Breath-Holding Spells
When to worry about breath-holding spells
Breath-holding spells in children aged about 6 months to 3 years are common and, though frightening to watch, are almost always harmless and self-limiting. They are triggered by crying, pain or fright, with the child going blue or pale and sometimes briefly losing consciousness. Worry — and seek prompt medical review — if spells start before 6 months, have no trigger, last over a minute, involve continued jerking, or come with poor recovery or general unwellness. This is a medical question first, so see your paediatrician before any therapy.
A blue or pale spell after a hard cry is one of the most frightening things a parent can witness — and yet, in most children, it is harmless and self-limiting.
In short
Breath-holding spells are common in healthy children between about 6 months and 3 years, and although they look terrifying, they almost always resolve on their own without lasting harm. They typically happen when a child is upset, frightened, in pain or frustrated — the breath stops on the out-breath, the child may go blue or pale, and may briefly stiffen or lose consciousness for a few seconds. You should seek a prompt medical review (not therapy-first) if the spells start before 6 months, happen without any trigger, last longer than about a minute, involve jerking that continues after they come round, or if your child seems unwell, very pale, or slow to recover.Understanding what's happening
There are two familiar types, and both are involuntary — your child is not doing this on purpose, and cannot control it.- Blue (cyanotic) spells — triggered by anger, frustration or a tantrum. The child cries hard, breathes out, then holds; the lips and face turn bluish.
- Pale (pallid) spells — triggered by sudden pain, a fright or a bump to the head. The child goes very pale and may faint quickly, sometimes with a brief stiffening.
In a typical spell the child recovers within under a minute, may be a little drowsy or tearful afterwards, and is soon back to normal. Iron-deficiency anaemia is a recognised contributor, so your doctor may check iron levels — treating low iron can reduce how often spells occur.
When to seek medical review
Arrange a prompt check with your paediatrician — and seek urgent care if a spell is unusually long or your child does not recover well — when you notice any of the following:- Spells before 6 months of age, or continuing beyond 6 years.
- A spell with no clear trigger (no crying, pain or fright beforehand).
- Loss of consciousness lasting more than about a minute, or jerking movements that continue after the child has come round.
- Difficulty waking, confusion, or a long, slow recovery afterwards.
- Spells becoming more frequent or more severe, or your child seeming generally pale, tired or unwell.
These features matter because they help your doctor tell ordinary breath-holding apart from seizures, heart-rhythm issues or anaemia. This is a medical question first — so the right first step is your paediatrician, not a therapist.
The Pinnacle way
We sit alongside your medical team, never in place of them. Once your paediatrician has confirmed the spells are benign, our clinicians can support your child's [emotional regulation and self-soothing](/) and gently coach you through calm responses during big feelings. A clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre under qualified clinician care — never from an online list. If frustration tolerance or communication is part of the picture, our behavioural and emotional support team can help your child express needs before they escalate.Trusted sources
American Academy of Pediatrics (healthychildren.org) guidance on breath-holding spells in infants and toddlers; CDC developmental health resources; NICE (nice.org.uk) advice on distinguishing breath-holding from seizures and on iron-deficiency assessment.Next step — Speak with your paediatrician first to confirm the spells are benign, then [book a developmental check](/) with a Pinnacle clinician to support your child's emotional regulation and your own confidence.
This is general information, not a diagnosis — a clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre under qualified clinician care.
What to watch
Seek prompt medical review if spells begin before 6 months or persist beyond 6 years, happen with no trigger, cause loss of consciousness longer than about a minute, involve jerking that continues after recovery, or leave your child confused, very pale, slow to wake or generally unwell. Increasing frequency or severity also warrants a check, and iron levels may need assessing.
Try this at home
Keep a short phone note of each spell — what triggered it, how long it lasted, the colour change, and how quickly your child recovered. This record is genuinely useful to your paediatrician and helps tell ordinary breath-holding from anything that needs more attention.
Trusted sources
Developed by SETU Consortium · Pinnacle Blooms Network · Last reviewed 2026-06-10
This is general information, not a diagnosis. A clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care.
Frequently asked
Are breath-holding spells dangerous?
In most children they are harmless and self-limiting, resolving within under a minute with no lasting harm. They are involuntary and not a sign of bad behaviour. See your paediatrician promptly, though, if a spell has no trigger, lasts unusually long, involves continued jerking, or your child recovers poorly.
At what age do breath-holding spells usually start and stop?
They most often appear between about 6 months and 3 years and typically settle by around 6 years. Spells beginning before 6 months or continuing beyond 6 years deserve a medical review to rule out other causes.
Could breath-holding spells be a seizure?
Ordinary breath-holding is triggered by crying, pain or fright and recovers quickly. Episodes with no trigger, prolonged loss of consciousness, or jerking that continues after the child comes round need a paediatrician's assessment to distinguish them from seizures.
Can low iron cause breath-holding spells?
Iron-deficiency anaemia is a recognised contributor, so your doctor may check iron levels. Treating low iron can reduce how often the spells happen.