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What causes breath-holding spells in a young baby?
Breath-holding spells in babies are an involuntary reflex, not a choice — triggered by sudden pain, fright, frustration or anger via an immature, over-reactive nervous system. Blue spells follow crying; pale spells follow pain or fright. They peak from 6 months to 2 years, are usually harmless, and most children outgrow them. See a doctor to confirm the cause, rule out seizures and check for iron deficiency.
In this answer 5 sections
Your baby goes silent mid-cry, holds their breath, and for a few terrifying seconds the world stops — but in most cases, this frightening moment is far more benign than it feels.
In short
Breath-holding spells are an involuntary reflex — your baby is not doing this on purpose and is not choosing to hold their breath. They are almost always triggered by a sudden upset: pain, fright, frustration or anger. The cause is an immature, over-reactive autonomic nervous system that briefly disrupts breathing and heart rhythm. They are common, peak between 6 months and 2 years, and the vast majority of children outgrow them with no lasting harm.
What actually happens
There are two recognised types, and both are reflexive — not behavioural:
- Blue (cyanotic) spells — the most common. After vigorous crying triggered by frustration or anger, the baby breathes out, then stops breathing, turns blue around the lips, and may briefly lose consciousness or stiffen. The trigger is usually emotional upset.
- Pale (pallid) spells — usually follow sudden pain or a fright (a bump on the head, a startle). The heart rate slows sharply, the baby turns very pale and goes limp. These are linked to a strong vagal (nerve) reflex.
Underlying contributors can include a tendency that runs in families, and sometimes iron deficiency, which is why a doctor may check iron levels. Importantly, breath-holding spells are not tantrums your baby controls, and they are not a sign of a behavioural problem.
When to see a doctor promptly
See your paediatrician to confirm what is happening — and seek prompt medical review if: the spells are very frequent, involve prolonged stiffening or jerking, your baby is hard to rouse afterwards, or you are unsure whether what you saw was a breath-holding spell or a seizure. A doctor can distinguish the two and check for iron deficiency.
The Pinnacle way
Developmental measurement supports care planning; diagnosis requires an appropriately qualified healthcare professional., under qualified clinician care — never from an article or an app. If your baby's spells leave you anxious about their wider development or emotional settling, a gentle developmental check gives you clarity, and you can understand how your child's starting point is measured. For ongoing support around emotional regulation as your child grows, our occupational therapy team can guide you.
Trusted sources
American Academy of Pediatrics guidance for families on breath-holding spells; NICE clinical knowledge on paediatric breath-holding; WHO frameworks on early childhood development.
Next step — If the spells worry you or you're unsure whether it was a seizure, have your baby reviewed by a paediatrician, and book a developmental check with a Pinnacle clinician for reassurance.
This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.
CONNECT THE ANSWER TO YOUR CHILD’S DAY
Something to notice. Something to discuss.
What to notice
Notice the trigger just before a spell — was it crying from frustration (blue spell) or a sudden bump or fright (pale spell)? Watch how quickly your baby recovers and whether they return to normal within a minute or two. Seek prompt medical review for very frequent spells, prolonged stiffening or jerking, difficulty rousing your baby afterwards, or any doubt about whether it was a seizure.
In everyday life
During a spell, stay calm and keep your baby safe — lay them flat on their side to protect them if they lose consciousness, and don't shake, splash water on, or put anything in their mouth. The breathing restarts on its own. Afterwards, comfort them as normal; staying calm helps you and your baby settle.
Bring your observations and questions to your child’s professional. Choose activities that suit your child’s comfort, abilities and agreed plan.
Bring your questions to a first visitQuestions families ask
Are breath-holding spells dangerous?
In the vast majority of cases they are harmless and children outgrow them, usually by school age. The episode looks frightening but breathing restarts on its own. Still, see a paediatrician to confirm what's happening and to rule out other causes such as seizures or iron deficiency.
Is my baby doing this on purpose?
No. Breath-holding spells are an involuntary reflex, not a behaviour your baby can control. They are not tantrums and are not a sign of misbehaviour or a behavioural problem — your baby cannot stop or choose them.
Could iron deficiency be causing the spells?
Sometimes. Iron deficiency is recognised as a possible contributing factor, which is why a doctor may check your baby's iron levels and, if low, recommend iron supplementation that can reduce the frequency of spells.
How do I tell a breath-holding spell apart from a seizure?
It can be hard to tell, and this is exactly why a medical review matters. Breath-holding spells follow a clear trigger like crying or a sudden fright, whereas seizures often have no trigger. A doctor can assess your baby and distinguish the two.
FOLLOW THE SOURCE
References behind this answer.
- Organisation website · further readingAAP HealthyChildren — breath-holding spells guidance for families
- Organisation website · further readingNICE — paediatric breath-holding clinical knowledge
- Organisation website · further readingWHO — early childhood development
References are supplied with this answer. An organisation homepage offers further reading; it does not establish an independent review of this page.
Content attribution: SETU Consortium · Pinnacle Blooms Network.
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