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Toddler Tantrums · Quick Answer

My Toddler Holds Their Breath When They Melt Down — Is That Dangerous?

It looks frightening, but breath-holding spells are common, and for most children they're harmless. Here's what to expect and what to do.

In this answer
  1. What a breath-holding spell looks like
  2. Why it happens
  3. What to do in the moment
  4. When to call the doctor
  5. The bottom line

These are called breath-holding spells, and Nemours KidsHealth is clear on the headline fact: children don't do this on purpose, and they can't control when it happens.

1What a Breath-Holding Spell Looks Like

There are two versions, and which one you're seeing changes what triggered it:

  1. 1
    Cyanotic spell: the face turns blue, usually after hard crying. This is the "anger or frustration" version.
  2. 2
    Pallid spell: the face turns white, with little or no crying first. This is the "startled or hurt themselves" version.

Either kind can end in a brief faint lasting up to about a minute, and in rare, extreme cases a seizure. Nemours is explicit that this does not cause lasting harm and does not raise the risk of a seizure disorder. Spells almost always last well under a minute, and children simply outgrow them, with no treatment needed.

Ages to expect this: breath-holding spells happen in otherwise healthy kids from about 6 months to 6 years old, and they're most common between 6 and 18 months.

2Why It Happens

Doctors don't know the exact cause. A few things that do seem related: spells tend to run in families, and iron-deficiency anemia may play a role in some children, which is one reason your pediatrician might ask about diet or check iron levels if spells are frequent. Being overtired or hungry tends to make any kind of meltdown (breath-holding included) more likely.

3What to Do in the Moment

  1. 1
    Lay them down. Put your child on the floor or in a crib, away from anything hard or sharp, in case they faint.
  2. 2
    Stay with them and stay calm. Your steady presence is what they need. There's nothing to "fix" mid-spell.
  3. 3
    If they pass out, check that nothing is in their mouth that could cause choking, and wait. They'll start breathing again on their own.
  4. 4
    Afterward, reassure them. Let your child know everything is okay and that this wasn't their fault. They didn't do it on purpose.

4When to Call the Doctor

Get medical care after your child's first-ever spell, so a doctor can confirm it's a breath-holding spell and not something else.
  • Call 911 if your child stays blue, or isn't breathing, for longer than a minute.
  • Mention frequent spells at a regular visit. Your doctor may check for iron-deficiency anemia and can suggest ways to limit how often they happen.
  • If the spells are wearing on you, Nemours notes it's reasonable to talk to a mental health professional about coping, too, not just about your child.

One thing not to do: don't start giving in to tantrums or demands just to head off a spell. It won't reduce how often they happen, and it teaches a different lesson than the one you want to send.

The bottom lineA breath-holding spell looks like an emergency, but for the vast majority of kids it's a scary-looking, harmless reflex they'll outgrow. Get your child checked out the first time it happens so you know what you're dealing with, then handle it the same calm way every time after.

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Sources
Nemours KidsHealth — "Breath-Holding Spells"