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Distraction is best response to a child's breath-holding spells

COLOGNE, Germany - Children's breath-holding spells are stressful but generally not dangerous, though in rare cases loss of consciousness results, according to the Cologne-based Professional Association of Children's and Young People's Physicians (BVKJ).

Some 2 to 5 per cent of children between the ages of six months and six years have such attacks, which normally cease spontaneously, leaving no damage, before they reach school age.

"Parents can prevent breath-holding spells only if they don't let the child work up an extreme temper tantrum by addressing the child in a loud voice or by distracting the child with unaccustomed noises," notes Professor Hans-Juergen Nentwich, a member of the BVKJ's executive board.

In a breath-holding spell, unlike an epileptic fit, children cry before holding their breath and may briefly lose consciousness, Nentwich says. A child that has passed out should be laid securely oor her side, and parents should remain calm. Consciousness will return in several seconds or minutes.

During an attack, the glottis closes spasmodically, breathing stops and blood pressure drops. The lack of oxygen in the body causes the child's lips or skin to turn blue. Short, jerky movements are also possible. According to the BVKJ, lively, irritable, and quick-tempered children are more susceptible to breath-holding spells, which sometimes run in the family.

If attacks occur repeatedly, it is important that parents have a paediatrician rule out epilepsy, Nentwich says. In most cases this simply requires describing the episodes in detail, and extensive diagnostic evaluation is not necessary.

Nentwich advises parents not to respond to breath-holding spells by giving their child undue attention and free rein, which could encourage repetition of the behaviour.