAT TO DO IN THESE SITUATIONS:This condition is harmless to the child with no long term effect on the brain and growth of the child.

The parent should not panic and should be very calm and comfortable.Those objects which may cause injury to the child and particularly sharp objects should be taken away from near of the child.

Make the child lie on the lap.

Do not through water on the face of the child as is usually practiced.It may be dangerous.

The child regain consciousness within a minute.If not,take the child to a doctor/clinic/hospital nearby.

If this episode is the first time,certainly go to the doctor/clinic/hospital.This is because, there may be some serious problems in heart and or brain of the child leading to these symptoms.There may be seizure disorder presenting like this.There may be congenital prolonged QT syndrome presenting like this.

If by proper clinical examination and if required proper investigations,it becomes clear that it is not due to any pathology in the brain and or heart,nothing to be worried.

It has been observed that ,these attacks are more common in children suffering from iron deficiency anemia

It should be investigated and treated ,the child becomes normal.

In some children,the episodes happens many times a day and in others only after few days or months.

It has been seen that ,it happens more frequently in circumstances where parents are more apprehensives.

So,parents should take care of themselves,not to show apprehensions in front of children and not to allow secondary gain to children.

Sometimes ,the episode becomes life threatening,and parents should learn ,how to resuscitate babies by giving mouth to mouth breath and chest compressin if required.

Sometimes ,medications in the form of atropine may be required,which should strictly be used by a qualified medical doctor.