# Breath holding spells and passing out



## liz111

My youngest son is 22 months old and has breath holding spells when he cries suddenly and then he promptly passes out for a second or two. When he comes to he seems completely normal. It seems to come on whenever he is startled (which happens easily; for example, if I get up suddenly and move quickly towards another one of my kids) or angry (if I tell him 'no' or take something away that he shouldn't be playing with). This is scary and also frustrating because I feel like I obviously need to discipline/direct him sometimes, but I am getting anxious to do so because I don't want to bring on a spell. We try to have a calm and structured home, but variables out of our control do (and should) come up, and my son has a hard time dealing with these. I am wondering if others have had experience with this and have any advice for me. Thanks!


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## oldsmom

I have seen a child hold their breath intentionally as a "punishment" to the parent when they don't get their way. And I have heard that passing out from doing so is relatively harmless. 

But I have not heard of this happening without intent. If he is unaware he is doing this, it may make sense to check with a physician to make sure it's not a medical problem.


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## liz111

Breath holding in infants is actually quite common, if you google cyanotic or pallid spells. I have talked with a couple doctors about it though, and my brother who is a physician has seen my son's episodes and isn't concerned. Intellectually I am not worried about the actual incidents being harmful (in some individuals' cases they are due to a physiological issue, but much more commonly it is caused by underdeveloped coping skills), but I can't help but get shaken up when I am actually witnessing my child doing this! We try to be really calm about it and not make a big deal of it, but it is still disconcerting.


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## indiana

My little brother had this. I'm 10 years older than him and was his regular babysitter, so I was often the one dealing with it. I feel for you. It is scary, and you feel so out of control because you never know when it's going to happen. In my brother's case, and I imagine in your son's, it wasn't his fault at all. He would start that big initial wail and just couldn't get that first breath in. It just wouldn't catch, and eventually he would pass out. Every time my own daughter has a long initial wail now, I feel that old feeling of dread. Thankfully, she does not have the same issue.

As long as there don't seem to be any secondary issues (my brother had epilepsy that was exacerbated by these spells, which did make it truly scary for us), I think the key is to discipline your child exactly as you would if he didn't have this. I think we made my brother's situation worse by being so afraid he would pass out and have a seizure. We were never willing/able to help him understand that, while he is welcome to cry his feelings out, crying will not get him what he wants. So he was MORE likely to cry and tantrum because he had learned that it was an effective way to get what he wanted. I am NOT saying that he passed out on purpose. Just that it took him a long time to find other ways to express his anger besides crying because crying worked. Obviously crying because he is hurt or scared is a whole different thing, and that's just where you have to be ready for him to pass out, unfortunately. 

I'm not advocating an unfeeling or overly strict approach to discipline, because I truly don't think most kids with this issue mean to do it as a manipulative tactic at all. Just a consistent, calm, steady approach in which your toddler doesn't feel overly powerful, which is a position of stress for a child that young. I've really been enjoying RIE discipline, and I think it might work well in your case, if you're not already doing it. Styles of discipline that emphasize communication over punishment tend to encourage you to move closer to your child and talk to him when he is angry or if you see the emotional kettle about to boil over, which would be very helpful for you since you will want to be near him if he's about to pass out. It enables you to move closer because discipline is needed, not because you see that he is about to pass out and you're scared. I think that will help keep him calmer and also change the approach to the breath holding from a reactive position to a proactive one. Janet Lansbury's book No Bad Kids is great.

You might already be doing all of those things, or doing something that works better for you and your family. In any case, I know how emotionally exhausting this is. My brother fell and hurt himself a couple times when he passed out, and with the seizures it just felt like we were always on pins and needles. I'm so sorry you're going through this, and I hope you're taking extra measures to take care of your body and mind and heart. Even if you know intellectually that this isn't hurting him, it is hard to see someone so little in that situation. Hugs, mama.


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