Definition of Breath holding spell:

A breath holding spell is an involuntary pause in breathing, sometimes accompanied by loss of consciousness. It usually occurs in response to an upsetting or surprising situation.

Causes, incidence, and risk factors:

Breath holding is seen in some normal children from as early as age 2 months, but can start as late as 2 years old. Severe spells can be seen in 4 - 5% of children. Most cases have stopped by the time a child reaches ages 6 - 8.

Breath holding spells appear to be a reflexive response to fear, a confrontational situation, a traumatic event (for example: pain), or to being startled. The sudden reaction can cause the nervous system to slow the heart rate or breathing temporarily, causing breath holding and color changes.

Breath holding spells can run in families, so if a child's parents had similar spells in childhood, the child may be more likely to have spells. They also can occur with genetic conditions, such as Riley-Day syndrome or Rett syndrome. Children with iron deficiency anemia may also have increased episodes of breath holding.